Surface Engineering of Cardiovascular Devices for Improved Hemocompatibility and Rapid Endothelialization

Abstract

Cardiovascular devices have been widely applied in the clinical treatment of cardiovascular diseases. However, poor hemocompatibility and slow endothelialization on their surface still exist. Numerous surface engineering strategies have mainly sought to modify the device surface through physical, chemical, and biological approaches to improve surface hemocompatibility and endothelialization. The alteration of physical characteristics and pattern topographies brings some hopeful outcomes and plays a notable role in this respect. The chemical and biological approaches can provide potential signs of success in the endothelialization of vascular device surfaces. They usually involve therapeutic drugs, specific peptides, adhesive proteins, antibodies, growth factors and nitric oxide (NO) donors. The gene engineering can enhance the proliferation, growth, and migration of vascular cells, thus boosting the endothelialization. In this review, the surface engineering strategies are highlighted and summarized to improve hemocompatibility and rapid endothelialization on the cardiovascular devices. The potential outlook is also briefly discussed to help guide endothelialization strategies and inspire further innovations. It is hoped that this review can assist with the surface engineering of cardiovascular devices and promote future advancements in this emerging research field.

Advances in coatings on magnesium alloys for cardiovascular stents – A review

“…Furthermore, HR tests revealed that LDH/PDA/Hep coating had a low HR (0.65%) in vitro, implying that heparinization was a promising strategy to enhance the hemocompatibility of samples. Li et al [ 242 ] conjugated the Hep molecule, the Arg–Glu–Asp–Val peptide (REDV, which is a tetrapeptide derived from fibronectin that can be specifically recognized by α 4 β 1 integrin on the surface of ECs [ 243 ]), and an anti-CD 34 antibody (CD 34 is a highly glycosylated type I transmembrane glycoprotein that interacts with anti-CD 34 antibodies and is an important way to promote EPC-targeted adhesion/capture [ 244 , 245 ]) on a silane-treated ZE21B alloy, for improving surface endothelialization. A blood compatibility test suggested that multi-functional coating effectively restrained platelet adhesion/activation and reduced the HR (<5%).…”

Enhancement of Endothelialization by Topographical Features Is Mediated by PTP1B-Dependent Endothelial Adherens Junctions Remodeling

“…A number of candidates for further study includes vinculin which is known to mediate crosstalk between cell–cell and cell–ECM interactions, and whose phosphorylation at residue Y822 were shown to be regulated by PTP1B, or VE-cadherin, whose turnover and BMP signaling was regulated downstream of YAP/TAZ to promote endothelia development . Finally, beyond our combined approach, we note that recently dynamic or on-demand modification of the substrate biomaterial/biochemical properties also offer significant enhancements in endothelialization. , We anticipate that further multifacted integration of these approaches may provide not only a better understanding of how the EC monolayers respond to physical and biochemical cues but also open new routes toward effective strategies to modulate EC behaviors for in vivo applications such as cardiovascular grafts.…”

Accelerated Endothelialization of Nanofibrous Scaffolds for Biomimetic Cardiovascular Implants

“…According to literature [ 11 , 69 , 73 ], the following important current questions cannot yet be conclusively or adequately addressed: (i) how long does complete endothealization of nonwoven materials take in vivo (with blood circulation)? (ii) do specific cells penetrate through the fiber network and does biodegradation influence the functionality?…”