Abstract
Polymers have found widespread applications in cardiology, in particular in coronary vascular intervention as stent platforms (scaffolds) and coating matrices for drug-eluting stents. Apart from permanent polymers, current research is focussing on biodegradable polymers. Since they degrade once their function is fulfilled, their use might contribute to the reduction of adverse events like in-stent restenosis, late stent-thrombosis, and hypersensitivity reactions. After reviewing current literature concerning polymers used for cardiovascular applications, this review deals with parameters of tissue and blood cell functions which should be considered to evaluate biocompatibility of stent polymers in order to enhance physiological appropriate properties. The properties of the substrate on which vascular cells are placed can have a large impact on cell morphology, differentiation, motility, and fate. Finally, methods to assess these parameters under physiological conditions will be summarized.
Highlights
Cardiovascular diseases (CVDs) are known as a variety of disorders that involve the heart or blood vessels and are considered to be the leading cause of mortality worldwide [1]
We report that ECs cultured on PLLA-based surfaces exhibit a well-marked endothelial surface layer (ESL) under arterial flow conditions, while biopolymers such as P(3HB) and P(4HB) exert a great impact on ESL width and attenuate endothelial barrier function, which is accompanied by low endothelial nitric oxide synthase (eNOS) and PECAM-1 expression [79, 80]
The issues regarding the implantation of vascular stents are mainly related to the induction of vascular injury, inflammation, and abnormal hemodynamics leading to the activation and growth of intimal smooth muscle cell (SMC)
Summary
Cardiovascular diseases (CVDs) are known as a variety of disorders that involve the heart or blood vessels and are considered to be the leading cause of mortality worldwide [1]. Current research is focused on the safety of coronary stents, but side effects, such as late and very late stent-thrombosis and in-stent restenosis, remain problematic [4, 5] In this context, polymers, which are capable of degrading, releasing drugs, or mimicking biological functionalities, are of great interest for the development of vascular implants. Sophisticated biomaterials are required to fulfil special demands with their specific properties and biocompatibility In this context, the present review is focused on polymers used as stent platforms and coating matrices for drug-eluting stents (DES), as well as on the description of parameters of vascular and blood cell function which are crucial for the evaluation of the biocompatibility of polymers. The last section deals with in vitro methods to assess these parameters under preferably physiological conditions and summarizes results of reports dealing with in vitro evaluation of polymers for cardiovascular implants
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