Kannojiya Vikas, Almasy Sara E, Monclova Jose L, Contreras Jerry, Costanzo Francesco, Manning Keefe B
Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, United States.
Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, United States.
Front Bioeng Biotechnol. 2024 Aug 14;12:1438359. doi: 10.3389/fbioe.2024.1438359. eCollection 2024.
Thrombus formation in blood-contacting medical devices is a major concern in the medical device industry, limiting the clinical efficacy of these devices. Further, a locally formed clot within the device has the potential to detach from the surface, posing a risk of embolization. Clot embolization from blood-contacting cardiovascular devices can result in serious complications like acute ischemic stroke and myocardial infarction. Therefore, clot embolization associated with device-induced thrombosis can be life-threatening and requires an enhanced fundamental understanding of embolization characteristics to come up with advanced intervention strategies. Therefore, this work aims to investigate the adhesive characteristics of blood clots on common biocompatible materials used in various cardiovascular devices. This study focuses on characterizing the adhesion strength of blood clots on materials such as polytetrafluoroethylene (PTFE), polyurethane (PU), polyether ether ketone (PEEK), nitinol, and titanium, frequently used in medical devices. In addition, the effect of incubation time on clot adhesion is explored. Results from this work demonstrated strongest clot adhesion to titanium with 3 h of incubation resulting in 1.06 ± 0.20 kPa detachment stresses. The clot adhesion strength on titanium was 51.5% higher than PEEK, 35.9% higher than PTFE, 63.1% higher than PU, and 35.4% higher than nitinol. Further, adhesion strength increases with incubation time for all materials. The percentage increase in detachment stress over incubation time (ranging from 30 min to 3 h) for polymers ranged from at least 108.75% (PEEK), 140.74% (PU), to 151.61% (PTFE). Whereas, for metallic surfaces, the percentage rise ranged from 70.21% (nitinol) to 89.28% (titanium). Confocal fluorescence imaging of clot remnants on the material surfaces revealed a well-bounded platelet-fibrin network at the residual region, representing a comparatively higher adhesive region than the non-residual zone of the surface.
血液接触型医疗器械中的血栓形成是医疗器械行业的一个主要问题，限制了这些器械的临床疗效。此外，器械内局部形成的凝块有可能从表面脱落，带来栓塞风险。血液接触型心血管器械的凝块栓塞可导致急性缺血性中风和心肌梗死等严重并发症。因此，与器械诱导血栓形成相关的凝块栓塞可能危及生命，需要对栓塞特征有更深入的基本了解，以提出先进的干预策略。因此，本研究旨在探究血凝块在各种心血管器械常用的生物相容性材料上的黏附特性。本研究重点表征血凝块在聚四氟乙烯（PTFE）、聚氨酯（PU）、聚醚醚酮（PEEK）、镍钛诺和钛等常用于医疗器械的材料上的黏附强度。此外，还探讨了孵育时间对凝块黏附的影响。本研究结果表明，血凝块对钛的黏附力最强，孵育3小时导致的剥离应力为1.06±0.20kPa。血凝块在钛上的黏附强度比PEEK高51.5%，比PTFE高35.9%，比PU高63.1%，比镍钛诺高35.4%。此外，所有材料的黏附强度均随孵育时间增加。聚合物在孵育时间（30分钟至3小时）内剥离应力的增加百分比范围从至少108.75%（PEEK）、140.74%（PU）到151.61%（PTFE）。而对于金属表面，增加百分比范围从70.21%（镍钛诺）到89.28%（钛）。材料表面凝块残余物的共聚焦荧光成像显示残余区域有界限分明的血小板 - 纤维蛋白网络，代表了比表面非残余区域黏附性相对更高的区域。
