Iris Publishers- Open access Journal of Biomedical Engineering & Biotechnology | Engineering Approaches to Prevent Blood Clotting from Medical Implants

Authored by Shih-Feng Chou

Injectable and/or Implantable medical devices are widely used in the treatment of diseases. Among them, vascular stents provide the medical solution to treat blood clotting. However, traditional metallic stents, even with current improvements in anticoagulation properties, have potential drawbacks in local inflammation when first implanted into the body and undesirable protein adsorption and cell adhesion after a prolonged period of time in the body. In this perspective, we discuss several engineering approaches, including drug-eluting materials, polymeric and non-polymeric coatings, and surface modifications to coating materials that can be applied to the surface of medical implants to significantly improve the hemocompatibility. These coatings are expected to have a slow degradation rate with the ability to either load drugs or attach biomacromolecules to form an architecture that mimics the surrounding cells. In general, our perspective provides a current view on the achievements of hemo-compatible coatings and future trends in coating materials that will extend the life of the medical implants.

The use of injectable and/or implantable medical devices has emerged as one of the most attractive engineering approaches toward the treatment of many diseases [1]. These medical implants not only provide structural support to the surrounding tissues but also can be integrated with medical functions, such as drug release or data recording/transmission, just to name a few. To fully capture the mechanical and biomedical aspects of these implantable medical devices, one important task is to minimize the inflammation response generated by the immune system. Through engineering approaches, a particular method that has been widely utilized is to coat the surface of the medical implants with a more biocompatible material that reduces the risk of device rejection [2].
One of the most widely used implantable medical devices is vascular heart stent for thrombosis treatment, where 1.8 million stent implant procedures were made each year in the US [3]. Traditionally, these vascular stents have been made from thromboresistant metals. However, deposition of proteins and local inflammation leading to an immune response prohibit the longterm use of these metallic stents. Due to the degradation of their medical performance, previous efforts have been focused on the development of polymeric coatings with drug release mechanisms that reduce the inflammatory response when stents are initially placed in the body. However, adverse side effects from this approach were noticeable due to the depletion of drug as well as cytotoxicity as a result of the enhanced biodegradation rate accompanied with drug release. In addition, the conventional polymeric coatings exhibited poor surface properties that result in undesirable protein adsorption and cell adhesion. Based on these observations, the focus of the coating materials has translated into the design of a more desirable coating surface with properties that can mimic the surrounding cells/tissues [4-6].

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