Abstract
Bare metal endovascular implants pose a significant risk of causing thrombogenic complications. Antithrombogenic surface modifications, such as phenox’s “Hydrophilic Polymer Coating” (pHPC), which was originally developed for NiTi implants, decrease the thrombogenicity of metal surfaces. In this study, the transferability of pHPC onto biomedical CoCr-based alloys is examined. Coated surfaces were characterized via contact-angle measurement and atomic force microscopy. The equivalence of the antithrombogenic effect in contact with whole human blood was demonstrated in vitro for CoCr plates compared to NiTi plates on a platform shaker and for braided devices in a Chandler loop. Platelet adhesion was assessed via scanning electron microscopy and fluorescence microscopy. The coating efficiency of pHPC on CoCr plates was confirmed by a reduction of the contact angle from 84.4° ± 5.1° to 36.2° ± 5.2°. The surface roughness was not affected by the application of pHPC. Platelet adhesion was significantly reduced on pHPC-coated specimens. The platelet covered area was reduced by 85% for coated CoCr plates compared to uncoated samples. Uncoated braided devices were completely covered by platelets, while on the pHPC-coated samples, very few platelets were visible. In conclusion, the antithrombogenic effect of pHPC coating can be successfully applied on CoCr plates as well as stent-like CoCr braids.
Highlights
Ischemic and hemorrhagic vascular diseases are among the most frequent causes of death in Western countries [1]
The 35NLT braid resembles the design of the p48 MW (HPC), and was used to compare the coating efficiency and antithrombogenicity of phenox’s “Hydrophilic Polymer Coating” (pHPC) on a flow diverter made of CoCr wires. 35NLT is a Co-based-alloy with Ni, Cr, and molybdenum (Mo) as the main alloying elements [34]
The purpose of this study was to evaluate the compatibility of pHPC with CoCr-alloy substrates to expand the range of antithrombogenic biomaterials that are commonly used in blood contact
Summary
Ischemic and hemorrhagic vascular diseases (e.g., myocardial infarct, stroke, atherosclerosis) are among the most frequent causes of death in Western countries [1]. Metallic implants are the mainstay of endovascular therapy, which is true for peripheral, cardiological, and neurovascular interventions. For the purpose of vessel occlusion, device-induced thrombus formation is desired, but when it comes to vessel reconstruction, the inherent thrombogenicity of stents and their derivates is an issue [2,3]. Extended research in the field of endovascular treatments of diseases has brought forth a large variety of devices designed for many purposes. While the designs of stents and flow diverters vary significantly, the most commonly used materials today are NiTi alloys, CoCr alloys, or medical-grade steel due to their excellent biocompatibility and mechanical properties [4]. Thrombus formation may result, eventually causing local and distal vessel occlusion [5,6,7,8]
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