Is there an alternative to systemic anticoagulation, as related to interventional biomedical devices?
To reduce the toxic effects, related clinical problems and complications such as bleeding disorders associated with systemic anticoagulation, it has been hypothesized that by coating the surfaces of medical devices, such as stents, bypass grafts, extracorporeal circuits, guide wires and catheters, there will be a significant reduction in the requirement for systemic anticoagulation or, ideally, it will no longer be necessary. However, current coating processes, even covalent ones, still result in leaching followed by reduced functionality. Alternative anticoagulants and related antiplatelet agents have been used for improvement in terms of reduced restenosis, intimal hyperphasia and device failure. This review focuses on existing heparinization processes, their application in clinical devices and the updated list of alternatives to heparinization in order to obtain a broad overview, it then highlights, in particular, the future possibilities of using heparin and related moieties to tissue engineer scaffolds.
Conn
Gemma
G
Biomaterials & Tissue Engineering Centre, Academic Division of Surgical and Interventional Sciences, University College London, Rowland Hill Street, Hampstead, London NW3 2PF, UK.
Kidane
Asmeret G
AG
Punshon
Geoffrey
G
Kannan
Ruben Y
RY
Hamilton
George
G
Seifalian
Alexander M
AM
D000925:Anticoagulants / Q000008:administration & dosage*; D001698:Biomedical Engineering / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage; D016503:Drug Delivery Systems / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors