Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Louisville, Louisville, KY, USA.
J Thorac Cardiovasc Surg. 2011 Oct;142(4):921-5. doi: 10.1016/j.jtcvs.2011.01.012. Epub 2011 Feb 16.
Platelet adhesion and activation are a significant source of clinical complications. Preventing foreign surface-platelet interaction may improve biocompatibility of implantable medical devices. This study evaluated efficacy of novel technique for electrically modifying surface of conductive biomaterial and attaching blood components to prevent thrombogenesis. Specifically, this new surface modification technology, Forcefield (ATS Medical, Inc, Minneapolis, Minn), was designed to prevent platelet adhesion on pyrolytic carbon. A modulated low-voltage current is directly applied to pyrolytic carbon surfaces to stimulate adherence of a layer of charged proteins from circulating blood components that is resistive to platelet deposition.
Feasibility of Forcefield technology was tested in line with cardiopulmonary bypass circuit in patients undergoing standard cardiac surgery (n = 6). Forcefield treatment was applied to segment of pyrolytic carbon with 15 minutes (n = 3) and 30 minutes (n = 3) of electrically stimulated exposure time, and resulting segments were compared with untreated pyrolytic carbon segment. Platelet adhesion confluence was then quantified by scanning electron microscopy.
Confluence of the Forcefield-treated pyrolytic carbon segments (3.3% ± 2.2%) was significantly reduced relative to untreated pyrolytic carbon control segments (81.7% ± 24%, P < .001). There were no discernible differences in cell confluence with Forcefield-treated segments as function of exposure time (15 or 30 minutes).
Forcefield technology may enable modification of pyrolytic carbon surfaces to prevent platelet adhesion and thrombogenesis of implanted medical devices, including heart valves, stents, catheters, and ventricular assist devices, and may eliminate the need for anticoagulant and antiplatelet therapies.
血小板黏附和激活是临床并发症的重要来源。防止外来表面与血小板相互作用可能会提高植入式医疗器械的生物相容性。本研究评估了一种新型技术,即通过电修饰导电生物材料表面并附着血液成分来预防血栓形成的效果。具体来说,这种新的表面改性技术 Forcefield(ATS Medical,Inc,明尼苏达州明尼阿波利斯)旨在防止血小板黏附在热解碳上。调制的低电压电流直接施加到热解碳表面,以刺激来自循环血液成分的带电荷蛋白质层的黏附,该蛋白质层抵抗血小板沉积。
根据接受标准心脏手术的患者的体外循环回路(n = 6)对 Forcefield 技术的可行性进行了测试。将 Forcefield 处理应用于热解碳的一段,暴露时间分别为 15 分钟(n = 3)和 30 分钟(n = 3),并将处理后的段与未经处理的热解碳段进行比较。然后通过扫描电子显微镜定量血小板黏附融合度。
经 Forcefield 处理的热解碳段的融合度(3.3% ± 2.2%)明显低于未经处理的热解碳对照段(81.7% ± 24%,P <.001)。随着暴露时间(15 或 30 分钟)的增加,Forcefield 处理段的细胞融合度没有明显差异。
Forcefield 技术可能使热解碳表面改性以防止血小板黏附和植入式医疗器械的血栓形成成为可能,包括心脏瓣膜、支架、导管和心室辅助装置,并且可能消除对抗凝和抗血小板治疗的需求。