Surface Nanostructuring of Parylene-C Coatings for Blood Contacting Implants

A bio-instructive parylene-based conformal coating suppresses thrombosis and intimal hyperplasia of implantable vascular devices

Implantable vascular devices are widely used in clinical treatments for various vascular diseases. However, current approved clinical implantable vascular devices generally have high failure rates primarily due to their surface lacking inherent functional endothelium. Here, inspired by the pathological mechanisms of vascular device failure and physiological functions of native endothelium, we developed a new generation of bioactive parylene (poly(p-xylylene))-based conformal coating to address these challenges of the vascular devices. This coating used a polyethylene glycol (PEG) linker to introduce an endothelial progenitor cell (EPC) specific binding ligand LXW7 (cGRGDdvc) onto the vascular devices for preventing platelet adhesion and selectively capturing endogenous EPCs. Also, we confirmed the long-term stability and function of this coating in human serum. Using two vascular disease-related large animal models, a porcine carotid artery interposition model and a porcine carotid artery-jugular vein arteriovenous graft model, we demonstrated that this coating enabled rapid generation of self-renewable "living" endothelium on the blood contacting surface of the expanded polytetrafluoroethylene (ePTFE) grafts after implantation. We expect this easy-to-apply conformal coating will present a promising avenue to engineer surface properties of "off-the-shelf" implantable vascular devices for long-lasting performance in the clinical settings.

Development of a Water Transmission Rate (WTR) Measurement System for Implantable Barrier Coatings

While water vapor transmission rate (WVTR) measurement is standardly used to assess material permeability, a system able to quantify liquid water transmission rate (WTR) measurement is highly desirable for implantable thin film barrier coatings. Indeed, since implantable devices are in contact or immersed in body fluids, liquid WTR was carried out to obtain a more realistic measurement of the barrier performance. Parylene is a well-established polymer which is often the material of choice for biomedical encapsulation applications due to its flexibility, biocompatibility, and attractive barrier properties. Four grades of parylene coatings were tested with a newly developed permeation measurement system based on a quadrupole mass spectrometer (QMS) detection method. Successful measurements of gas and water vapor and the water transmission rates of thin parylene films were performed and validated, comparing the results with a standardized method. In addition, the WTR results allowed for the extraction of an acceleration transmission rate factor from the vapor-to-liquid water measurement mode, which varies from 4 to 4.8 between WVTR and WTR. With a WTR of 72.5 µm g m^-2 day^-1, parylene C displayed the most effective barrier performance.

Bio-inspired hemocompatible surface modifications for biomedical applications

When blood first encounters the artificial surface of a medical device, a complex series of biochemical reactions is triggered, potentially resulting in clinical complications such as embolism/occlusion, inflammation, or device failure. Preventing thrombus formation on the surface of blood-contacting devices is crucial for maintaining device functionality and patient safety. As the number of patients reliant on blood-contacting devices continues to grow, minimizing the risk associated with these devices is vital towards lowering healthcare-associated morbidity and mortality. The current standard clinical practice primarily requires the systemic administration of anticoagulants such as heparin, which can result in serious complications such as post-operative bleeding and heparin-induced thrombocytopenia (HIT). Due to these complications, the administration of antithrombotic agents remains one of the leading causes of clinical drug-related deaths. To reduce the side effects spurred by systemic anticoagulation, researchers have been inspired by the hemocompatibility exhibited by natural phenomena, and thus have begun developing medical-grade surfaces which aim to exhibit total hemocompatibility via biomimicry. This review paper aims to address different bio-inspired surface modifications that increase hemocompatibility, discuss the limitations of each method, and explore the future direction for hemocompatible surface research.

Wettability and Surface Roughness of Parylene C on Three-Dimensional-Printed Photopolymers

The use of poly-(para-chloro-xylylene) (Parylene C) in microelectromechanical systems and medical devices has increased rapidly. However, little research has been conducted on the wettability and surface roughness of Parylene C after being soaked in solutions. In this study, the contact angle and surface roughness (arithmetic average of roughness) of Parylene C on three-dimensional (3D)-printed photopolymer in 10% sodium hydroxide, 10% ammonium hydroxide, and 100% phosphate-buffered saline (PBS) solutions were investigated using a commercial contact angle measurement system and laser confocal microscope, respectively. The collected data indicated that 10% ammonium hydroxide had no major effect on the contact angle of Parylene C on a substrate, with a Shore A hardness of 50. However, 10% sodium hydroxide, 10% ammonium hydroxide, and 100% PBS considerably affected the contact angle of Parylene C on a substrate with a Shore A hardness of 85. Substrates with Parylene C coating exhibited lower surface roughness than uncoated substrates. The substrates coated with Parylene C that were soaked in 10% ammonium hydroxide exhibited high surface roughness. The aforementioned results indicate that 3D-printed photopolymers coated with Parylene C can offer potential benefits when used in biocompatible devices.

Recent Developments in Blood-Compatible Superhydrophobic Surfaces

Superhydrophobic surfaces, as indicated in the name, are highly hydrophobic and readily repel water. With contact angles greater than 150° and sliding angles less than 10°, water droplets flow easily and hardly wet these surfaces. Superhydrophobic materials and coatings have been drawing increasing attention in medical fields, especially on account of their promising applications in blood-contacting devices. Superhydrophobicity controls the interactions of cells with the surfaces and facilitates the flowing of blood or plasma without damaging blood cells. The antibiofouling effect of superhydrophobic surfaces resists adhesion of organic substances, including blood components and microorganisms. These attributes are critical to medical applications such as filter membranes, prosthetic heart valves, extracorporeal circuit tubing, and indwelling catheters. Researchers have developed various methods to fabricate blood-compatible or biocompatible superhydrophobic surfaces using different materials. In addition to being hydrophobic, these surfaces can also be antihemolytic, antithrombotic, antibacterial, and antibiofouling, making them ideal for clinical applications. In this review, the authors summarize recent developments of blood-compatible superhydrophobic surfaces, with a focus on methods and materials. The expectation of this review is that it will support the biomedical research field by providing current trends as well as future directions.

Curvature-induced defects on carbon-infiltrated carbon nanotube forests

A morphological study of the micro-scale defects induced by growing a carbon-infiltrated carbon nanotube (CICNT) forest on concave substrates was conducted. Two CICNT heights (roughly 60 μm and 400 μm) and 4 curvatures (1–4 mm ID) were studied in order to test the geometric limitations. Defects were categorized and quantified by scanning electron microscopy (SEM) of the tops and cross-sections. These deformities were categorized as increased roughness on the top surface, a corrugated (also called wavy or rippled) forest, a curved forest, an inside crevice where the forest separates, and increased forest density on the top surface. Roughness increased nearly 3-fold with the taller forest heights no matter the substrate curvature. Due to the geometric limitations of CICNT height and substrate curvature, all other microscale defects were significantly more present on samples with a small radius of curvature and a tall CICNT forest (p < 0.05). These buckling and warping types of defects were attributed to the increase in circumferential compression as the forest grows as well as the van der Waals interactions between the nanotubes. Because the fabrication process for CICNT involves growing a CNT forest and then infiltrating it with pyrolytic carbon, this work may be applicable to other CNT forests on concave substrates within these forest heights and substrate curvatures.

A morphological study of the micro-scale defects induced by growing a carbon-infiltrated carbon nanotube (CICNT) forest on concave substrates was conducted.

A transparent hydrophilic anti-biofouling coating for intraocular lens materials prepared by "bridging" of the intermediate adhesive layer

The attachment of bio-foulants, including unwanted cells, proteins, and bacteria, to a medical device such as an intraocular lens can lead to implantation failure. Hydrophilic polymers are often used as surface modifiers in the fabrication of anti-biofouling coatings, but a hydrophilic coating can easily become swollen and peel off the substrate. In this study, we chose polymethyl methacrylate (PMMA) as the representative material of intraocular lenses because PMMA has better biocompatibility, a higher refractive index, better optical clarity, lighter weight, more stable performance, and lower cost than other intraocular lens materials. We fabricated polyvinyl alcohol (PVA) coatings with or without a "bridge", that is, an intermediate adhesive layer (AL), to increase the adhesion bonding effect between the anti-biofouling coating and the substrate. The results indicated that the prepared coatings were transparent and noncytotoxic. Moreover, the anti-adhesion properties of the cells and the resistance properties to nonspecific protein adsorption of PMMA modified by both AL and PVA coatings were better and more durable compared with the sample only modified with a physically dipped PVA coating. The coating prepared by AL "bridging" provides a new strategy for the preparation of a transparent hydrophilic anti-biofouling coating suitable for PMMA intraocular lens materials.

3D Printing of Cell Culture Devices: Assessment and Prevention of the Cytotoxicity of Photopolymers for Stereolithography

3D printing is increasingly important for the rapid prototyping of advanced and tailor-made cell culture devices. In this context, stereolithography represents a method for the rapid generation of prototypes from photocurable polymers. However, the biocompatibility of commercially available photopolymers is largely unknown. Therefore, we evaluated the cytotoxicity of six polymers, two of them certified as biocompatible according to ISO 10993-5:2009, and we evaluated, if coating with Parylene, an inert polymer widely used in medical applications, might shield cells from the cytotoxic effects of a toxic polymer. In addition, we evaluated the processability, reliability, and consistency of the details printed. Human mesenchymal stem cells (MSCs) were used for cytotoxicity testing as they are widely used and promising for numerous applications in regenerative medicine. MSCs were incubated together with printed photopolymers, and the cytotoxicity was assessed. All photopolymers significantly reduced the viability of MSCs while the officially biocompatible resins displayed minor toxic effects. Further, coating with Parylene completely protected MSCs from toxic effects. In conclusion, none of the tested polymers can be fully recommended for rapid prototyping of cell culture devices. However, coating with Parylene can shield cells from toxic effects and thus might represent a viable option until more compatible materials are available.

Parylene-C coated microporous PDMS structure protecting from functional deconditioning of platelets exposed to cardiostimulants

Most elderly patients after orthopedic and dental implant surgeries are exposed to cardiostimulants to reduce potential blood pressure-related risks of cardiovascular diseases. Such treatments lead to deconditioning of platelet function, which is an important factor in wound healing treatments. We introduced an innovative parylene-C coated microporous PDMS structure that can prevent the functional deconditioning of platelets caused by certain cardiostimulants. At different concentrations of cardiostimulants (IPR; isoprenaline and DA; dopamine), pre-activation, activation, and post-activation of platelets were intensively examined under mechanical and chemical stimulation mimicking the physiological environment on four different surfaces (glass, flat parylene-C coated glass (F-PPXC), microporous PDMS structure (P-PDMS), and parylene-C-coated microporous PDMS structure (S-PPXC)). The 3D microporous structure with parylene-C (S-PPXC) surface could attenuate the deconditioning of platelet function caused by IPR. Moreover, the S-PPXC surface further enhanced the DA-dependent stimulation of platelet function. The reason for this is that the 3D microporous structure with parylene-C S-PPXC induced stable and fast adhesion of platelets through increased surface roughness and softness, resulting in a significant enhancement of platelet activity. Therefore, we propose the use of functional S-PPXC surfaces as a novel strategy in the development of biomedical products.

Functionalization of the Parylene C Surface Enhances the Nucleation of Calcium Phosphate: Combined Experimental and Molecular Dynamics Simulations Approach

Interactions at the solid-body fluid interfaces play a vital role in bone tissue formation at the implant surface. In this study, fully atomistic molecular dynamics (MD) simulations were performed to investigate interactions between the physiological components of body fluids (Ca2+, HPO42-, H2PO4-, Na+, Cl-, and H2O) and functionalized parylene C surface. In comparison to the native parylene C (-Cl surface groups), the introduction of -OH, -CHO, and -COOH surface groups significantly enhances the interactions between body fluid ions and the polymeric surface. The experimentally observed formation of calcium phosphate nanocrystals is discussed in terms of MD simulations of the calcium phosphate clustering. Surface functional groups promote the clustering of calcium and phosphate ions in the following order: -OH > -CHO > -Cl (parent parylene C) ≈ -COO-. This promoting role of surface functional groups is explained as stimulating the number of Ca2+ and HPO42- surface contacts as well as ion chemisorption. The molecular mechanism of calcium phosphate cluster formation at the functionalized parylene C surface is proposed.