Surface Engineering of Bioactive Coatings for Improved Stent Hemocompatibility: A Comprehensive Review

Abstract

Cardiovascular diseases continue to be a major contributor to illness and death on a global scale, and the implementation of stents has given rise to a revolutionary transformation in the field of interventional cardiology. The thrombotic and restenosis complications associated with stent implantation pose ongoing challenges. In recent years, bioactive coatings have emerged as a promising strategy to enhance stent hemocompatibility and reduce thrombogenicity. This review article provides an overview of the surface engineering techniques employed to improve the hemocompatibility of stents and reduce thrombus formation. It explores the mechanisms underlying thrombosis and discusses the factors influencing platelet activation and fibrin formation on stent surfaces. Various bioactive coatings, including anticoagulant agents, antiplatelet agents, and surface modifications, are discussed in detail, highlighting their potential in reducing thrombogenicity. This article also highlights a multitude of surface modification techniques which can be harnessed to enhance stent hemocompatibility including plasma treatment, physical vapor deposition (PVD), chemical vapor deposition (CVD), and electrodeposition. These techniques offer precise control over surface properties such as roughness, charge, and composition. The ultimate goal is to reduce platelet adhesion, tailor wettability, or facilitate the controlled release of bioactive agents. Evaluation methods for assessing hemocompatibility and thrombogenicity are also reviewed, ranging from in vitro assays to animal models. Recent advances in the field, such as nanotechnology-based coatings and bioactive coatings with controlled drug release systems, are highlighted. Surface engineering of bioactive coatings holds great promise for enhancing the long-term outcomes of stent implantation by enhancing hemocompatibility and reducing thrombogenicity. Future research directions and potential clinical applications are discussed, underscoring the need for continued advancements in this field.

Polymer-Drug Anti-Thrombogenic and Hemocompatible Coatings as Surface Modifications

“…Over the years, the design and material from which stents are made have undergone significant modifications. Systematizing the available types of vascular scaffolds, three groups can be distinguished: metal stents-BMSs (bear metal stents), drug-eluting metal stents [51]-DESs (drug-eluting stents) (Figure 1) [52] and a group of bioresorbable stents-BRSs (bioresorbable stents) [53,54]. Metal stents can be made of thin 316L-grade stainless steel, cobalt-chromium, and platinum-chromium.…”

Interaction Regularity of Biomolecules on Mg and Mg-Based Alloy Surfaces: A First-Principles Study

“…The biomolecular coating modified on the surface of biomedical materials is a direct contact site for cell adhesion and growth on the material surface, which has a significant impact on human physiological activities [1][2][3][4][5][6]. Numerous in vivo and in vitro animal experiments have shown that Mg alloy materials modified with functional biomolecular coatings have good biocompatibility, biomechanical compatibility, antibacterial properties, and appropriate corrosion resistance performance [7][8][9][10].…”