Hydrophilic Polymer Embolism: An Update for Physicians

Mehta, Rashi I.; Mehta, Rupal I.

doi:10.1016/j.amjmed.2017.01.032

Cited by 41 publications

(54 citation statements)

References 18 publications

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“…Hydrophilic polymer is a type of synthetic material used as the coating on vascular devices such as stents, sheaths and guide wires 15 . Hydrophilic polymer has unique properties that improve biocompatibility while reducing friction between vessel walls and devices 15,16 . However, in more recent years, hydrophilic polymer emboli have been identified as a potentially fatal iatrogenic complication 16 .…”

Section: Discussionmentioning

confidence: 99%

Factor V Leiden and superior mesenteric artery occlusion: A case study

Atayde¹

2020

Journal of Perioperative Nursing

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Factor V Leiden (FVL) is an inherited condition that prolongs the clotting process; this subsequently places individuals at a higher risk of developing a thromboembolism 1. This case study will discuss a 41-year-old female who developed a superior mesenteric artery occlusion with subsequent small bowel ischaemia on a background of FVL. The discussion will illustrate the rarity of an arterial occlusion, the risk factors that are associated with an ischaemic small bowel, the implications of inheriting FVL and some of the associated social aspects of an ileostomy.

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Section: Discussionmentioning

confidence: 99%

Factor V Leiden and superior mesenteric artery occlusion: A case study

Atayde¹

2020

Journal of Perioperative Nursing

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“…Similarly, a lack of adequate substrate coverage of an anti-biofouling coating on a medical device or ship hull could enable organisms to exploit coating defects and attach to the substrate, potentiating problems such as infection or increased drag, respectively. Likewise, delamination of a polymer coating on an intravascular implant could pose risk for lethal thrombosis or embolism 27 .…”

Section: Discussionmentioning

confidence: 99%

Using nonthermal plasma treatment to improve quality and durability of hydrophilic coatings on hydrophobic polymer surfaces

Learn

Lai

Recum

2019

Preprint

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Low surface energy substrates, which include many polymers in medicine/industry, present challenges toward achieving uniform, adherent, durable coatings, thus limiting intended coating function. Examples include hydrophobic polymers such as polypropylene, polyethylene, polytetrafluoroethylene, and polydimethylsiloxane. These inert materials are used in various biomedical implants due to favorable bulk properties despite perhaps unfavorable surface properties. The capability to coat such materials holds great value as the surface heavily influences biological response and implant function in vivo. Likewise, paint/ink coatings are often necessary on these same plastics, as their final appearance can be critical for automotive, packaging, and consumer products. Substrate exposure to nonthermal plasma was explored here as a means to improve quality of coatings, specifically cyclodextrin-based polyurethanes previously explored for biomedical applications such as controlled drug delivery and antibiofouling, upon otherwise incompatible polypropylene substrates. Plasma treatment was found to increase wettability and oxygen content on substrate surfaces. These plasma-induced surface alterations were associated with enhanced coating uniformity, and improved coating/substrate adherencedetermined to derive partly from interfacial covalent bond formation. Findings demonstrate the utility of plasma-based surface activation as a strategy to improve coating quality on polymeric substrates, and reveal insights regarding mechanisms by which plasma improves polymer coating adherence.2 reduction of non-specific protein adsorption or bacterial attachment, sustained drug release, enhancement of attachment of certain host cells, and prevention of corrosion.A large number of biomedical implants are composed of polymers that possess low surface energy. Such polymeric materials include: 1) polypropylene (PP), present in surgical meshes and sutures, 2) polyethylene (PE), found in total joint replacements, 3) polydimethylsiloxane (PDMS), utilized in plastic surgery, and 4) polytetrafluoroethylene (PTFE), used for catheters and arterial grafts. The low surface energy of these materials is disadvantageous for several reasons: (i) it promotes adsorption and denaturation of proteins on the bare surface, along with subsequent inflammatory responses, as it is favorable for proteins to displace water at the hydrophobic surface and change conformation to allow core nonpolar amino acids to associate with the material 1 , and (ii) it decreases the receptiveness of these materials toward coatings 2 , which could otherwise allow for improved host response and device function. In general, the surface energy of a substrate should exceed that of a coating to achieve reasonable spreading and adhesion. If not, coatings applied to low surface energy substrates suffer from lack of uniformity, adherence, and durability, limiting the intended function of the coating over the lifetime of the implant.An attractive solution to promote uniformity and adherence of c...

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“…Most major brands now offer "hydrogelcoated" catheters, with brand names such as Biocath and Lubri-sil (Bard), Flocath (Teleflex), Serpia (Braun), Convey and HydroPlus (Boston Scientific), and HydroPicc (Access Vascular). [41][42][43] Despite showing clinical performance and being adopted by healthcare professionals, there are concerns about adverse effects stemming from coating failure and delamination, since these grafted coatings are usually tens of nanometers thick. [41,42] The evidence led the FDA to issue a safety communication in 2015 and a labeling guidance in 2019 to address these complications.…”

mentioning

confidence: 99%

“…[41][42][43] Despite showing clinical performance and being adopted by healthcare professionals, there are concerns about adverse effects stemming from coating failure and delamination, since these grafted coatings are usually tens of nanometers thick. [41,42] The evidence led the FDA to issue a safety communication in 2015 and a labeling guidance in 2019 to address these complications. [44,45] Based on the current clinical data and published literature it is evident that the development of a thrombosis-resistant and bacteria-repellent surface would be a major advancement in the ever growing field of cardiovascular and critical care devices.…”

mentioning

confidence: 99%

Ultrathin and Robust Hydrogel Coatings on Cardiovascular Medical Devices to Mitigate Thromboembolic and Infectious Complications

Parada

Riley

et al. 2020

Adv Healthcare Materials

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Thromboembolic and infectious complications stemming from the use of cardiovascular medical devices are still common and result in significant morbidity and mortality. There is no strategy to date that effectively addresses both challenges at the same time. Various surface modification strategies (e.g., silver, heparin, and liquid-impregnated surfaces) are proposed yet each has several limitations and shortcomings. Here, it is shown that the incorporation of an ultrathin and mechanically robust hydrogel layer reduces bacterial adhesion to medical-grade tubing by 95%. It is additionally demonstrated, through a combination of in vitro and in vivo tests, that the hydrogel layer significantly reduces the formation and adhesion of blood clots to the tubing without affecting the blood's intrinsic clotting ability. The adhesion of clots to the tubing walls is reduced by over 90% (in vitro model), which results in an ≈60% increase in the device occlusion time (time before closure due to clot formation) in an in vivo porcine model. The advantageous properties of this passive coating make it a promising surface material candidate for medical devices interfacing with blood. Cardiovascular devices such as intravascular (IV) catheters are essential for the diagnosis and treatment of many acute and chronic

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Hydrophilic Polymer Embolism: An Update for Physicians

Cited by 41 publications

References 18 publications

Factor V Leiden and superior mesenteric artery occlusion: A case study

Factor V Leiden and superior mesenteric artery occlusion: A case study

Using nonthermal plasma treatment to improve quality and durability of hydrophilic coatings on hydrophobic polymer surfaces

Ultrathin and Robust Hydrogel Coatings on Cardiovascular Medical Devices to Mitigate Thromboembolic and Infectious Complications

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