A New Non-Thrombogenic Surface Prepared by Selective Covalent Binding of Heparin Via a Modified Reducing Terminal Residue

Larm, Olle; Larsson, Rolf; Olsson, Per

doi:10.3109/10731198309118804

Cited by 387 publications

(195 citation statements)

References 8 publications

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“…Covalent heparin bonding was performed by IRD Biomaterial AB (Bromma, Sweden) as described by Larm et al 12 This method includes several different steps, some performed at a temperature of 50 ° C, and results in a stabilized heparin layer with (theoretically) more active groups than are available after conventional covalent bonding. These grafts were also rinsed with 3000 mi saline solution immediately before insertion.…”

Section: Graft Materialsmentioning

confidence: 99%

In vivo evaluation of the acute thrombogenicity of the modified human umbilical vein and autologous artery

Björck

Bergqvist

Dougan

et al. 1985

Journal of Vascular Surgery

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With the aim to evaluate acute thrombogenicity, segments of human umbilical vein grafts (Dardik Biograft, Meadox Medicals, Inc., Oakland, N.I.), nonheparinized, heparin-alcohol-treated, or covalently heparinized, were implanted into the carotid arteries of sheep. Autologous carotid arteries were used as control grafts. Flow was restricted to 25 ml/ min. Accumulation of autologous a2P-labeled platelets was registered at both anastomotic and midgraft regions for 240 minutes. At the end of the perfusion period, grafts were removed, opened longitudinally, and the thrombus-free surface (TFS) and thrombus weight determined. The ex vivo determinations showed good correlation with results obtained with in vivo registration. In vivo accumulation of platelets was significantly larger in nonheparinized human umbilical vein grafts compared with heparin-alcohol treated grafts. Covalently heparinized grafts showed a tendency toward lower radioactive values, but visual examination after perfusion revealed areas of "intimal" damage with thrombotic deposits, probably caused by heparinization procedure. Autologous arteries showed the largest TFS and the smallest thrombi, Platelet accumulation in autologous arteries decreased almost to reference values after an initial rapid increase. In conclusion, heparin-alcohol treatment of human umbilical vein grafts reduces acute thrombogenicity. Although covalent heparin bonding seems to act in the same way, the fragility of the graft appears to preclude use of this method. Autologous arteries exhibit excellent antithrombotic characteristics. (J VASe SURG 1985; 2:434-42.)The autologous vein is considered the best available graft for use in small-diameter artery bypass surgery) When not available, human umbilical vein grafts and expanded polytetrafluoroethylene (PTFE) grafts appear to be the best alternatives. 2-4 In a recent randomized clinical trial, human umbilical vein grafts performed significantly better than PTFE grafts in fcmoropopliteal bypass surgery. SThe procedure for irrigating human umbilical vein grafts immediately prior to implantation includes flushing with heparin, and it has been demonstrated in an experimental canine model that hcparin treatment of the graft surface decreased the acute thrombogenicity of the graft, particularly if the luminal surface was incubated with ethyl alcohol after exposure to heparin. 6 It thus seems advisable to stabilize the hcparin layer. In a similar experimental

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Section: Graft Materialsmentioning

confidence: 99%

In vivo evaluation of the acute thrombogenicity of the modified human umbilical vein and autologous artery

Björck

Bergqvist

Dougan

et al. 1985

Journal of Vascular Surgery

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“…The most successful approach to date has been to chemically immobilize heparin on blood-contacting surfaces to reduce thrombosis and lower anticoagulant administration 9,10 . Although this approach has been widely adopted, major limitations persist because the surface-bound heparin leaches, resulting in a progressive loss of anticoagulation activity 4,11 and the use of heparin-coated materials has not led to a drastic reduction in the clinical use of soluble heparin 12 .…”

Section: ____________________________________________________________mentioning

confidence: 99%

A bioinspired omniphobic surface coating on medical devices prevents thrombosis and biofouling

et al. 2014

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________________________________________________________________Countless lives have been saved by implantable medical devices (e.g., total artificial hearts, ventricular assist devices, pacemakers, cardioverterdefibrillators, and central lines) and extracorporeal devices that flow whole human blood outside the body through indwelling catheters and external circuits, during cardiopulmonary bypass (CPB), hemodialysis, and extracorporeal membrane oxygenation (ECMO) 1,2 . However, the need to co-administer soluble anticoagulant drugs, such as heparin, with many of these procedures, significantly reduces their safety and hampers their effectiveness 3,4 . Without systemic anticoagulation, these extracorporeal and indwelling devices can rapidly occlude due to thrombosis because clots form when fibrin and platelets in the flowing blood adhere to the surfaces of these artificial materials 5 . Unfortunately, heparin causes significant morbidity and mortality including post-operative bleeding, thrombocytopenia, hypertriglyceridemia, hyperkalemia and hypersensitivity 6 , and its use is contraindicated in several patient populations 7 . In fact, the majority of drug-related deaths from adverse clinical events in the UnitedStates are due to systemic anticoagulation 8 .This need to prevent blood clotting while minimizing administration of anticoagulant drugs has led to the search for biomaterial surface coatings that can directly suppress blood clot formation. The most successful approach to date has been to chemically immobilize heparin on blood-contacting surfaces to reduce thrombosis and lower anticoagulant administration 9,10 . Although this approach has been widely adopted, major limitations persist because the surface-bound heparin leaches, resulting in a progressive loss of anticoagulation 24,25 . Importantly, the TP continues to retain the free LP as a thin mobile liquid layer even when the surface is challenged with a flowing immiscible fluid, such as blood (Fig. 1a). We refer to this unique anti-thrombogenic bilayer composed of the TP and LP coating as a Tethered-Liquid Perfluorocarbon (TLP) surface. RESULTS A generic blood repellent surface coatingTo test the anti-adhesive properties of the TLP coating method, we examined surface adhesion of fresh whole human blood on an acrylic surface sloped at an angle of 30 degrees, with or without a TLP coating composed of tethered perfluorohexane and liquid perfluorodecalin. Blood droplets immediately adhered to the control uncoated acrylic surface and left a trail of blood components over the course of 5 sec (Fig. 1b, top, Supplementary Fig. 1 and Supplementary Movie 1).In contrast, when the same surface was coated with TLP, the blood droplet almost immediately slid off the surface (< 0.3 sec), and remarkably, there was no evidence of any residual blood trail (Fig. 1b, Supplementary Fig. 1 and Supplementary Movie 2). We quantified blood adhesion to surfaces by measuring the minimum angle required to cause a droplet to slide ("sliding angle") ( Fig. 1c). Control uncoated s...

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“…10) To further improve the clinical results of coronary stenting, attention was directed to coating the stent with material that would reduce their inherent thrombogenicity and decrease the incidence of in-stent restenosis. 2,4,5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Most coatings tested are placed mainly to provide a biologically inert barrier between the stent surface and the circulating blood. In contrast to these, immobilized-heparin surface coatings have been studied as means of providing a biologically active exterior that interacts with the circulating blood.…”

Section: Discussionmentioning

confidence: 99%

<b>Comparison of Initial Efficacy and Long-term Follow-up of Heparin-coated Jostent With Conventional NIR Stent</b>

et al. 2003

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SUMMARYThe implantation of heparin-coated stents was reported to be well tolerated, but there are conflicting results about acute in-hospital complications, (sub)acute thrombosis rates, and long-term follow-up compared to uncoated stents. We compared the angiographic and clinical results after coronary placement of two stent models: the heparin-coated premounted Jostent and the uncoated premounted NIR stent. Of 710 patients revascularized, a total of 426 patients received Jostent (n = 230) or NIR stent (n = 196) implantation. The primary end points were acute or subacute thrombosis, urgent CABG, AMI or death, while the secondary end points were the comparison of the restenosis rates of the stents at the 6 th month and of the functional angina classification of the stent groups at the 1 st , 6 th and 12 th months. There were no significant differences between the Jostent and NIR stent groups regarding angiographic and procedural success. Acute thrombosis rates in the Jostent and NIR stent groups were similar while no subacute thrombosis was observed in either group. The major adverse cardiac event rates of the groups also did not differ. Angiographic restenosis occurred in 17% of the Jostent group and 16% of the NIR stent group (NS). The combined clinical and angiographic restenosis rate was also similar between the Jo and NIR groups (19% and 18%, respectively). Comparison of functional angina classes at the 1 st , 6 th and 12 th months revealed no significant difference between the study groups.In conclusion, when compared with implantation of an uncoated premounted NIR stent, implantation of a heparin-coated premounted Jostent does not provide any more benefit with respect to initial efficacy, sub(acute) thrombosis and 6-month restenosis rates and 12-month clinical outcomes. (Jpn Heart J 2003; 44: 889-898)

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A New Non-Thrombogenic Surface Prepared by Selective Covalent Binding of Heparin Via a Modified Reducing Terminal Residue

Cited by 387 publications

References 8 publications

In vivo evaluation of the acute thrombogenicity of the modified human umbilical vein and autologous artery

In vivo evaluation of the acute thrombogenicity of the modified human umbilical vein and autologous artery

A bioinspired omniphobic surface coating on medical devices prevents thrombosis and biofouling

<b>Comparison of Initial Efficacy and Long-term Follow-up of Heparin-coated Jostent With Conventional NIR Stent</b>

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