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Advanced Polymers in Medicine pp 481–511Cite as

Recent Advances in Hemocompatible Polymers for Biomedical Applications

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Abstract

Blood-material interactions are critical to the success of implantable medical devices that are used in thousands of patients every day. Some common blood-contacting devices include catheters, stents, vascular grafts, heart valve prostheses, and extracorporeal circulation/membrane oxygenation systems. Among other complications, thrombosis and clot formation remains one of the major challenges in clinical application of these devices. The initial biological response of blood to a foreign surface is the rapid adsorption of plasma proteins, which is followed by platelet adhesion and activation, and ultimately thrombus formation. The key factors in clot formation are the chemical and physical nature of the surfaces and their interactions with the blood components, such as platelets and plasma proteins. Despite decades of research, an ideal non-thrombogenic surface is still yet to be identified and clinical use of these blood-contacting devices requires use of anticoagulation agents, increasing the risk of bleeding in patients. In this chapter, we will review some of the current and most promising strategies that have been used over the years to develop polymeric materials with improved hemocompatibility, including highly hydrophilic or hydrophobic surfaces, albumin coated surfaces, zwitterionic polymers, attached endothelial cells, patterned surfaces, immobilized heparin, and nitric oxide (NO) releasing/generating surfaces. We will also discuss some of the important techniques employed (using in vitro and in vivo models) to assess the hemocompatibility of any new material, including the measurement of platelet preservation, platelet and protein adhesion, the effect of flow rates on thrombosis, and the ultimate surface clot area.

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Abbreviations

A-A:

Arterio-arterlial

A-V:

Arterio-venous

Alb:

Albumin

Alg:

Sodium alginate

APTT:

Activated partial thromboplastin time

ATRP:

Atom transfer radical polymerization

CysNO:

S-nitrosocysteine

DACA:

Diaminoalkyltrimethoxysilane

DBHD/N2O2 :

Diazeniumdiolated dibutylhexanediamine

DBHD:

N,N′-dibutyl-1,6-hexanediamine

DMHD/N2O2 :

Diazeniumdiolated N,N′-dimethyl-1,6-hexanediamine

DMMSA:

N,N-dimethyl-N-methacryloxyethyl-N-(3-sulfopropyl) ammonium

DMPAMS:

N,N-dimethyl, N-(2-ethyl phosphate ethyl)-aminopropyltrimethyoxysilane

DOS:

Dioctyl sebacate

EC:

Endothelial cells

ECC:

Extracorporeal circulation

GPx:

Glutathione peroxidase

GSH:

Glutathione

GSNO:

S-nitrosoglutathione

HEMA:

2-hydroxyethyl methacrylate

IgG:

Immunoglobulin

LPEI/N2O2 :

Diazeniumdiolated linear polyethylenimine

MDI:

Methylene diphenyl isocyanate

NO:

Nitric oxide

NOgen:

NO-generating

NONOate:

Diazeniumdiolate

NOrel:

NO-releasing

P(PEGDMA):

Poly(poly(ethylene glycol) dimethacrylate)

PAAm:

Polyacrylamides

PDMS:

Poly(dimethylsiloxane)

PEG:

Poly(ethylene glycol)

PEI:

Polyethylenimine

PEGME:

Poly(ethylene glycol) monomethyl ether

PEO:

Poly(ethylene oxide)

PGA:

Polyglycolic acid

PHEMA:

Poly(hydroxyethyl methacrylate)

PLGA:

Poly(lactic-co-glycolic acid)

PMEA:

Poly(2-methoxyethyl acrylate)

PNVP:

Poly(N-vinyl pyrrolidone)

PRP:

Platelet-rich plasma

PS-CO2 :

Carbon dioxide as plasma-treated polystyrene

PTFE:

Polytetrafluoroethylene

PVA:

Poly(vinyl alcohol)

PVC:

Poly(vinyl chloride)

PVMMA:

Poly(vinyl methyl ether-co-malic anhydride)

PVP:

Poly(vinyl pyrrolidone)

RSNO:

S-nitrosothiol

RSSR:

Disulfide

SeCA:

Selenocystamine

SeDPA:

3,3′-diselenidedipropionic acid

SNAC:

S-nitroso-N-acetyl-L-cysteine

SNAP:

S-nitroso-N-acetylpenicillamine

SR:

Silicone rubber

vWF:

von Willebrand Factor

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Authors and Affiliations

  1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA

    Elizabeth J. Brisbois & Hitesh Handa

  2. Department of Chemistry, University of Michigan, Ann Arbor, MI, USA

    Mark E. Meyerhoff

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  1. Elizabeth J. Brisbois
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  2. Hitesh Handa
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  3. Mark E. Meyerhoff
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Correspondence to Mark E. Meyerhoff .

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  1. Pharmacy, Health and Nutritional Sci., University of Calabria, Rende, Italy

    Francesco Puoci

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Brisbois, E.J., Handa, H., Meyerhoff, M.E. (2015). Recent Advances in Hemocompatible Polymers for Biomedical Applications. In: Puoci, F. (eds) Advanced Polymers in Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-12478-0_16

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