Titanium Dioxide Covalently Immobilized Citric Acid (TiO₂‐CA) Nanohybrid Coating of Neurovascular Flow Diverter to Improve Antithrombogenic and Pro‐Endothelialization Properties

Abstract

FDs can also treat aneurysms that had been previously intractable or untreatable. The mechanics lie in FDs being able to alter the direction of blood flow in the aneurysm's parent vessel to reduce the blood flow velocity inside it to favor thrombosis and therefore accomplish embolization. [2] It also serves to boost reendothelialization, remodel the vascular wall, and exclude aneurysms from circulation eventually. [3] To date, numerous studies have confirmed the efficacy and safety of FDs. [4] Although FDs are still in their infancy, there have already been several products available on the market, namely Pipeline (Medtronic, USA), p48 and p64flow modulation devices (Phenox, Germany), FRED (MicroVention, USA), Derivo (Acandis, Germany), Silk (Balt Extrusion, France), and Surpass/Streamline (Stryker, USA), and there will be more. [4b] The FDs currently used, however, are not without problems. The biggest problem is that they will trigger plasma protein adhesion and activate coagulation cascade reactions once they are placed into the target blood vessel, which leads readily to thrombosis. [3] Thus, dual antiplatelet therapy (DAPT), such as aspirin and clopidogrel, is mandatory for patients to avoid