Permanent Polymer Coating for in vivo MRI Visualization of Tissue Reinforcement Prostheses

Abstract

The clinical advantage of MRI visualization of prostheses in soft tissue prolapses is very appealing as over 1,000000 MRI-transparent synthetic meshes are implanted annually, and postoperative complications such as mesh shrinkage and migration are frequent. Here, the synthesis of a new material composed of a DTPA-Gd complex grafted onto a backbone of PMA via a covalent bond is described (DTPA-Gd-PMA). This new polymer is sprayed onto meshes and gives an MR signal for a long period without any significant release of Gd. In vitro cytocompatibility tests on fibroblasts show limited cytotoxicity. Microscopic investigations indicate that vital cells rapidly colonize the material. Finally, coated meshes implanted in rats are easily recognizable using an MR imaging system.

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

“…The presence of covalently grafted DTPA‐Gd onto the surface of coated meshes allowed H) in vitro and I,J) in vivo (in rat) mesh visualization using experimental 7 Tesla apparatus (meshes are denoted by white arrows). Adapted with permission . Copyright 2012, Wiley .…”

“…Alternatively, positive contrast agents (T 1 agents, including Gd) are known to exhibit a hypersignal in MRI, which could hypothetically facilitate the identification of a material after implantation. As an alternative to the signal enhancement of iron‐based contrast agents, the identification of the mesh after implantation has been proposed by using paramagnetic element (Gd) immobilized onto the surface of coated PP meshes . Using anionic activation, a covalent and stable non‐labile bond was created between the substrate (i.e., degradable PCL for short‐term application or biostable poly(methyl acrylate) (PMA) for long‐term visualization and the chelated contrast agent (diethylenetriamine pentaacetic acid, DTPA‐Gd).…”

“…As an alternative to the signal enhancement of iron‐based contrast agents, the identification of the mesh after implantation has been proposed by using paramagnetic element (Gd) immobilized onto the surface of coated PP meshes . Using anionic activation, a covalent and stable non‐labile bond was created between the substrate (i.e., degradable PCL for short‐term application or biostable poly(methyl acrylate) (PMA) for long‐term visualization and the chelated contrast agent (diethylenetriamine pentaacetic acid, DTPA‐Gd). Then, the obtained polymers (PCL‐DTPA‐Gd or PMA‐DTPA‐Gd) were used as coating agents and sprayed onto the surface of the PP mesh substrates (Figure ,G).…”

“… Illustration of some of the recent advances in mesh functionalities. Adapted with permission . Copyright 2012, Wiley .…”

Tolerance and Long-Term MRI Imaging of Gadolinium-Modified Meshes Used in Soft Organ Repair

“…We previously described a method to covalently bind gadolinium to resorbable (poly(ε-caprolactone), PCL) and non-resorbable (poly(methyl acrylate), PMA) polymers and then coat the resulting Gd-polymers onto PP meshes. With this approach we obtained a satisfactory visualisation of the optimised meshes in experimental ( in vitro ) and clinical ( in vivo ) MRI [ 17 ]. With the present study we sought to evaluate (i) the preclinical tolerance and (ii) long-term MRI visibility of the previously described Gadolinium-modified PP meshes.…”