Slepian M J
University Heart Center, University of Arizona, Tucson, USA.
Semin Interv Cardiol. 1996 Mar;1(1):103-16.
Polymeric endoluminal paving is a process in which biodegradable polymers may be locally applied percutaneously to blood vessels as endoluminal liners, resurfacing or 'paving', the underlying vascular wall. Depending upon the type of polymer selected, endoluminal polymer layers may function as wall supports, barriers, therapeutic biomaterials or depots for local sustained drug delivery. In the original description of the paving process, that is solid paving, structural polymers were utilized. In this article a second form of paving--gel paving is described. In this process, hydrogel polymers are locally applied or polymerized on vascular endoluminal surfaces. Endoluminal hydrogel layers have been demonstrated to function as physical non-pharmacological barriers limiting cell and protein deposition and effectively reducing underlying arterial wall thrombogenicity. Hydrogel paving layers also provide a means for prolonged local arterial wall drug delivery. In this report an update on gel paving is provided. The overall process of polymeric endoluminal paving is initially reviewed. Gel paving and the rationale for this approach is described. Both thermoreversible as well as photopolymerizable PEG-lactide hydrogel paving systems are outlined. Recent experimental studies with gel paving examining polymer application, haemocompatability and endoluminal surface thromboprotection, effects on post-injury neointimal thickening and local drug delivery, are then reviewed. Finally, the role of gel paving in future approaches to vascular therapy is discussed.
聚合物腔内铺衬是一种可将可生物降解聚合物经皮局部应用于血管作为腔内衬里的过程，用于重塑或“铺衬”其下的血管壁。根据所选聚合物的类型，腔内聚合物层可起到血管壁支撑物、屏障、治疗性生物材料或局部持续给药的药物储存库的作用。在最初对铺衬过程（即固体铺衬）的描述中，使用的是结构聚合物。在本文中，描述了铺衬的第二种形式——凝胶铺衬。在此过程中，水凝胶聚合物被局部应用于血管腔内表面或在其上聚合。腔内水凝胶层已被证明可作为物理性非药理学屏障，限制细胞和蛋白质沉积，并有效降低其下动脉壁的血栓形成倾向。水凝胶铺衬层还提供了一种延长局部动脉壁药物递送的方法。在本报告中，提供了关于凝胶铺衬的最新情况。首先回顾了聚合物腔内铺衬的总体过程。描述了凝胶铺衬及其采用该方法的基本原理。概述了热可逆以及可光聚合的聚乙二醇-丙交酯水凝胶铺衬系统。随后回顾了近期关于凝胶铺衬的实验研究，这些研究考察了聚合物应用、血液相容性和腔内表面血栓保护、对损伤后新生内膜增厚的影响以及局部药物递送。最后，讨论了凝胶铺衬在未来血管治疗方法中的作用。
