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Kannojiya V, Almasy SE, Monclova JL, Contreras J, Costanzo F, Manning KB. Characterizing thrombus adhesion strength on common cardiovascular device materials. Front Bioeng Biotechnol 2024; 12:1438359. [PMID: 39205855 PMCID: PMC11349534 DOI: 10.3389/fbioe.2024.1438359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Thrombus formation in blood-contacting medical devices is a major concern in the medical device industry, limiting the clinical efficacy of these devices. Further, a locally formed clot within the device has the potential to detach from the surface, posing a risk of embolization. Clot embolization from blood-contacting cardiovascular devices can result in serious complications like acute ischemic stroke and myocardial infarction. Therefore, clot embolization associated with device-induced thrombosis can be life-threatening and requires an enhanced fundamental understanding of embolization characteristics to come up with advanced intervention strategies. Therefore, this work aims to investigate the adhesive characteristics of blood clots on common biocompatible materials used in various cardiovascular devices. This study focuses on characterizing the adhesion strength of blood clots on materials such as polytetrafluoroethylene (PTFE), polyurethane (PU), polyether ether ketone (PEEK), nitinol, and titanium, frequently used in medical devices. In addition, the effect of incubation time on clot adhesion is explored. Results from this work demonstrated strongest clot adhesion to titanium with 3 h of incubation resulting in 1.06 ± 0.20 kPa detachment stresses. The clot adhesion strength on titanium was 51.5% higher than PEEK, 35.9% higher than PTFE, 63.1% higher than PU, and 35.4% higher than nitinol. Further, adhesion strength increases with incubation time for all materials. The percentage increase in detachment stress over incubation time (ranging from 30 min to 3 h) for polymers ranged from at least 108.75% (PEEK), 140.74% (PU), to 151.61% (PTFE). Whereas, for metallic surfaces, the percentage rise ranged from 70.21% (nitinol) to 89.28% (titanium). Confocal fluorescence imaging of clot remnants on the material surfaces revealed a well-bounded platelet-fibrin network at the residual region, representing a comparatively higher adhesive region than the non-residual zone of the surface.
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Affiliation(s)
- Vikas Kannojiya
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States
| | - Sara E. Almasy
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States
| | - Jose L. Monclova
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States
| | - Jerry Contreras
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States
| | - Francesco Costanzo
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, United States
| | - Keefe B. Manning
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States
- Department of Surgery, Penn State College of Medicine, Penn State Hershey Medical Center, Hershey, PA, United States
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2
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Hollis IB, Jennings DL, Krim S, Ton VK, Ducharme A, Cowger J, Looby M, Eulert-Green JJ, Bansal N, Horn E, Byku M, Katz J, Michaud CJ, Rajapreyar I, Campbell P, Vale C, Cosgrove R, Hernandez-Montfort J, Otero J, Ingemi A, Raj S, Weeks P, Agarwal R, Martinez ES, Tops LF, Ahmed MM, Kiskaddon A, Kremer J, Keebler M, Ratnagiri RK. An ISHLT consensus statement on strategies to prevent and manage hemocompatibility related adverse events in patients with a durable, continuous-flow ventricular assist device. J Heart Lung Transplant 2024; 43:1199-1234. [PMID: 38878021 DOI: 10.1016/j.healun.2024.04.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 07/15/2024] Open
Abstract
Life expectancy of patients with a durable, continuous-flow left ventricular assist device (CF-LVAD) continues to increase. Despite significant improvements in the delivery of care for patients with these devices, hemocompatability-related adverse events (HRAEs) are still a concern and contribute to significant morbility and mortality when they occur. As such, dissemination of current best evidence and practices is of critical importance. This ISHLT Consensus Statement is a summative assessment of the current literature on prevention and management of HRAEs through optimal management of oral anticoagulant and antiplatelet medications, parenteral anticoagulant medications, management of patients at high risk for HRAEs and those experiencing thrombotic or bleeding events, and device management outside of antithrombotic medications. This document is intended to assist clinicians caring for patients with a CF-LVAD provide the best care possible with respect to prevention and management of these events.
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Affiliation(s)
- Ian B Hollis
- University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina; University of North Carolina Medical Center, Chapel Hill, North Carolina.
| | - Douglas L Jennings
- New York Presbyterian Columbia Irving Medical Center/Long Island University College of Pharmacy, New York, New York
| | - Selim Krim
- John Ochsner Heart and Vascular Institute, New Orleans, Louisiana
| | - Van-Khue Ton
- Massachusetts General Hospital, Boston, Massachusetts
| | - Anique Ducharme
- Montreal Heart Institute/Université de Montréal, Montreal, Quebec, Canada
| | | | - Mary Looby
- Inova Fairfax Medical Campus, Falls Church, Virginia
| | | | - Neha Bansal
- Mount Sinai Kravis Children's Hospital, New York, New York
| | - Ed Horn
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mirnela Byku
- University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Jason Katz
- Division of Cardiology, NYU Grossman School of Medicine & Bellevue Hospital, New York, New York
| | | | | | | | - Cassandra Vale
- The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Richard Cosgrove
- Cornerstone Specialty Hospital/University of Arizona College of Pharmacy, Tucson, Arizona
| | | | - Jessica Otero
- AdventHealth Littleton Hospital, Littleton, Colorado
| | | | | | - Phillip Weeks
- Memorial Hermann-Texas Medical Center, Houston, Texas
| | - Richa Agarwal
- Duke University Medical Center, Durham, North Carolina
| | | | - Laurens F Tops
- Leiden University Medical Center, Leiden, the Netherlands
| | | | - Amy Kiskaddon
- Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Mary Keebler
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Lautner-Csorba O, Gorur R, Major T, Wu J, Sheet P, Hill J, Yu M, Xi C, Bartlett RH, Schwendeman SP, Lautner G, Meyerhoff ME. Antithrombotic and Antimicrobial Potential of S-Nitroso-1-Adamantanethiol-Impregnated Extracorporeal Circuit. ASAIO J 2024:00002480-990000000-00526. [PMID: 39037705 DOI: 10.1097/mat.0000000000002276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
This study presents the utilization of a novel, highly lipophilic nitric oxide (NO) donor molecule, S-nitroso-1-adamantanethiol (SNAT), for developing an NO-emitting polymer surface aimed at preventing thrombus formation and bacterial infection in extracorporeal circuits (ECCs). S-nitroso-1-adamantanethiol, a tertiary nitrosothiol-bearing adamantane species, was synthesized, characterized, and used to impregnate polyvinyl chloride (PVC) tubing for subsequent in vivo evaluation. The impregnation process with SNAT preserved the original mechanical strength of the PVC. In vitro assessments revealed sustained NO release from the SNAT-impregnated PVC tubing (iSNAT), surpassing or matching endothelial NO release levels for up to 42 days. The initial NO release remained stable even after 1 year of storage at -20°C. The compatibility of iSNAT with various sterilization techniques (OPA Plus, hydrogen peroxide, EtO) was tested. Acute in vivo experiments in a rabbit model demonstrated significantly reduced thrombus formation in iSNAT ECCs compared with controls, indicating the feasibility of iSNAT to mitigate coagulation system activation and potentially eliminate the need for systemic anticoagulation. Moreover, iSNAT showed substantial inhibition of microbial biofilm formation, highlighting its dual functionality. These findings underscore the promising utility of iSNAT for long-term ECC applications, offering a multifaceted approach to enhancing biocompatibility and minimizing complications.
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Affiliation(s)
| | - Roopa Gorur
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan
| | - Terry Major
- From the Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jianfeng Wu
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan
| | - Partha Sheet
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, Michigan
| | - Joseph Hill
- From the Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Minzhi Yu
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, Michigan
| | - Chuanwu Xi
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan
| | - Robert H Bartlett
- From the Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Steven P Schwendeman
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, Michigan
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Gergely Lautner
- Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor, Michigan
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan
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Luu CH, Nguyen NT, Ta HT. Unravelling Surface Modification Strategies for Preventing Medical Device-Induced Thrombosis. Adv Healthc Mater 2024; 13:e2301039. [PMID: 37725037 DOI: 10.1002/adhm.202301039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/29/2023] [Indexed: 09/21/2023]
Abstract
The use of biomaterials in implanted medical devices remains hampered by platelet adhesion and blood coagulation. Thrombus formation is a prevalent cause of failure of these blood-contacting devices. Although systemic anticoagulant can be used to support materials and devices with poor blood compatibility, its negative effects such as an increased chance of bleeding, make materials with superior hemocompatibility extremely attractive, especially for long-term applications. This review examines blood-surface interactions, the pathogenesis of clotting on blood-contacting medical devices, popular surface modification techniques, mechanisms of action of anticoagulant coatings, and discusses future directions in biomaterial research for preventing thrombosis. In addition, this paper comprehensively reviews several novel methods that either entirely prevent interaction between material surfaces and blood components or regulate the reaction of the coagulation cascade, thrombocytes, and leukocytes.
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Affiliation(s)
- Cuong Hung Luu
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
| | - Nam-Trung Nguyen
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
| | - Hang Thu Ta
- School of Environment and Science, Griffith University, Nathan, Queensland, 4111, Australia
- Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland, 4111, Australia
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Exarchos V, Zacharova E, Neuber S, Giampietro C, Motta SE, Hinkov H, Emmert MY, Nazari-Shafti TZ. The path to a hemocompatible cardiovascular implant: Advances and challenges of current endothelialization strategies. Front Cardiovasc Med 2022; 9:971028. [PMID: 36186971 PMCID: PMC9515323 DOI: 10.3389/fcvm.2022.971028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiovascular (CV) implants are still associated with thrombogenicity due to insufficient hemocompatibility. Endothelialization of their luminal surface is a promising strategy to increase their hemocompatibility. In this review, we provide a collection of research studies and review articles aiming to summarize the recent efforts on surface modifications of CV implants, including stents, grafts, valves, and ventricular assist devises. We focus in particular on the implementation of micrometer or nanoscale surface modifications, physical characteristics of known biomaterials (such as wetness and stiffness), and surface morphological features (such as gratings, fibers, pores, and pits). We also review how biomechanical signals originating from the endothelial cell for surface interaction can be directed by topography engineering approaches toward the survival of the endothelium and its long-term adaptation. Finally, we summarize the regulatory and economic challenges that may prevent clinical implementation of endothelialized CV implants.
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Affiliation(s)
- Vasileios Exarchos
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
| | - Ema Zacharova
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
- Department of Life Sciences, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
| | - Sebastian Neuber
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
| | - Costanza Giampietro
- Experimental Continuum Mechanics, Empa Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
- Department of Mechanical and Process Engineering, Institute for Mechanical Systems, ETH Zürich, Zurich, Switzerland
| | - Sarah E. Motta
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Hristian Hinkov
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
| | - Maximilian Y. Emmert
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Clinic for Cardiovascular Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Timo Z. Nazari-Shafti
- Cardiosurgical Research Group, Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- Translational Cardiovascular Regenerative Technologies Group, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité (Junior) (Digital) Clinician Scientist Program, Berlin, Germany
- *Correspondence: Timo Z. Nazari-Shafti,
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6
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Kaliaraj GS, Siva T, Ramadoss A. Surface functionalized bioceramics coated on metallic implants for biomedical and anticorrosion performance - a review. J Mater Chem B 2021; 9:9433-9460. [PMID: 34755756 DOI: 10.1039/d1tb01301g] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In modern days, the usage of trauma fixation devices has significantly increased due to sports injury, age-related issues, accidents, and revision surgery purposes. Numerous materials such as stainless steel, titanium, Co-Cr alloy, polymers, and ceramics have been used to replace the missing or defective parts of the human body. After implantation, body fluids (Na+, K+, and Cl-), protein, and blood cells interact with the surface of metallic implants, which favours the release of ions from the metallic surface to surrounding body tissues, leading to a hypersensitive reaction. Body pH, temperature, and interaction of immune cells also cause metal ion leaching and lose host cell interaction and effective mineralization for better durability. Moreover, microbial invasion is another important crisis, which produces extracellular compounds onto the biomaterial surface through which it escapes from the antimicrobial agents. To enhance the performance of materials by improving mechanical, corrosion resistance, antimicrobial, and biocompatibility properties, surface modification is a prerequisite method in which chemical vapour deposition (CVD), physical vapour deposition (PVD), sol-gel method, and electrochemical deposition are generally involved. The properties of bioceramics such as chemical inertness, bioactivity, biocompatibility, and corrosion protection make them most suitable for the surface functionalization of metallic implants. To the best of our knowledge, very limited literature is available to discuss the interaction of body proteins, pH, and temperature onto bioceramic coatings. Hence, the present review focuses on the corrosion behaviour of different ceramic composite coating materials with different conditions. This review initially briefs the properties and surface chemistry of metal implants and the need for surface modifications by different deposition techniques. Further, mechanical, cytotoxicity, antimicrobial property, and electrochemical behaviour of ceramics and metal nitride coatings are discussed. Finally, future perspectives of coatings are outlined for biomedical applications.
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Affiliation(s)
- Gobi Saravanan Kaliaraj
- Centre for Nanoscience and Nanotechnology, Sathyabama Institute of Science and Technology, Chennai 600119, India.
| | - T Siva
- School for Advanced Research in Petrochemicals, Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemicals Engineering & Technology, Bhubaneswar 751024, India.
| | - Ananthakumar Ramadoss
- School for Advanced Research in Petrochemicals, Laboratory for Advanced Research in Polymeric Materials, Central Institute of Petrochemicals Engineering & Technology, Bhubaneswar 751024, India.
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7
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Zhang M, Tansley GD, Dargusch MS, Fraser JF, Pauls JP. Surface Coatings for Rotary Ventricular Assist Devices: A Systematic Review. ASAIO J 2021; 68:623-632. [PMID: 34324447 DOI: 10.1097/mat.0000000000001534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rotary ventricular assist devices (VADs) are frequently used to provide mechanical circulatory support to patients suffering from end-stage heart failure. Therefore, these devices and especially their pump impeller and housing components have stringent requirements on wear resistance and hemocompatibility. Various surface coatings have been investigated to improve the wear resistance or hemocompatibility of these devices. The aim of the present systematic review was to build a comprehensive understanding of these coatings and provide potential future research directions. A Boolean search for peer-reviewed studies was conducted in online databases (Web of Science, Scopus, PubMed, and ScienceDirect), and a preferred reporting items for systematic reviews and meta-analyses (PRISMA) process was followed for selecting relevant papers for analysis. A total of 45 of 527 publications were included for analysis. Eighteen coatings were reported to improve wear resistance or hemocompatibility of rotary VADs with the most common coatings being diamond-like carbon (DLC), 2-methacryloyloxyethyl phosphorylcholine (MPC), and heparin. Ninety-three percent of studies focused on hemocompatibility, whereas only 4% of studies focused on wear properties. Thirteen percent of studies investigated durability. This review provides readers with a systematic catalogue and critical review of surface coatings for rotary VADs. The review has identified that more comprehensive studies especially investigations on wear properties and durability are needed in future work.
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Affiliation(s)
- Meili Zhang
- From the Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia School of Mechanical and Mining Engineering, University of Queensland, Brisbane, Queensland, Australia School of Engineering and Built Environment, Griffith University, Brisbane, Queensland, Australia School of Medicine, University of Queensland, Brisbane, Queensland, Australia School of Medicine, Griffith University, Brisbane, Queensland, Australia
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8
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Pandiyarajan CK, Genzer J. UV- and Thermally-Active Bifunctional Gelators Create Surface-Anchored Polymer Networks. Macromol Rapid Commun 2021; 42:e2100266. [PMID: 34173291 DOI: 10.1002/marc.202100266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/26/2021] [Indexed: 11/05/2022]
Abstract
A versatile one-step synthesis of surface-attached polymer networks using small bifunctional gelators (SBG), namely 4-azidosulfonylphenethyltrimethoxysilane (4-ASPTMS) and 6-azidosulfonylhexyltriethoxysilane (6-ASHTES) is reported. A thin layer (≈200 nm) of a mixture comprising ≈90% precursor polymer and 10% of 4-ASPTMS or 10% 6-ASHTES on a silicon wafer is deposited. Upon UV irradiation (≈l-254 nm) or annealing (>100 °C) layers, sulfonyl azides (SAz) release nitrogen by forming singlet and triplet nitrenes that concurrently react with any C─H bond in the vicinity resulting in sulfonamide crosslinks. Condensation among tri-alkoxy groups (i.e., methoxy or ethoxy) in bulk connects the SBG units, which completes the crosslinking. Concurrently, when such functionalities react with hydroxyl groups at the surface, which enable the covalent attachment of the crosslinked polymer chains. A systematic investigation on reaction mechanism and gel formation using spectroscopic ellipsometry (SE) and Fourier-transform infrared spectroscopy in the attenuated total reflection mode (FTIR-ATR) is performed. Analogous thermally initiated gelation for both 4-ASPTMS and 6-ASHTES is found. The 6-ASHTES is UV inactive at ≈l-254 nm, while the 4-ASPTMS is active and forms gels. The difference is attributed to the aromatic nature of 4-ASPTMS that absorb UV light at ≈l-254 nm due to π-π* transition.
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Affiliation(s)
| | - Jan Genzer
- Global Station for Soft Matter, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, 060-0808, Japan
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9
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Apte G, Lindenbauer A, Schemberg J, Rothe H, Nguyen TH. Controlling Surface-Induced Platelet Activation by Agarose and Gelatin-Based Hydrogel Films. ACS OMEGA 2021; 6:10963-10974. [PMID: 34056249 PMCID: PMC8153948 DOI: 10.1021/acsomega.1c00764] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/01/2021] [Indexed: 05/31/2023]
Abstract
Platelet-surface interaction is of paramount importance in biomedical applications as well as in vitro studies. However, controlling platelet-surface activation is challenging and still requires more effort as they activate immediately when contacting with any nonphysiological surface. As hydrogels are highly biocompatible, in this study, we developed agarose and gelatin-based hydrogel films to inhibit platelet-surface adhesion. We found promising agarose films that exhibit higher surface wettability, better controlled-swelling properties, and greater stiffness compared to gelatin, resulting in a strong reduction of platelet adhesion. Mechanical properties and surface wettability of the hydrogel films were varied by adding magnetite (Fe3O4) nanoparticles. While all of the films prevented platelet spreading, films formed by agarose and its nanocomposite repelled platelets and inhibited platelet adhesion and activation stronger than those of gelatin. Our results showed that platelet-surface activation is modulated by controlling the properties of the films underneath platelets and that the bioinert agarose can be potentially translated to the development of platelet storage and other medical applications.
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Affiliation(s)
- Gurunath Apte
- Junior
Research Group, Department of Bioprocess Technique,
and Department of Biomaterials, Institute for Bioprocessing and Analytical Measurement
Techniques (iba), Rosenhof, 37308 Heilbad Heiligenstadt, Germany
| | - Annerose Lindenbauer
- Junior
Research Group, Department of Bioprocess Technique,
and Department of Biomaterials, Institute for Bioprocessing and Analytical Measurement
Techniques (iba), Rosenhof, 37308 Heilbad Heiligenstadt, Germany
| | - Jörg Schemberg
- Junior
Research Group, Department of Bioprocess Technique,
and Department of Biomaterials, Institute for Bioprocessing and Analytical Measurement
Techniques (iba), Rosenhof, 37308 Heilbad Heiligenstadt, Germany
| | - Holger Rothe
- Junior
Research Group, Department of Bioprocess Technique,
and Department of Biomaterials, Institute for Bioprocessing and Analytical Measurement
Techniques (iba), Rosenhof, 37308 Heilbad Heiligenstadt, Germany
| | - Thi-Huong Nguyen
- Junior
Research Group, Department of Bioprocess Technique,
and Department of Biomaterials, Institute for Bioprocessing and Analytical Measurement
Techniques (iba), Rosenhof, 37308 Heilbad Heiligenstadt, Germany
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10
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Zhussupbekov M, Wu WT, Jamiolkowski MA, Massoudi M, Antaki JF. Influence of shear rate and surface chemistry on thrombus formation in micro-crevice. J Biomech 2021; 121:110397. [PMID: 33845357 DOI: 10.1016/j.jbiomech.2021.110397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 02/02/2023]
Abstract
Thromboembolic complications remain a central issue in management of patients on mechanical circulatory support. Despite the best practices employed in design and manufacturing of modern ventricular assist devices, complexity and modular nature of these systems often introduces internal steps and crevices in the flow path which can serve as nidus for thrombus formation. Thrombotic potential is influenced by multiple factors including the characteristics of the flow and surface chemistry of the biomaterial. This study explored these elements in the setting of blood flow over a micro-crevice using a multi-constituent numerical model of thrombosis. The simulations reproduced the platelet deposition patterns observed experimentally and elucidated the role of flow, shear rate, and surface chemistry in shaping the deposition. The results offer insights for design and operation of blood-contacting devices.
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Affiliation(s)
- Mansur Zhussupbekov
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Wei-Tao Wu
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Megan A Jamiolkowski
- U.S. Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH), Office of Science and Engineering Laboratories (OSEL), Silver Spring, Maryland, USA
| | - Mehrdad Massoudi
- U.S. Department of Energy, National Energy Technology Laboratory (NETL), Pittsburgh, PA, USA
| | - James F Antaki
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
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11
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Kannojiya V, Das AK, Das PK. Comparative assessment of different versions of axial and centrifugal LVADs: A review. Artif Organs 2021; 45:665-681. [PMID: 33434332 DOI: 10.1111/aor.13914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/18/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
Continuous-flow left ventricular assist devices (LVADs) have gained tremendous acceptance for the treatment of end-stage heart failure patients. Among different versions, axial flow and centrifugal flow LVADs have shown remarkable potential for clinical implants. It is also very crucial to know which device serves its purpose better to treat heart failure patients. A thorough comparison of axial and centrifugal LVADs, which may guide doctors in deciding before the implant, still lacks in the literature. In this work, an assessment of axial and centrifugal LVADs has been made to suggest a better device by comparing their engineering, clinical, and technological development of design aspects. Hydrodynamic and hemodynamic aspects for both types of pumps are discussed along with their biocompatibility, bearing types, and sizes. It has been observed numerically that centrifugal LVADs perform better over axial LVADs in every engineering aspect like higher hydraulic efficiency, better characteristics curve, lesser power intake, and also lesser blood damage. However, the clinical outcomes suggest that centrifugal LVADs experience higher events of infections, renal, and respiratory dysfunction. In contrast, axial LVADs encountered higher bleeding and cardiac arrhythmia. Moreover, recent technological developments suggested that magnetic type bearings along with biocompatible coating improve the life of LVADs.
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Affiliation(s)
- Vikas Kannojiya
- Mechanical and Industrial Engineering Department, IIT Roorkee, Roorkee, India
| | - Arup Kumar Das
- Mechanical and Industrial Engineering Department, IIT Roorkee, Roorkee, India
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12
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Cafolla C, Foster W, Voïtchovsky K. Lubricated friction around nanodefects. SCIENCE ADVANCES 2020; 6:eaaz3673. [PMID: 32284981 PMCID: PMC7124950 DOI: 10.1126/sciadv.aaz3673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/08/2020] [Indexed: 06/11/2023]
Abstract
The lubrication properties of nanoconfined liquids underpin countless natural and industrial processes. However, our current understanding of lubricated friction is still limited, especially for nonideal interfaces exhibiting nanoscale chemical and topographical defects. Here, we use atomic force microscopy to explore the equilibrium and dynamical behavior of a model lubricant, squalane, confined between a diamond tip and graphite in the vicinity of an atomic step. We combine high-resolution imaging of the interface with highly localized shear measurements at different velocities and temperatures to derive a quantitative picture of the lubricated friction around surface defects. We show that defects tend to promote local molecular order and increase friction forces by reducing the number of stable molecular configurations in their immediate vicinity. The effect is general, can propagate over hundreds of nanometers, and can be quantitatively described by a semiempirical model that bridges the molecular details and mesoscale observations.
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Jeakle MM, Major TC, Meyerhoff ME, Bartlett RH. Comparison of Diazeniumdiolated Dialkylhexanediamines as Nitric Oxide Release Agents on Nonthrombogenicity in an Extracorporeal Circulation Model. ACS APPLIED BIO MATERIALS 2020; 3:466-476. [PMID: 35019463 DOI: 10.1021/acsabm.9b00924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
When blood from a patient is circulated through extracorporeal circuits (ECCs), such as in cardiopulmonary bypass or extracorporeal life support, platelets in the blood are activated and form a thrombus. This is prevented clinically with a range of different systemic anticoagulation agents (e.g., heparin); however, this increases a patient's risk of hemorrhage. Previous work with nitric oxide (NO) releasing materials using the combined diazeniumdiolated diamine, N-N-di-N'-butyl-1,6-hexanediamine (DBHD), and a polymer-linked thrombin inhibitor, argatroban (AG), showed significant nonthrombogenicity in ECCs using a 4 h rabbit model. Herein, we evaluated if diazeniumdiolated N-N-di-N'-propyl-1,6-hexanediamine (DPHDN2O2), which has a slightly lower degree of lipophilicity compared to DBHDN2O2, would provide similar nonthrombogenicity as the AG/DBHDN2O2-polymer-coated circuits. While DPHDN2O2 releases NO at a higher flux rate than DBHDN2O2 when coated (within CarboSil polymer) on the inner wall of polyvinyl chloride tubing, neither coated circuit significantly affected animal hemodynamics. Both diazeniumdiolated diamines, in combination with immobilized AG or alone, significantly reduced thrombus formation similarly in the 4 h rabbit model (vs uncoated control): AG/DBHDN2O2: 0.12 ± 0.03 cm2; DBHDN2O2: 2.57 ± 0.82 cm2; AG/DPHDN2O2: 0.68 ± 0.22 cm2; DPHDN2O2: 1.87 + 1.26 cm2; uncoated control: 6.95 ± 0.82 cm2. AG/DPHDN2O2 was no different than AG/DBHDN2O in preserving platelet count and function. In addition, AG did not leach into the systemic circulation as the total clotting times were insignificantly different from the baseline values (AG/DPHDN2O2: 12.7 + 0.5 s (n = 3); AG/DBHDN2O2: 12.3 + 0.7 s (n = 3); baseline: 13.9 + 0.3 s (n = 13)). Based on these results, both DPHDN2O2 and DPHDN2O2 are good candidates as NO donor molecules for creating nonthrombogenic polymer coatings for ECCs.
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Affiliation(s)
- Mark M Jeakle
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
| | - Terry C Major
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Robert H Bartlett
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109, United States
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Klein M, Kuhn Y, Woelke E, Linde T, Ptock C, Kopp A, Bletek T, Schmitz‐Rode T, Steinseifer U, Arens J, Clauser JC. In vitro study on the hemocompatibility of plasma electrolytic oxidation coatings on titanium substrates. Artif Organs 2019; 44:419-427. [DOI: 10.1111/aor.13592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/09/2019] [Accepted: 10/24/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Mario Klein
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
| | - Yasmin Kuhn
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
| | - Eva Woelke
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
| | | | | | | | | | - Thomas Schmitz‐Rode
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
- Department of Mechanical and Aerospace Engineering, Faculty of Engineering, Monash Institute of Medical Engineering Monash University Melbourne Australia
| | - Jutta Arens
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
| | - Johanna C. Clauser
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty RWTH Aachen University Aachen Germany
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Ishihara K. Blood-Compatible Surfaces with Phosphorylcholine-Based Polymers for Cardiovascular Medical Devices. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2019; 35:1778-1787. [PMID: 30056709 DOI: 10.1021/acs.langmuir.8b01565] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
For the acquisition of blood-compatible materials, various hydrophilic polymers for surface modification have been examined. Among them, polymers with a representative phospholipid polar group, the phosphorylcholine (PC) group, are a successful example. These polymers were designed from inspiration of the cell membrane surface and provide protein adsorption resistance even following contact with plasma. This important property is based on the unique hydration state of water molecules surrounding hydrated polymer; in other words, water molecules weakly interact with the polymers and maintain their favorable cluster structure through hydrogen bonding. These polymers are not only hydrophilic, but also electrically neutral, important characteristics which make hydrogen bonding with water molecules less likely to occur and avoid hydrophobic interactions. Phosphorylcholine groups and other zwitterionic structures are significant as hydrophilic functional groups meeting these important requirements. In this review, blood compatibility of a polymer having a PC group is introduced in relation to its hydration structure, followed by a description of the applications of this polymer to cardiovascular medical devices.
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Affiliation(s)
- Kazuhiko Ishihara
- Department of Materials Engineering , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8656 , Japan
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16
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Goodwin K, Kluis A, Alexy T, John R, Voeller R. Neurological complications associated with left ventricular assist device therapy. Expert Rev Cardiovasc Ther 2018; 16:909-917. [DOI: 10.1080/14779072.2018.1540300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Kevin Goodwin
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Austin Kluis
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Tamas Alexy
- Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Ranjit John
- Division of Cardiovascular Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Rochus Voeller
- Division of Cardiovascular Surgery, University of Minnesota, Minneapolis, MN, USA
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17
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Breugem SJM, Linnartz J, Sierevelt I, Bruijn JD, Driessen MJM. Evaluation of 1031 primary titanium nitride coated mobile bearing total knee arthroplasties in an orthopedic clinic. World J Orthop 2017; 8:922-928. [PMID: 29312851 PMCID: PMC5745435 DOI: 10.5312/wjo.v8.i12.922] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/06/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the influence of the titanium nitride (TiN) coating on the results of a total knee arthroplasty (TKA).
METHODS A total of 910 patients (338 men; 572 woman), with a mean age of 65 (range 36-94) undergoing 1031 primary TKAs were assessed. Clinical evaluation and patient-reported outcomes were gathered one year after surgery. The questionnaires included the Knee injury and Osteoarthritis Outcome Score (KOOS)-Dutch version, Visual Analogue Scale (VAS) pain scores in rest and during active knee movement, VAS-satisfaction scores, and EQ-5D-3L health scores. This was aimed to assess the overall knee function and patient satisfaction, and to enable us to make a gross comparison to other TKAs.
RESULTS At a mean follow-up of 46 mo (range 1-92) the overall implant survival was 97.7% and 95.1% for any operative reason related to the implant. Twenty-three knees (2.2%) required revision surgery. Arthrofibrosis was the most common indication for a re-operation. The clinical evaluation and patient-reported outcomes revealed good to excellent patient satisfaction and function of the arthroplasty. The median postoperative VAS-pain scores on a scale of 0-100, at one year after surgery were 1 in rest and 2 during movement.
CONCLUSION The TiN coated, mobile bearing TKA results are excellent and similar to those of other widely used TKA designs. Residual pain of the knee remains a concern and the TiN coating in combination with the mobile bearing does not seem to be the simple solution to this problem. Future research will have to show that the coating gives a better survival than the cobalt chrome version.
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Affiliation(s)
| | - Jeroen Linnartz
- Orthopedium, Orthopedic Clinic, Delft 2616 LS, The Netherlands
| | | | - Jon D Bruijn
- Orthopedium, Orthopedic Clinic, Delft 2616 LS, The Netherlands
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18
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Bleeding and thrombosis associated with ventricular assist device therapy. J Heart Lung Transplant 2017; 36:1164-1173. [DOI: 10.1016/j.healun.2017.05.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/03/2017] [Accepted: 05/09/2017] [Indexed: 01/03/2023] Open
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19
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Cortella LRX, Cestari IA, Guenther D, Lasagni AF, Cestari IN. Endothelial cell responses to castor oil-based polyurethane substrates functionalized by direct laser ablation. ACTA ACUST UNITED AC 2017; 12:065010. [PMID: 28762961 DOI: 10.1088/1748-605x/aa8353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Surface-induced thrombosis and lack of endothelialization are major drawbacks that hamper the widespread application of polyurethanes for the fabrication of implantable cardiovascular devices. Endothelialization of the blood-contacting surfaces of these devices may avoid thrombus formation and may be implemented by strategies that introduce micro and submicron patterns that favor adhesion and growth of endothelial cells. In this study, we used laser radiation to directly introduce topographical patterns in the low micrometer range on castor oil-based polyurethane, which is currently employed to fabricate cardiovascular devices. We have investigated cell adhesion, proliferation, morphology and alignment in response to these topographies. Reported results show that line-like and pillar-like patterns improved adhesion and proliferation rate of cultured endothelial cells. The line-like pattern with 1 μm groove periodicity was the most efficient to enhance cell adhesion and induced marked polarization and alignment. Our study suggests the viability of using laser radiation to functionalize PU-based implants by the introduction of specific microtopography to facilitate the development of a functional endothelium on target surfaces.
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Affiliation(s)
- L R X Cortella
- Bioengineering Department, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr Enéas de Carvalho Aguiar, 44, 05403-900-São Paulo, SP, Brazil
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20
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Left Ventricular Assist Devices: Challenges Toward Sustaining Long-Term Patient Care. Ann Biomed Eng 2017; 45:1836-1851. [DOI: 10.1007/s10439-017-1858-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/22/2017] [Indexed: 11/25/2022]
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21
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Sukavaneshvar S. Device thrombosis and pre-clinical blood flow models for assessing antithrombogenic efficacy of drug-device combinations. Adv Drug Deliv Rev 2017; 112:24-34. [PMID: 27496706 DOI: 10.1016/j.addr.2016.07.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/31/2016] [Accepted: 07/26/2016] [Indexed: 12/20/2022]
Abstract
Thrombosis associated with blood-contacting devices is a complex process involving several component interactions that have eluded precise definition. Extensive investigations of individual biological modules such as protein adsorption, coagulation cascade activation and platelet activation/adhesion/aggregation have provided an initial foundation for developing biomaterials for blood-contacting devices, but a material that is intrinsically non-thrombogenic is yet to be developed. The well-recognized association between fluid dynamics parameters such as shear stress, vortices, stagnation and thrombotic processes such as platelet aggregation and coagulation aggravate thrombosis on most device geometries that elicit these flow disturbances. Thus, antithrombotic drugs that were developed to treat thrombosis associated with vascular diseases such as atherosclerosis have also been adapted to mitigate the risk of device thrombosis. However, balancing the risk of bleeding with the antithrombotic efficacy of these drugs continues to be a challenge, and surface modification of devices with these drug molecules to mitigate device thrombosis locally has been explored. Pre-clinical blood flow models to test the effectiveness of these drug-device combinations have also evolved and several in-vitro, ex-vivo, and in-vivo test configurations are available with their attendant merits and limitations. Despite considerable efforts toward iterative design and testing of blood contacting devices and antithrombogenic surface modifications, device thrombosis remains an unsolved problem.
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22
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New Challenges in the Treatment of Patients With Left Ventricular Support: LVAD Thrombosis. Curr Heart Fail Rep 2016; 13:302-309. [DOI: 10.1007/s11897-016-0310-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Pandiyarajan CK, Prucker O, Rühe J. Humidity Driven Swelling of the Surface-Attached Poly(N-alkylacrylamide) Hydrogels. Macromolecules 2016. [DOI: 10.1021/acs.macromol.6b01379] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- C. K. Pandiyarajan
- Laboratory for Chemistry
and Physics of Interfaces, Department of Microsystems Engineering
(IMTEK), University of Freiburg, 79110 Freiburg, Germany
| | - Oswald Prucker
- Laboratory for Chemistry
and Physics of Interfaces, Department of Microsystems Engineering
(IMTEK), University of Freiburg, 79110 Freiburg, Germany
| | - Jürgen Rühe
- Laboratory for Chemistry
and Physics of Interfaces, Department of Microsystems Engineering
(IMTEK), University of Freiburg, 79110 Freiburg, Germany
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24
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The Quest for Nonthrombotic Surface Modifications to Achieve Hemocompatibility of Implantable Devices. ASAIO J 2016; 61:623-34. [PMID: 26366685 DOI: 10.1097/mat.0000000000000283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The use of blood-contacting implantable devices is limited by surface-induced thrombosis, which has led to the development of thromboresistant surfaces. Multidisciplinary efforts have promoted the development of surface modifications to minimize thrombosis by targeting surface-induced coagulation. To this date, no material has been identified that remains irrevocably hemocompatible with time but many options are now available with their own limitations. Essential to this review is the understanding of some of the challenges in this field and newer opportunities for hemocompatibility research. This report will also briefly review many of the achievements in the development of hemocompatible biomaterial coating, including surface modifications against protein adsorption and platelet adhesion, biomimetism, and endothelialization.
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25
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Jamiolkowski MA, Pedersen DD, Wu WT, Antaki JF, Wagner WR. Visualization and analysis of biomaterial-centered thrombus formation within a defined crevice under flow. Biomaterials 2016; 96:72-83. [PMID: 27156141 DOI: 10.1016/j.biomaterials.2016.04.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/08/2016] [Accepted: 04/20/2016] [Indexed: 01/14/2023]
Abstract
The blood flow pathway within a device, together with the biomaterial surfaces and status of the patient's blood, are well-recognized factors in the development of thrombotic deposition and subsequent embolization. Blood flow patterns are of particular concern for devices such as blood pumps (i.e. ventricular assist devices, VADs) where shearing forces can be high, volumes are relatively large, and the flow fields can be complex. However, few studies have examined the effect of geometric irregularities on thrombus formation on clinically relevant opaque materials under flow. The objective of this study was to quantify human platelet deposition onto Ti6Al4V alloys, as well as positive and negative control surfaces, in the region of defined crevices (∼50-150 μm in width) that might be encountered in many VADs or other cardiovascular devices. To achieve this, reconstituted fresh human blood with hemoglobin-depleted red blood cells (to achieve optical clarity while maintaining relevant rheology), long working optics, and a custom designed parallel plate flow chamber were employed. The results showed that the least amount of platelet deposition occurred in the largest crevice size examined, which was counterintuitive. The greatest levels of deposition occurred in the 90 μm and 53 μm crevices at the lower wall shear rate. The results suggest that while crevices may be unavoidable in device manufacturing, the crevice size might be tailored, depending on the flow conditions, to reduce the risk of thromboembolic events. Further, these data might be used to improve the accuracy of predictive models of thrombotic deposition in cardiovascular devices to help optimize the blood flow path and reduce device thrombogenicity.
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Affiliation(s)
- Megan A Jamiolkowski
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, USA; Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Drake D Pedersen
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, USA; Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wei-Tao Wu
- Dept. of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - James F Antaki
- Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dept. of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - William R Wagner
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, USA; Dept. of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dept. of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Dept. of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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26
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Kaufmann F, Krabatsch T. Using medical imaging for the detection of adverse events (“incidents”) during the utilization of left ventricular assist devices in adult patients with advanced heart failure. Expert Rev Med Devices 2016; 13:463-74. [DOI: 10.1586/17434440.2016.1166051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature. BIOMED RESEARCH INTERNATIONAL 2015; 2015:485975. [PMID: 26583113 PMCID: PMC4637053 DOI: 10.1155/2015/485975] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 05/24/2015] [Indexed: 12/12/2022]
Abstract
Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports of third body wear due to delamination, increased ultrahigh molecular weight polyethylene wear, and cohesive failure of the TiN-coating. This might be due to the coating process. The TiN-coating process should be optimized and standardized for titanium alloy articulating surfaces. The clinical benefit of TiN-coating of CoCrMo knee implant surfaces should be further investigated.
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28
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Patel H, Madanieh R, Kosmas CE, Vatti SK, Vittorio TJ. Complications of Continuous-Flow Mechanical Circulatory Support Devices. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 9:15-21. [PMID: 26052234 PMCID: PMC4441367 DOI: 10.4137/cmc.s19708] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/01/2014] [Accepted: 12/06/2014] [Indexed: 11/05/2022]
Abstract
Left ventricular assist devices (LVADs), more importantly the continuous-flow subclass, have revolutionized the medical field by improving New York Heart Association (NYHA) functional class status, quality of life, and survival rates in patients with advanced systolic heart failure. From the first pulsatile device to modern day continuous-flow devices, LVADs have continued to improve, but they are still associated with several complications. These complications include infection, bleeding, thrombosis, hemolysis, aortic valvular dysfunction, right heart failure, and ventricular arrhythmias. In this article, we aim to review these complications to understand the most appropriate approach for their prevention and to discuss the available therapeutic modalities.
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Affiliation(s)
- Harsh Patel
- Department of Internal Medicine, SUNY Downstate School of Medicine, Brooklyn, NY, USA
| | - Raef Madanieh
- St. Francis Hospital - The Heart Center , Center for Advanced Cardiac Therapeutics, Roslyn, NY, USA
| | - Constantine E Kosmas
- Icahn School of Medicine at Mount Sinai, Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, USA
| | - Satya K Vatti
- St. Francis Hospital - The Heart Center , Center for Advanced Cardiac Therapeutics, Roslyn, NY, USA
| | - Timothy J Vittorio
- St. Francis Hospital - The Heart Center , Center for Advanced Cardiac Therapeutics, Roslyn, NY, USA
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29
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Kormos RL. Left ventricular assist device pump thrombosis: understanding mechanisms as a key to causality. J Thorac Cardiovasc Surg 2014; 149:673-4. [PMID: 25583104 DOI: 10.1016/j.jtcvs.2014.11.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 11/24/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Robert L Kormos
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
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30
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Robotti F, Franco D, Bänninger L, Wyler J, Starck CT, Falk V, Poulikakos D, Ferrari A. The influence of surface micro-structure on endothelialization under supraphysiological wall shear stress. Biomaterials 2014; 35:8479-86. [DOI: 10.1016/j.biomaterials.2014.06.046] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 06/22/2014] [Indexed: 01/06/2023]
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31
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Ryan Stanfield J, Bamberg S. Durability evaluation of biopolymer coating on titanium alloy substrate. J Mech Behav Biomed Mater 2014; 35:9-17. [DOI: 10.1016/j.jmbbm.2014.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 03/11/2014] [Accepted: 03/13/2014] [Indexed: 10/25/2022]
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32
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Jamiolkowski MA, Woolley JR, Kameneva MV, Antaki JF, Wagner WR. Real time visualization and characterization of platelet deposition under flow onto clinically relevant opaque surfaces. J Biomed Mater Res A 2014; 103:1303-11. [PMID: 24753320 DOI: 10.1002/jbm.a.35202] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/31/2014] [Accepted: 04/18/2014] [Indexed: 11/07/2022]
Abstract
Although the thrombogenic nature of the surfaces of cardiovascular devices is an important aspect of blood biocompatibility, few studies have examined platelet deposition onto opaque materials used for these devices in real time. This is particularly true for the metallic surfaces used in current ventricular assist devices (VADs). Using hemoglobin depleted red blood cells (RBC ghosts) and long working distance optics to visualize platelet deposition, we sought to perform such an evaluation. Fluorescently labeled platelets mixed with human RBC ghosts were perfused across six opaque materials (a titanium alloy (Ti6Al4V), silicon carbide (SiC), alumina (Al2O3, 2-methacryloyloxyethyl phosphorylcholine polymer coated Ti6Al4V (MPC-Ti6Al4V), yttria partially stabilized zirconia (YZTP), and zirconia toughened alumina (ZTA)) for 5 min at wall shear rates of 400 and 1000 s(-1). Ti6Al4V had significantly increased platelet deposition relative to MPC-Ti6Al4V, Al2 O3 , YZTP, and ZTA at both wall shear rates (p < 0.01). For all test surfaces, increasing the wall shear rate produced a trend of decreased platelet adhesion. The described system can be a utilized as a tool for comparative analysis of candidate blood-contacting materials with acute blood contact.
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Affiliation(s)
- Megan A Jamiolkowski
- McGowan Institute for Regenerative Medicine, Pittsburgh, Pennsylvania; Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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33
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Handa H, Major TC, Brisbois EJ, Amoako KA, Meyerhoff ME, Bartlett RH. Hemocompatibility Comparison of Biomedical Grade Polymers Using Rabbit Thrombogenicity Model for Preparing Nonthrombogenic Nitric Oxide Releasing Surfaces. J Mater Chem B 2014; 2:1059-1067. [PMID: 24634777 DOI: 10.1039/c3tb21771j] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Nitric oxide (NO) is an endogenous vasodilator as well as natural inhibitor of platelet adhesion/activation. Nitric oxide releasing (NOrel) materials can be prepared by doping an NO donor species, such as diazeniumdiolated dibutylhexanediamine (DBHD/N2O2), within a polymer coating. The inherent hemocompatibility properties of the base polymer can also influence the efficiency of such NO release coatings. In this study, four biomedical grade polymers were evaluated in a 4 h rabbit model of thrombogenicity for their effects on extracorporeal circuit thrombus formation and circulating platelet count. At the end of 4 h, Elast-Eon E2As was found to preserve 58% of baseline platelets versus 48, 40, and 47% for PVC/DOS, Tecophilic SP-60D-60, and Tecoflex SG80A, respectively. Elast-Eon also had significantly lower clot area of 5.2 cm2 compared to 6.7, 6.1, and 6.9 cm2 for PVC/DOS, SP-60D-60, and SG80A, respectively. Based on the results obtained for the base polymer comparison study, DBHD/N2O2-doped E2As was evaluated in short-term (4 h) rabbit studies to observe the NO effects on prevention of clotting and preservation of platelet function. Platelet preservation for this optimal NO release formulation was 97% of baseline after 4 h, and clot area was 0.9 cm2 compared to 5.2 cm2 for controls, demonstrating that combining E2As with NO release provides a truly advanced hemocompatible polymer coating for extracorporeal circuits and potentially other blood contacting applications.
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Affiliation(s)
- Hitesh Handa
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI USA
| | - Terry C Major
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI USA
| | | | - Kagya A Amoako
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI USA
| | - Mark E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, MI USA
| | - Robert H Bartlett
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI USA
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Ye SH, Jang YS, Yun YH, Shankarraman V, Woolley JR, Hong Y, Gamble LJ, Ishihara K, Wagner WR. Surface modification of a biodegradable magnesium alloy with phosphorylcholine (PC) and sulfobetaine (SB) functional macromolecules for reduced thrombogenicity and acute corrosion resistance. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2013; 29:8320-7. [PMID: 23705967 PMCID: PMC3716277 DOI: 10.1021/la401341y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Siloxane functionalized phosphorylcholine (PC) or sulfobetaine (SB) macromolecules (PCSSi or SBSSi) were synthesized to act as surface modifying agents for degradable metallic surfaces to improve acute blood compatibility and slow initial corrosion rates. The macromolecules were synthesized using a thiol-ene radical photopolymerization technique and then utilized to modify magnesium (Mg) alloy (AZ31) surfaces via an anhydrous phase deposition of the silane functional groups. X-ray photoelectron spectroscopy surface analysis results indicated successful surface modification based on increased nitrogen and phosphorus or sulfur composition on the modified surfaces relative to unmodified AZ31. In vitro acute thrombogenicity assessment after ovine blood contact with the PCSSi and SBSSi modified surfaces showed a significant decrease in platelet deposition and bulk phase platelet activation compared with the control alloy surfaces. Potentiodynamic polarization and electrochemical impedance spectroscopy data obtained from electrochemical corrosion testing demonstrated increased corrosion resistance for PCSSi- and SBSSi-modified AZ31 versus unmodified surfaces. The developed coating technique using PCSSi or SBSSi showed promise in acutely reducing both the corrosion and thrombotic processes, which would be attractive for application to blood contacting devices, such as vascular stents, made from degradable Mg alloys.
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Affiliation(s)
- Sang-Ho Ye
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Yong-Seok Jang
- Department of Bioengineering, North Carolina Agricultural & Technical State University, Greensboro, NC, 27411
| | - Yeo-Heung Yun
- Department of Bioengineering, North Carolina Agricultural & Technical State University, Greensboro, NC, 27411
| | - Venkat Shankarraman
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Joshua R. Woolley
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Yi Hong
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Lara J. Gamble
- Department of Bioengineering and NESAC/BIO, University of Washington, Seattle, WA 98195, USA
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
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Pandiyarajan CK, Prucker O, Zieger B, Rühe J. Influence of the molecular structure of surface-attached poly(N-alkyl acrylamide) coatings on the interaction of surfaces with proteins, cells and blood platelets. Macromol Biosci 2013; 13:873-84. [PMID: 23596084 DOI: 10.1002/mabi.201200445] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/10/2013] [Indexed: 11/10/2022]
Abstract
Blood protein adsorption and blood platelet adhesion onto surface-attached poly(alkylacrylamide) networks that exhibit small and systematic variations in chemical composition are investigated. The polymer coatings are generated by depositing a thin layer of benzophenone-group-containing copolymer onto a solid substrate, followed by photo crosslinking and simultaneous surface-attachment. The correlation of the swelling of the obtained surface-attached networks with the adsorption of blood proteins and cellular adhesion is studied. The swollen surface-attached layers are inert to blood proteins and platelet cells. These results suggest that the hydrogel-coated materials are promising candidates for the generation of hemocompatible surfaces.
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Affiliation(s)
- C K Pandiyarajan
- Laboratory for Chemistry and Physics of Interfaces, Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110 Freiburg, Germany
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He F, Wang X, Maruyama O, Kosaka R, Sogo Y, Ito A, Ye J. Improvement in endothelial cell adhesion and retention under physiological shear stress using a laminin-apatite composite layer on titanium. J R Soc Interface 2013; 10:20130014. [PMID: 23407573 DOI: 10.1098/rsif.2013.0014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Apatite (Ap), laminin-apatite composite (L5Ap, L10Ap, L20Ap and L40Ap) and albumin-apatite (AlbAp) composite layers were prepared on titanium (Ti) using a supersaturated calcium phosphate solution supplemented with laminin (0, 5, 10, 20 and 40 μg ml(-1)) or albumin (800 μg ml(-1)). With an increase in the concentrations of laminin in the supersaturated calcium phosphate solutions, the amounts of laminin immobilized on the Ti increased. The number of human umbilical vein endothelial cells (HUVECs) adhered to the laminin-apatite composite layers were remarkably higher than those to the untreated Ti, Ap layer and AlbAp composite layer. The number of cells adhered to the L40Ap was 4.3 times the untreated Ti. Moreover, cells adhered to the laminin-apatite composite layers showed significantly higher cell retention under the physiological shear stress for 1 h and 2 h than those to the untreated Ti, Ap layer and AlbAp composite layer. The number of cells remaining on the L40Ap under the physiological shear stress for 2 h was 9.5 times that of the untreated Ti. The laminin-apatite composite layer is a promising interfacial layer for endothelialization of blood-contacting materials.
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Affiliation(s)
- Fupo He
- Human Technology Research Institute, National Institute of Advanced Industrial Science and Technology, Central 6, 1-1-1 Higashi, Tsukuba, Ibaraki 305-8566, Japan
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Soto-Gutierrez A, Wertheim JA, Ott HC, Gilbert TW. Perspectives on whole-organ assembly: moving toward transplantation on demand. J Clin Invest 2012; 122:3817-23. [PMID: 23114604 DOI: 10.1172/jci61974] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There is an ever-growing demand for transplantable organs to replace acute and chronically damaged tissues. This demand cannot be met by the currently available donor organs. Efforts to provide an alternative source have led to the development of organ engineering, a discipline that combines cell biology, tissue engineering, and cell/organ transplantation. Over the last several years, engineered organs have been implanted into rodent recipients and have shown modest function. In this article, we summarize the most recent advances in this field and provide a perspective on the challenges of translating this promising new technology into a proven regenerative therapy.
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Affiliation(s)
- Alejandro Soto-Gutierrez
- Department of Pathology, Transplantation Section of Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Steinmetzer T, Baum B, Biela A, Klebe G, Nowak G, Bucha E. Beyond Heparinization: Design of Highly Potent Thrombin Inhibitors Suitable for Surface Coupling. ChemMedChem 2012; 7:1965-73. [DOI: 10.1002/cmdc.201200292] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Indexed: 11/10/2022]
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Affiliation(s)
- Peter M. Eckman
- From the Department of Medicine, Division of Cardiovascular Medicine (P.M.E.) and Department of Surgery, Division of Cardiovascular and Thoracic Surgery (R.J.), University of Minnesota, Minneapolis
| | - Ranjit John
- From the Department of Medicine, Division of Cardiovascular Medicine (P.M.E.) and Department of Surgery, Division of Cardiovascular and Thoracic Surgery (R.J.), University of Minnesota, Minneapolis
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NCO-sP(EO-stat-PO) coatings on gold sensors--a QCM study of hemocompatibility. SENSORS 2011; 11:5253-69. [PMID: 22163899 PMCID: PMC3231391 DOI: 10.3390/s110505253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 04/19/2011] [Accepted: 05/09/2011] [Indexed: 11/17/2022]
Abstract
The reliability of implantable blood sensors is often hampered by unspecific adsorption of plasma proteins and blood cells. This not only leads to a loss of sensor signal over time, but can also result in undesired host vs. graft reactions. Within this study we evaluated the hemocompatibility of isocyanate conjugated star shaped polytheylene oxide-polypropylene oxide co-polymers NCO-sP(EO-stat-PO) when applied to gold surfaces as an auspicious coating material for gold sputtered blood contacting sensors. Quartz crystal microbalance (QCM) sensors were coated with ultrathin NCO-sP(EO-stat-PO) films and compared with uncoated gold sensors. Protein resistance was assessed by QCM measurements with fibrinogen solution and platelet poor plasma (PPP), followed by quantification of fibrinogen adsorption. Hemocompatibility was tested by incubation with human platelet rich plasma (PRP). Thrombin antithrombin-III complex (TAT), β-thromboglobulin (β-TG) and platelet factor 4 (PF4) were used as coagulation activation markers. Furthermore, scanning electron microscopy (SEM) was used to visualize platelet adhesion to the sensor surfaces. Compared to uncoated gold sensors, NCO-sP(EO-stat-PO) coated sensors revealed significant better resistance against protein adsorption, lower TAT generation and a lower amount of adherent platelets. Moreover, coating with ultrathin NCO-sP(EO-stat-PO) films creates a cell resistant hemocompatible surface on gold that increases the chance of prolonged sensor functionality and can easily be modified with specific receptor molecules.
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41
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Mau J, Menzie S, Huang Y, Ward M, Hunyor S. Nonsurround, nonuniform, biventricular-capable direct cardiac compression provides Frank-Starling recruitment independent of left ventricular septal damage. J Thorac Cardiovasc Surg 2011; 142:209-15. [DOI: 10.1016/j.jtcvs.2010.05.057] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2009] [Revised: 04/14/2010] [Accepted: 05/06/2010] [Indexed: 12/31/2022]
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42
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Ye SH, Johnson CA, Woolley JR, Murata H, Gamble LJ, Ishihara K, Wagner WR. Simple surface modification of a titanium alloy with silanated zwitterionic phosphorylcholine or sulfobetaine modifiers to reduce thrombogenicity. Colloids Surf B Biointerfaces 2010; 79:357-64. [PMID: 20547042 PMCID: PMC3178391 DOI: 10.1016/j.colsurfb.2010.04.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 04/16/2010] [Accepted: 04/19/2010] [Indexed: 10/19/2022]
Abstract
Thrombosis and thromboembolism remain problematic for a large number of blood contacting medical devices and limit broader application of some technologies due to this surface bioincompatibility. In this study we focused on the covalent attachment of zwitterionic phosphorylcholine (PC) or sulfobetaine (SB) moieties onto a TiAl(6)V(4) surface with a single step modification method to obtain a stable blood compatible interface. Silanated PC or SB modifiers (PCSi or SBSi) which contain an alkoxy silane group and either PC or SB groups were prepared respectively from trimethoxysilane and 2-methacryloyloxyethyl phosphorylcholine (MPC) or N-(3-sulfopropyl)-N-(methacryloxyethyl)-N,N-dimethylammonium betaine (SMDAB) monomers by a hydrosilylation reaction. A cleaned and oxidized TiAl(6)V(4) surface was then modified with the PCSi or SBSi modifiers by a simple surface silanization reaction. The surface was assessed with X-ray photoelectron spectroscopy (XPS), attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) and contact angle goniometry. Platelet deposition and bulk phase activation were evaluated following contact with anticoagulated ovine blood. XPS results verified successful modification of the PCSi or SBSi modifiers onto TiAl(6)V(4) based on increases in surface phosphorous or sulfur respectively. Surface contact angles in water decreased with the addition of hydrophilic PC or SB moieties. Both the PCSi and SBSi modified TiAl(6)V(4) surfaces showed decreased platelet deposition and bulk phase platelet activation compared to unmodified TiAl(6)V(4) and control surfaces. This single step modification with PCSi or SBSi modifiers offers promise for improving the surface hemocompatibility of TiAl(6)V(4) and is attractive for its ease of application to geometrically complex metallic blood contacting devices.
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Affiliation(s)
- Sang-Ho Ye
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Carl A. Johnson
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Joshua R. Woolley
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Hironobu Murata
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Lara J. Gamble
- Department of Bioengineering and NESAC/BIO, University of Washington, Seattle, WA 98195, USA
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
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Abstract
We present many examples of surface engineered polymeric biomaterials with nanosize modified layers, controlled protein adsorption, and cellular interactions potentially applicable for tissue and/or blood contacting devices, scaffolds for cell culture and tissue engineering, biosensors, biological microchips as well as approaches to their preparation.
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44
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Major TC, Brant DO, Reynolds MM, Bartlett RH, Meyerhoff ME, Handa H, Annich GM. The attenuation of platelet and monocyte activation in a rabbit model of extracorporeal circulation by a nitric oxide releasing polymer. Biomaterials 2009; 31:2736-45. [PMID: 20042236 DOI: 10.1016/j.biomaterials.2009.12.028] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Accepted: 12/11/2009] [Indexed: 12/31/2022]
Abstract
Nitric oxide (NO) has been shown to reduce thrombogenicity by decreasing platelet and monocyte activation by the surface glycoprotein, P-selectin and the integrin, CD11b, respectively. In order to prevent platelet and monocyte activation with exposure to an extracorporeal circulation (ECC), a nitric oxide releasing (NORel) polymeric coating composed of plasticized polyvinyl chloride (PVC) blended with a lipophilic N-diazeniumdiolate was evaluated in a 4 h rabbit thrombogenicity model using flow cytometry. The NORel polymer significantly reduced ECC thrombus formation compared to polymer control after 4 h blood exposure (2.8 +/- 0.7 NORel vs 6.7 +/- 0.4 pixels/cm(2) control). Platelet count (3.4 +/- 0.3 NORel vs 2.3 +/- 0.3 x 10(8)/ml control) and function as measured by aggregometry (71 +/- 3 NORel vs 17 +/- 6% control) were preserved after 4 h exposure in NORel versus control ECC. Plasma fibrinogen levels significantly decreased in both NORel and control groups. Platelet P-selectin mean fluorescence intensity (MFI) as measured by flow cytometry was attenuated after 4 h on ECC to ex vivo collagen stimulation (27 +/- 1 NORel vs 40 +/- 2 MFI control). Monocyte CD11b expression was reduced after 4 h on ECC with NORel polymer (87 +/- 14 NORel vs 162 +/- 30 MFI control). These results suggest that the NORel polymer coatings attenuate the increase in both platelet P-selectin and monocytic CD11b integrin expression in blood exposure to ECCs. These NO-mediated platelet and monocytic changes were shown to improve thromboresistance of these NORel-polymer-coated ECCs for biomedical devices.
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Affiliation(s)
- Terry C Major
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
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Ye SH, Johnson CA, Woolley JR, Oh HI, Gamble LJ, Ishihara K, Wagner WR. Surface modification of a titanium alloy with a phospholipid polymer prepared by a plasma-induced grafting technique to improve surface thromboresistance. Colloids Surf B Biointerfaces 2009; 74:96-102. [PMID: 19647420 PMCID: PMC2811089 DOI: 10.1016/j.colsurfb.2009.06.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 06/26/2009] [Accepted: 06/29/2009] [Indexed: 11/29/2022]
Abstract
To improve the thromboresistance of a titanium alloy (TiAl(6)V(4)) surface which is currently utilized in several ventricular assist devices (VADs), a plasma-induced graft polymerization of 2-methacryloyloxyethyl phosphorylcholine (MPC) was carried out and poly(MPC) (PMPC) chains were covalently attached onto a TiAl(6)V(4) surface by a plasma induced technique. Cleaned TiAl(6)V(4) surfaces were pretreated with H(2)O-vapor-plasma and silanated with 3-methacryloylpropyltrimethoxysilane (MPS). Next, a plasma-induced graft polymerization with MPC was performed after the surfaces were pretreated with Ar plasma. Surface compositions were verified by X-ray photoelectron spectroscopy (XPS). In vitro blood biocompatibility was evaluated by contacting the modified surfaces with ovine blood under continuous mixing. Bulk phase platelet activation was quantified by flow cytometric analysis, and surfaces were observed with scanning electron microscopy after blood contact. XPS data demonstrated successful modification of the TiAl(6)V(4) surfaces with PMPC as evidenced by increased N and P on modified surfaces. Platelet deposition was markedly reduced on the PMPC grafted surfaces and platelet activation in blood that contacted the PMPC-grafted samples was significantly reduced relative to the unmodified TiAl(6)V(4) and polystyrene control surfaces. Durability studies under continuously mixed water suggested no change in surface modification over a 1-month period. This modification strategy shows promise for further investigation as a means to reduce the thromboembolic risk associated with the metallic blood-contacting surfaces of VADs and other cardiovascular devices under development.
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Affiliation(s)
- Sang Ho Ye
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Carl A. Johnson
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Joshua R. Woolley
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Heung-Il Oh
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Lara J. Gamble
- Departments of Bioengineering and NESAC/BIO, University of Washington, Seattle, WA 98195, USA
| | - Kazuhiko Ishihara
- Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
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