Combination of polycarboxybetaine coating and factor XII inhibitor reduces clot formation while preserving normal tissue coagulation during extracorporeal life support

Naito, Noritsugu; Ukita, Rei; Wilbs, Jonas; Wu, Kan; Lin, Xiaojie; Carleton, Neil; Roberts, Kalliope; Jiang, Shaoyi; Heinis, Christian; Cook, Keith E.

doi:10.1016/j.biomaterials.2021.120778

Cited by 40 publications

(42 citation statements)

References 47 publications

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“…These molecules are able to profoundly block contact activation with no effect on hemostasis initiated by TF exposure. At present, these molecules have been used successfully in preclinical models of extracorporeal life support ( 83 , 84 ), and were associated with excellent thrombosis prevention with minimal bleeding risk (sometimes lower than UFH). In human, FXI ASO were more effective than LMWH to prevent venous thrombosis after total knee arthroplasty with a lower incidence of clinically relevant bleeding ( 85 ).…”

Section: Discussionmentioning

confidence: 99%

Uninterrupted DOACs Approach for Catheter Ablation of Atrial Fibrillation: Do DOACs Levels Matter?

Hardy

Douxfils

Dincq

et al. 2022

Front. Cardiovasc. Med.

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Most patients present for catheter ablation of atrial fibrillation (CAAF) with residual or full effect of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). In daily practice, it has been observed that the activated clotting time (ACT) was actually poorly sensitive to the effect of DOACs and that patients on DOACs required more unfractionated heparin (UFH) to achieve the ACT target of 300 s during the procedure, leading some authors to worry about potential overdosing. Conversely, we hypothesize that these higher doses of UFH are necessary to achieve adequate hemostasis during CAAF regardless of the residual effect of DOACs. During CAAF, thrombosis is promoted mainly by the presence of thrombogenic sheaths and catheters in the bloodstream. Preclinical data suggest that only high doses of DOACs are able to mitigate catheter-induced thrombin generation, whereas low dose UFH already do so. In addition, the effect of UFH seems to be lower in patients on DOACs, compared to patients on VKAs, explaining part of the differences observed in heparin requirements. Clinical studies could not identify increased bleeding risk in patients on DOACs compared to those on VKAs despite similar efficacy during CAAF procedures. Moreover, targeting a lower ACT was associated with an increased periprocedural thrombotic risk for both DOAC and VKA patients. Therefore, the low sensitivity of the ACT to the residual effect of DOACs should not be a major concern in its use in the interventional cardiology laboratory.

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Section: Discussionmentioning

confidence: 99%

Uninterrupted DOACs Approach for Catheter Ablation of Atrial Fibrillation: Do DOACs Levels Matter?

Hardy

Douxfils

Dincq

et al. 2022

Front. Cardiovasc. Med.

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“…Artificial lung thrombogenicity is among one of the key challenges for its prolonged use. Attempts are being made to coat the surface of the membrane with polymeric substances to reduce the clotting, coagulation, and plasma leaks [136][137][138][139]. Surface-generated nitric oxide (NO) is used to reduce the platelet activation and coagulation on fibers.…”

Section: Total Artificial Lungmentioning

confidence: 99%

Bioengineering Progress in Lung Assist Devices

2021

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Artificial lung technology is advancing at a startling rate raising hopes that it would better serve the needs of those requiring respiratory support. Whether to assist the healing of an injured lung, support patients to lung transplantation, or to entirely replace native lung function, safe and effective artificial lungs are sought. After 200 years of bioengineering progress, artificial lungs are closer than ever before to meet this demand which has risen exponentially due to the COVID-19 crisis. In this review, the critical advances in the historical development of artificial lungs are detailed. The current state of affairs regarding extracorporeal membrane oxygenation, intravascular lung assists, pump-less extracorporeal lung assists, total artificial lungs, and microfluidic oxygenators are outlined.

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“…The adhesion of proteins, bacteria, and platelets on blood-contacting biomedical devices is the main reason for thrombosis and infection 8 . Many studies have shown that zwitterionic polymers are ideal candidates to prevent the formation of thrombosis and the occurrence of infection, owing to their superhydrophilic properties via equal amounts of positive and negative charged moieties on the same side chain 9 – 11 . Generally, the formation of zwitterionic polymer brushes on blood-contacting biomedical devices is a promising strategy to resist biofouling.…”

Section: Introductionmentioning

confidence: 99%

Microgel reinforced zwitterionic hydrogel coating for blood-contacting biomedical devices

et al. 2022

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Zwitterionic hydrogels exhibit eminent nonfouling and hemocompatibility. Several key challenges hinder their application as coating materials for blood-contacting biomedical devices, including weak mechanical strength and low adhesion to the substrate. Here, we report a poly(carboxybetaine) microgel reinforced poly(sulfobetaine) (pCBM/pSB) pure zwitterionic hydrogel with excellent mechanical robustness and anti-swelling properties. The pCBM/pSB hydrogel coating was bonded to the PVC substrate via the entanglement network between the pSB and PVC chain. Moreover, the pCBM/pSB hydrogel coating can maintain favorable stability even after 21 d PBS shearing, 0.5 h strong water flushing, 1000 underwater bends, and 100 sandpaper abrasions. Notably, the pCBM/pSB hydrogel coated PVC tubing can not only mitigate the foreign body response but also prevent thrombus formation ex vivo in rats and rabbits blood circulation without anticoagulants. This work provides new insights to guide the design of pure zwitterionic hydrogel coatings for biomedical devices.

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Combination of polycarboxybetaine coating and factor XII inhibitor reduces clot formation while preserving normal tissue coagulation during extracorporeal life support

Cited by 40 publications

References 47 publications

Uninterrupted DOACs Approach for Catheter Ablation of Atrial Fibrillation: Do DOACs Levels Matter?

Uninterrupted DOACs Approach for Catheter Ablation of Atrial Fibrillation: Do DOACs Levels Matter?

Bioengineering Progress in Lung Assist Devices

Microgel reinforced zwitterionic hydrogel coating for blood-contacting biomedical devices

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