Thrombogenicity of hydrophilic and nonhydrophilic microcatheters and guiding catheters.

PURPOSE: To assess in a swine model the in vivo thrombogenicity of various microcatheters and guiding catheters as a function of catheter material, catheter coating, and duration of implantation. METHODS: Microcatheters (Tracker 18 and Fastracker 18, Target Therapeutics, Fremont, Calif; Magic 1.8, Balt, Montmorency, France; and Transit, Cordis Endovascular Systems, Miami Lakes, Fla) were placed through 6F guiding catheters (Fasguide, Target Therapeutics, and Envoy, Cordis Endovascular Systems) into the common carotid arteries of swine for 30 minutes (short term), 90 minutes (medium term), and 35 days (long term). Guiding catheters were implanted for 5 hours. At the end of the implantation periods the catheters were retracted and fixed for scanning electron microscopy. RESULTS: The surface of the Fastracker microcatheter was devoid of debris after both short- and medium-term implantation. The Tracker microcatheter had minimal accumulation of cellular elements whereas the Transit microcatheter showed moderate accumulation of nondeformed red blood cells. Neither the Tracker nor the Transit microcatheter showed evidence of increasing debris accumulation after medium-term implantation as compared with short-term implantation. The Magic microcatheter was coated with gross thrombus after both short- and medium-term implantation. The Fasguide guiding catheter was nearly devoid of debris, while the Envoy guiding catheter had moderate thrombus formation. Long-term implantation of the Fastracker microcatheter was well tolerated whereas that of the Transit catheter resulted in vessel occlusion. CONCLUSIONS: Hydrophilic microcatheters and guiding catheters are less thrombogenic than their nonhydrophilic counterparts, but not all hydrophilic coatings are equally hypothrombogenic. Degree of thrombogenicity depends on catheter material rather than surface morphology. Medium-term implantation did not yield increasing thrombus formation relative to short-term implantation.

Initial experience with collagen-filled Guglielmi detachable coils for endovascular treatment of experimental aneurysms.

PURPOSE: To evaluate the effectiveness of Guglielmi detachable coils (GDCs) filled with collagen threads in the permanent treatment of experimental aneurysms. METHODS: Seventeen side-wall aneurysms were surgically constructed in the canine common carotid artery; six were treated with conventional GDCs and 11 with collagen-filled GDCs. One aneurysms was removed at 1 week, the others were studied by digital subtraction angiography for a period of 8 to 12 weeks. Longitudinal sections of all aneurysms were examined by light microscopy. RESULTS: Angiograms obtained throughout the follow-up period showed no significant difference between aneurysms treated with conventional GDCs and those treated with collagen-filled GDCs. Light microscopy revealed a dense meshwork of newly formed collagen and fibroblasts near the collagen-filled GDCs, whereas a loose cellular meshwork surrounded the conventional GDCs at 8 and 12 weeks after treatment. CONCLUSION: Collagen threads within GDCs do not noticeably improve angiographic treatment of experimental aneurysms; however, these threads did induce local proliferation of fibroblasts and production of collagen within the aneurysmal cavities.

Platelet deposition and fibrinogen binding on surfaces coated with heparin or friction-reducing polymers.

The blood-contacting properties of polyethylene coated with a lubricious hydrophilic coating; an uncoated polyethylene; or a photoheparin-treated polyethylene-negative control sample were compared by measuring fibrinogen adsorption, antifibrinogen binding, and platelet attachment from human plasma. The polyethylene surfaces coated with a hydrophilic polymer were found to be similar to surfaces coated with heparin. Fibrinogen adsorption on the hydrophilic coating was 60% lower than adsorption on either the uncoated or heparin-coated polyethylene samples. Antifibrinogen binding from buffer to the hydrophilic coating was also reduced more than 85% from binding to uncoated polyethylene samples. Both the hydrophilic coating and heparin coating showed a reduction in platelet attachment by a factor of 100 over the uncoated sample as well as significantly reduced platelet activation.

Surface and blood-contacting properties of alkylsiloxane monolayers supported on silicone rubber.

Self-assembled monolayers of alkylsiloxanes supported on polydimethyl siloxane (PDMS) rubber were used as model systems to study the relation between blood compatibility and surface chemistry. The inner lumen of PDMS tubes was first treated with an oxygen plasma. The resultant oxidized surfaces were postderivatized by reacting them with alkyltrichlorosilanes to form the monolayer films. The chemical properties of the monolayers were controlled by varying the head-group chemical compositions. Surface derivatization was verified using variable-angle X-ray photoelectron spectroscopy (XPS or ESCA). Blood compatibility was evaluated using a canine ex vivo arteriovenous series shunt model. Surfaces grafted with hydrophobic head-groups as -CH3 and -CF3 had significantly lower platelet and fibrinogen deposition than the surfaces composed of hydrophilic groups such as -CO2CH3, -(CH2CH2O)3COCH3, and -(OCH2CH2)3OH.

Blood-contacting properties of polydimethylsiloxane polyurea-urethanes.

A series of polyurethanes was synthesized from amino-terminated polydimethylsiloxane oligomers of two molecular weights. The oligomers had been extended with hexane diisocyanate to give internal urea linkages in the soft segment. These polymers have been shown to have higher tensile properties over similar polymers without the internal urea linkages due to the greater phase mixing and interfacial bonding between the hard and soft segment microdomains. The surface properties of these materials were evaluated by dynamic contact angle measurements and the blood compatibility by a canine ex vivo series shunt. The silicone-urea polyurethanes had favourable blood-contacting properties compared to a polyetherurethane. The polymers composed of the higher molecular weight silicone oligomers had the least platelet and fibrinogen deposition.

Platinum coil coatings to increase thrombogenicity: a preliminary study in rabbits.

The authors investigate a modification of the Gugliemi detachable coil. They have developed a rabbit model and coating technique to test differences in thrombogenicity of platinum coils with a variety of polyurethanes.

Effect of hand segment chemistry and strain on the stability of polyurethanes: in vivo biostability.

We investigated four polyurethanes that were synthesized with different hard segments and four commercial polyurethanes for in vivo biostability. The four polyurethanes with the varying hard segments were based on a 3:2:1 mole ratio of methylene diphenylene diisocyanate (MDI) or methylene dicyclohexane diisocyanate (H12MDI), butanediol (BD) or ethylene diamine (ED) and polytetramethylene oxide (PTMO) (MW = 1000). Four commercial polyurethanes were also used: Biomer, Pellethane, Medtronic experimental C-19 (C-19) and Medtronic experimental C-36 (C-36). Films of the polymers were implanted subcutaneously in rats for up to 12 wk to assess their biostability. Polymer films were implanted either with a 100% strain applied or in the unstrained state. Measurement of tensile properties, molecular weight and surface properties before and after implantation assessed the stability of each of the polymers. Surface cracking was observed with scanning electron microscopy and the extent and depth of cracking were determined. Pellethane, C-19 and C-36 showed the least evidence of degradation, although all underwent strain-induced phenomena that decreased their tensile elongation when an external force was applied. After implantation, the BD chain-extended polymers retained their tensile properties better than ED chain-extended polymers. H12MDI-based polyurethanes were more susceptible to surface cracking and molecular weight changes than MDI-based polyurethanes, possibly due to the lack of a crystallizable hard segment.

Thrombus deposition on polyurethanes designed for biomedical applications.

Thrombogenicity was assessed by measuring the amount of 111In-platelets and 125I-fibrinogen deposited on the inner luminal surface of six polyurethanes for up to 60 min of blood contact in a canine ex-vivo shunt model. Commercial and laboratory synthesized polymers were examined. Two of the commercially synthesized polyurethanes (Biostable PURs) do not contain ether linkages in the polymer backbone and have previously shown resistance to oxidative and hydrolytic degradation. Static contact angle measurements, dynamic contact angle measurements, and ESCA were used to characterize the surfaces of these polyurethanes. The effectiveness of an acetone extraction used to remove extrusion waxes from Pellethane 2363-80A was similarly studied. Both Pellethane 2363-80A and the ether-free materials had relatively nonthrombogenic surfaces, as indicated by low platelet and fibrinogen deposition, making them potentially good candidates for biomedical applications.

Effect of soft segment chemistry on the biostability of segmented polyurethanes. II. In vitro hydrolytic degradation and lipid sorption.

A series of segmented polyurethanes (SPUs) with various polyol soft segments was prepared and their hydrolytic degradation and degradation due to lipid sorption was investigated. The hydrolytic degradation of the SPUs was investigated in a papain solution, where it was shown that the SPU based on poly(ethyleneoxide) (PEO) soft segment was susceptible to hydrolytic degradation. X-ray photoelectron spectroscopic (XPS) data suggest dissociation of the urethane linkage by enzymatic degradation. Degradation by lipid sorption was observed for the SPU based on a poly(dimethylsiloxane) (PDMS) soft segment. This is ascribed to the high solubility of lipid in the PDMS segment of the SPU.

Biostability and blood-contacting properties of sulfonate grafted polyurethane and Biomer.

Sulfonate-containing polyurethanes were evaluated for in vivo biodegradation using subcutaneously implanted tensile bars. In addition, these anionically charged polyurethanes were evaluated for in vivo activation of human complement C3a and ex vivo platelet deposition in arteriovenously-shunted canines. The sulfonate derivatized polymers included laboratory synthesized polyurethane and Biomer. Other polymers used for references included Intramedic polyethylene, Silastic and a poly(ethylene oxide) based polyurethane. The biodegradation results indicated that Biomer and the laboratory sulfonated Biomer (both manufactured with stabilizers), remained mechanically stable, retaining both tensile strength and elasticity after 4 weeks of subcutaneous implantation. The unstabilized polyurethanes (with or without sulfonation), however, showed marked cracking and a loss of mechanical properties after the same period of subcutaneous implantation. Sulfonated polyurethanes depressed human complement C3a activation in plasma, as indicated by decreased levels of anaphylatoxin production. The results of canine ex vivo blood contacting experiments were conducted in both an acute and chronic model and demonstrated decreased platelet deposition and activation for the sulfonated polyurethanes.

Effect of soft segment chemistry on the biostability of segmented polyurethanes. I. In vitro oxidation.

A series of segmented polyurethanes (SPUs) containing various polyol soft segments was prepared and their resistance to oxidative degradation was investigated after aging in AgNO3 solution. The SPU with the polyether soft segment showed a large reduction in mechanical strength after exposure to the oxidative environment. Surface cracking was often observed for these specimens. XPS measurements revealed that scission of the ether linkage occurs upon oxidation. The oxidative resistance of SPUs containing aliphatic hydrocarbon soft segments was significantly improved over the poly(tetramethylene oxide) (PTMO) based polyurethane.