San Valentin Erin Marie, Damasco Jossana A, Bernardino Marvin, Court Karem A, Godin Biana, Canlas Gino Martin, Melancon Adam, Chintalapani Gouthami, Jacobsen Megan C, Norton William, Layman Rick R, Fowlkes Natalie, Chen Stephen R, Huang Steven Y, Melancon Marites P
bioRxiv. 2023 Feb 6:2023.02.06.527049. doi: 10.1101/2023.02.06.527049.
The use of absorbable inferior vena cava filters (IVCFs) constructed with poly-p-dioxanone (PPDO) eliminates risks and complications associated with the use of retrievable metallic filters. Radiopacity of radiolucent PPDO IVCFs can be improved with the incorporation of nanoparticles (NPs) made of high-atomic number materials such as gold and bismuth. In this study, we focused on incorporating tungsten NPs (WNPs), along with polyhydroxybutyrate (PHB), polycaprolactone (PCL), and polyvinylpyrrolidone (PVP) polymers to increase the surface adsorption of the WNPs. We compared the imaging properties of WNPs with single-polymer PHB (W-P) and WNPs with polymer blends consisting of PHB, PCL, and PVP (W-PB). Our analyses using PPDO sutures showed enhanced radiopacity with either W-P or W-PB coating, without compromising the inherent physico-mechanical properties of the PPDO sutures. We observed a more sustained release of WNPs from W-PB-coated sutures than W-P-coated sutures. We successfully deployed W-P- and W-PB-coated IVCFs into the inferior vena cava of pig models, with monitoring by fluoroscopy. At the time of deployment, W-PB-coated IVCFs showed a 2-fold increase in radiopacity compared to W-P-coated IVCFs. Longitudinal monitoring of IVCFs over a 12-week period showed a drastic decrease in radiopacity at week 3 for both filters. Results of this study highlight the utility of NPs and polymers for enhancing radiopacity of medical devices; however, different methods of incorporating NPs and polymers can still be explored to improve the efficacy, safety, and quality of absorbable IVCFs.
使用由聚对二氧环己酮（PPDO）制成的可吸收下腔静脉滤器（IVCF）可消除与使用可回收金属滤器相关的风险和并发症。通过掺入由高原子序数材料（如金和铋）制成的纳米颗粒（NP），可提高放射性不透明PPDO IVCF的射线不透性。在本研究中，我们专注于掺入钨纳米颗粒（WNP），以及聚羟基丁酸酯（PHB）、聚己内酯（PCL）和聚乙烯吡咯烷酮（PVP）聚合物，以增加WNP的表面吸附。我们比较了WNP与单聚合物PHB（W-P）以及WNP与由PHB、PCL和PVP组成的聚合物共混物（W-PB）的成像特性。我们使用PPDO缝线进行的分析表明，W-P或W-PB涂层均可提高射线不透性，且不影响PPDO缝线的固有物理机械性能。我们观察到，与W-P涂层缝线相比，W-PB涂层缝线释放WNP的过程更持久。我们成功地将W-P和W-PB涂层的IVCF植入猪模型的下腔静脉，并通过荧光透视进行监测。在植入时，W-PB涂层的IVCF与W-P涂层的IVCF相比，射线不透性增加了两倍。在12周内对IVCF进行纵向监测发现，两种滤器在第3周时射线不透性均急剧下降。本研究结果突出了纳米颗粒和聚合物在增强医疗器械射线不透性方面的效用；然而，仍可探索不同的掺入纳米颗粒和聚合物的方法，以提高可吸收IVCF的疗效、安全性和质量。
