Study of drug-eluting coating on metal coronary stent

Drug-eluting stent has been proved to decrease the restenosis caused by the stent implantation, owing to the existence of a drug-eluting coating on the stent. For ensuring the effectivity and security of the drug-eluting stent during the service period, the uniform surface, good deformation and stabilized drug release behavior of the stents should be satisfied. In this study, the performances mentioned were studied on stainless steel stents. The results showed that the surface morphology of the coating was affected by the sorts of solvent, the parameters of the spraying process and the addition of the plasticizer. The drug-eluting profile of the coating was influenced by the plasticizer content and PLGA/drug ratio of the coating. Meanwhile, the plasticizer as an additional agent obviously increased the deformation performance of the coating. Optimized parameters for preparation of the drug-eluting coating were investigated to obtain a drug-eluting coating with good integrated performances.     

药物洗脱支架载体材料的选择与优化

对药物洗脱支架药物载体材料和支架涂层进行了综述,指出了药物载体材料的选择范围,提出了药物载体材料的优化原则、药物配合的条件以及药物载体材料的发展方向.     

Three-dimensional compositional analysis of drug eluting stent coatings using cluster secondary ion mass spectrometry

Cluster secondary ion mass spectrometry (cluster SIMS) employing an SF5+ polyatomic primary ion sputter source in conjunction with a Bi3+ analysis source was used to obtain three-dimensional molecular information in polymeric-based drug-eluting stent coatings. The formulations of the coatings varied from 0% to 50% (w/w) sirolimus drug in poly(lactic-co-glycolic acid) and were prepared on both MP35N metal alloy coupons and bare metal stents. All cluster SIMS depth profiles obtained indicated a drug-enriched surface region, followed by a drug-depletion region, and finally a constant bulk composition region, similar to previous data obtained in polymeric blend systems. The drug overlayer thickness was determined to increase with increasing sirolimus content. Sample temperature was determined to play an important role in the resulting depth profiles, where it was shown that the best profiles were obtained at low temperatures (-100 degrees C). At these temperatures, molecular signals typically remained constant through the entire depth of the film (approximately 6.5 microm) in some cases, as opposed to the typical 1 microm-2 microm depth limit, which is achievable at room temperature. The 3-D imaging capabilities of cluster SIMS were successfully demonstrated and indicated a significant amount of subsurface domain formation in the 25% and 50% sirolimus samples, but not in the 5% sample, which was homogeneous. These results clearly illustrate the utility of cluster SIMS for probing the 3-D structure in polymeric-based drug delivery devices.     

管腔内支架表面涂层的研究综述

本文针对介入治疗技术中管腔内支架表面改性的研究进展，评述了无机涂层、有机涂层、药物涂层及其他涂层的制备技术、实验结果与作用机理，并对未来管腔内支架表面涂层的研究趋势作了分析。     

Novel paclitaxel-coated angioplasty balloon catheter based on cetylpyridinium salicylate: Preparation,characterization and simulated use in an in vitro vessel model

Drug-coated balloons (DCB), which have emerged as therapeutic alternative to drug-eluting stents in percutaneous cardiovascular intervention, are well described with regard to clinical efficiency and safety within a number of clinical studies. In vitro studies elucidating the correlation of coating method and composition with DCB performance are however rare but considered important for the understanding of DCB requirements and the improvement of established DCB. In this context, we evaluated the applicability of a pipetting, dip-coating, and spray-coating process for the establishment of DCB based on paclitaxel (PTX) and the ionic liquid cetylpyridinium salicylate (Cetpyrsal) as novel innovative additive in three different compositions. Among tested methods and compositions, the pipetting process with 50 wt.% PTX resulted in most promising coatings as drug load was less controllable by the other processes and higher PTX contents led to considerable drug crystallization, as visualized by electron microscopy, accelerating PTX loss during short-term elution. Applying these conditions, homogeneous coatings could be applied on balloon catheter, whose simulated use in an in vitro vessel model revealed percental drug losses of 36 and 28% during transit and percental drug transfers of 12 and 40% under expansion for coatings applied in expanded and folded balloon condition, respectively. In comparison to literature values, these results support the high potential of Cetpyrsal as novel DCB matrix regarding low drug loss and efficient drug transfer.     

Influence of unsaturated carbonic acids on hemocompatibility and cytotoxicity of poly-vinylacetate based co-polymers

The aim of this study was to investigate hemocompatibility and cytotoxicity properties of synthetic polymer coatings containing various unsaturated carbonic acids with vinylacetate. Co-polymers of vinylacetate and crotonic acid (CA), maleic acid (MA), and itaconic acid (IA) were made. The materials were characterized in terms of their adhesion to metal supports (titanium and stainless steel) as well as hemocompatibility (% hemolysis, wettability, erythrocyte aggregation, hemoglobin content, thrombocyte count and lipid peroxidation levels) and cytotoxicity (human endothelial cell activity in vitro and chromosome aberrations, bone marrow proliferation and cell ploidy in rats). Co-polymers of unsaturated carbonic acids with vinylacetate exhibited good hemocompatibility properties, as opposed to vinylacetate homopolymer for which substantial levels of hemolysis were observed. By coating the metal supports with co-polymers the cytotoxic effects associated with the bare metal samples were markedly reduced. MA samples showed excellent hemocompatibility and no cytotoxicity, yet they lacked good adhesion properties to metal substrate, probably due to high water content. CA samples, having the highest density of carboxylic groups among the samples under investigation, showed increased bone marrow proliferation activity and cell ploidy in rats, as compared to controls. The most promising results in the present study were obtained for the samples with IA, which showed good adhesion to metal substrates, good hemocompatibility and low cytotoxicity. Thus, co-polymers of vinylacetate and IA rich in carboxylic groups are promising materials for the design of novel drug-eluting stents.     

Development of a biodegradable sirolimus-eluting stent coated by ultrasonic atomizing spray

In this study, poly(D,L lactic-co-glycolic acid) (PLGA) was used as a drug carrier to generate two types of stents loaded with different concentrations of sirolimus. These stents were prepared by ultrasonic atomizing spray coating. Ultrasonic atomizing spray nozzle uses a low-pressure air/gas to produce a soft, highly focused beam of small spray drops. An isolated hypotube delivers liquid to the nozzle's atomizing surface while air/gas, delivered through the nozzle orifice at a fixed low pressure, shapes the atomized drops into a very precise, targeted spray. The stent was moved both in the traverse direction and rotated during the spraying process. The morphology of the sirolimus-eluting stents was examined by scanning electron microscopy (SEM) which indicated that the coating was very smooth and uniform. The coating was found to have the ability to withstand the compressive and tensile strains imparted without cracking during the stent inflation process. Release profile of sirolimus was measured by high performance liquid chromatography (HPLC). The release behavior of sirolimus from the stent surface had a two phase release profile with a burst release period of about 2 days, followed by a sustained and slow release phase. The mass loss behavior of PLGA appeared linear throughout most of the degradation period. At 28 days, neointimal formation was found to be significantly decreased for both sirolimus-eluting stents as compared to bare-metal stents (BMS). Assessment of vascular healing revealed an absence of increased inflammation in both sirolimus-eluting stents. Inflammation is commonly observed in drug-eluting stents (DES) with nonbiodegradable polymeric coatings. Taking these results into account, these novel sirolimus-eluting stents may be good candidates to resolve in-stent restenosis.     

Design,Characterization, and 3D Printing of Cardiovascular Stents with Zero Poisson’s Ratio in Longitudinal Deformation

Inherent drawbacks associated with drug-eluting stents have prompted the development of bioresorbable cardiovascular stents. Additive manufacturing (3-dimentional (3D) printing) has been widely applied in medical devices. In this study, we develop a novel screw extrusion-based 3D printing system with a new designed mini-screw extruder to fabricate stents. A stent with a zero Poisson’s ratio (ZPR) structure is designed, and a preliminary monofilament test is conducted to investigate appropriate fabrication parameters. 3D-printed stents with different geometric structures are fabricated and analyzed by observation of the surface morphology. An evaluation of the mechanical properties and a preliminary biological evaluation of 3D-printed stents with different parameters are carried out. In conclusion, the screw extrusion-based 3D printing system shows potential for customizable stent fabrication.     

Improvement of efficacy and decrement cytotoxicity of oxaliplatin anticancer drug using bovine serum albumin nanoparticles: synthesis,characterisation and release behaviour

To sustained release of an anticancer drug, oxaliplatin (OX), a non‐toxic and biocompatible nanocarrier based on bovine serum albumin (BSA) were synthesised by desolvation method and characterised using Fourier‐transform infrared (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM) and dynamic light scattering. The results showed that the BSA nanoparticles (BSANPs) with a mean magnitude of 187.9 ± 1.2 nm have spherical morphology with a smooth surface and a uniform distribution. Furthermore, OX was loaded onto the BSANPs and the loading was confirmed by FTIR, AFM and FESEM techniques. The percentage of encapsulation efficiency and drug loading were determined by absorption spectroscopy (UV–vis). The drug release studies showed that release of OX from BSANPs exhibited slower release rate. However, the release kinetics followed the first‐order kinetic for both of them with the non‐Fickian release behaviour. The electrochemical analysis showed stability of OX loaded onto the BSANPs (OX@BSANPs) and confirmed the diffusion mechanism. Furthermore, the results of MTT assay revealed increasing of normal cell viability and cancer cell death in the OX@BSANPs compared to only OX. It was shown that the BSANPs could be safely used as a biocompatible nanocarrier for the sustained release of OX.Inspec keywords: nanoparticles, drug delivery systems, molecular biophysics, encapsulation, cancer, proteins, drugs, cellular biophysics, light scattering, nanofabrication, atomic force microscopy, biomedical materials, diffusion, toxicology, nanomedicine, field emission scanning electron microscopy, Fourier transform infrared spectra, ultraviolet spectra, visible spectra, surface morphologyOther keywords: cytotoxicity, biocompatible nanocarrier, bovine serum albumin nanoparticles, desolvation method, atomic force microscopy, dynamic light scattering, BSA nanoparticles, FESEM, UV‐visible absorption spectroscopy, drug release rate, nonFickian release behaviour, oxaliplatin anticancer drug, Fourier‐transform infrared spectroscopy, FTIR spectroscopy, spherical morphology, encapsulation efficiency, release kinetics, first‐order kinetics, electrochemical analysis, diffusion mechanism, MTT assay, cell viability, cancer cell death     

Lightweight pozzolanic materials used in mortars: Evaluation of their influence on density,mechanical strength and water absorption

Lightweight aggregates are widely used in renders to obtain low densities and better workability. This type of aggregate requires higher than normal water:cement ratios, especially in renders involving the addition of alkyl celluloses or modified starches. This paper reports the effect of some lightweight materials (expanded perlite, expanded glass, hollow micro-spheres and expanded polystyrene) on density, fluency, sorptivity, water absorption and mechanical strength, all of which play an important role in renders and coatings. The percentages of the lightweight materials are: 0%, 0.58% and 1.74% w/w on the whole composition. The experiments show that mechanical strength, sorptivity and water absorption are affected in different ways, depending on the lightweight material and the dose used. Expanded glass and hollow micro-spheres showed some pozzolanic activity, which was corroborated, by short-term compressive strength tests, in specimens of lime and cement that were tested after seven days. Finally, conductivity tests were carried out using lime suspensions in the presence of such pozzolanic materials.     

Heat denatured/aggregated albumin-based biomaterial: effects of preparation parameters on biodegradability and mechanical properties

Albumin-based biomaterials prepared using heat-aggregation or cross-linking agents have been used in various biomedical applications such as solder materials for laser-assisted tissue welding, anti-bacterial coatings and drug carriers. In this study, solid albumin-based materials were prepared via heat aggregation of albumin solution. The study aimed to determine the influences of the preparation parameters such as albumin concentration in solution, solution pH and temperature, on the mechanical properties as well as the biodegradation rate of heat-aggregated albumin-based materials. The results demonstrated that the materials prepared from the albumin solution with the pH of 8.5 had the highest mechanical strength. Augmenting the albumin concentration in solution led to an increase in mechanical strength, and the materials prepared from the solution with isoelectric albumin pH (pH 4.8) possessed the lowest biodegradation rate and those prepared at pH 12 showed the highest biodegradation rate.     

Controlled drug release using nanoporous anodic aluminum oxide on stent

Local drug delivery system was demonstrated by using drug-eluting stents coated with nanoporous anodic aluminum oxide (AAO) for controlled drug release. 316 stainless steel coronary stents were coated with nanoporous AAO, which was fabricated by anodization of Al deposited on stents. Effects of diameter and depth of AAO on the release of drug were investigated. Image of the AAO pore diameter and depth were examined by SEM. Amount of the drug release from the AAO with various pore diameters and depths was analyzed by HPLC.     

Redox/pH dual stimuli‐responsive ZnO QDs‐gated mesoporous silica nanoparticles as carriers in cancer therapy

New drug delivery system (ZnO@CMS) of the redox and pH dual‐stimuli responsive based on colloidal mesoporous silica nanoparticles (CMS) has been designed, in which zinc oxide quantum dots (ZnO QDs) as a capping agent was conjugated on the surface of nanoparticles by amide bonds. The release behaviour of doxorubicin (DOX) as the model drug from ZnO@CMS (ZnO@CMS‐DOX) indicated the redox and pH dual‐stimuli responsive properties due to the acidic dissolution of ZnO QDs and cleavage of the disulphide bonds. The haemolysis and bovine serum albumin adsorption assays showed that the modification of ZnO QDs on the mesoporous silica nanoparticles modified by mercapto groups (CMS‐SH)(ZnO@CMS) had better biocompatibility compared to CMS‐SH. The cell viability and cellular uptake tests revealed that the ZnO@CMS might achieve the antitumour effect on cancer cells due to the cytotoxicity of ZnO QDs. Therefore, ZnO@CMS might be potential nanocarriers of the drug delivery system in cancer therapy. The in vivo evaluation of ZnO@CMS would be carried out in future work.Inspec keywords: biochemistry, nanomedicine, cellular biophysics, pH, toxicology, tumours, semiconductor quantum dots, proteins, colloids, II‐VI semiconductors, mesoporous materials, silicon compounds, oxidation, cancer, drug delivery systems, zinc compounds, adsorption, molecular biophysics, nanomagnetics, drugs, biomedical materials, nanofabrication, nanoparticles, nanoporous materialsOther keywords: cancer therapy, drug delivery system, amide bonds, haemolysis, bovine serum albumin adsorption assays, mercapto groups, cancer cells, cytotoxicity, antitumour effect, redox/pH dual stimuli‐responsive zinc oxide quantum dots‐gated colloidal mesoporous silica nanoparticles, ZnO, SiO₂      

Effect of a novel peptide,WKYMVm- and sirolimus-coated stent on re-endothelialization and anti-restenosis

The drug-eluting stent still has limitations such as thrombosis and inflammation. These limitations often occur in the absence of endothelialization. This study investigated the effects of WKYMVm- and sirolimus-coated stents on re-endothelialization and anti-restenosis. The WKYMVm peptide, specially synthesized for homing endothelial colony-forming cells, was coated onto a bare-metal stent with hyaluronic acid through a simple dip-coating method (designated HA-Pep). Thereafter, sirolimus was consecutively coated to onto the HA-Pep (designated Pep/SRL). The cellular response to stents by human umbilical-vein endothelial cells and vascular smooth-muscle cells was examined by XTT assay. Stents were implanted into rabbit iliac arteries, isolated 6 weeks post-implantation, and then subjected to histological analysis. The peptide was well attached to the surface of the stents and the sirolimus coating made the surface smooth. The release pattern for sirolimus was similar to that of commercial sirolimus-coated stents (57.2 % within 7 days, with further release for up to 28 days). Endothelial-cell proliferation was enhanced in the HA-Pep group after 7 days of culture (38.2 ± 7.62 %, compared with controls). On the other hand, the proliferation of smooth-muscle cells was inhibited in the Pep/SRL group after 7 days of culture (40.7 ± 6.71 %, compared with controls). In an animal study, the restenosis rates for the Pep/SRL group (13.5 ± 4.50 %) and commercial drug-eluting stents (Xience Prime?; 9.2 ± 7.20 %) were lower than those for bare-metal stents (25.2 ± 4.52 %) and HA-Pep stents (26.9 ± 3.88 %). CD31 staining was incomplete for the bare-metal and Xience Prime? groups. On the other hand, CD31 staining showed a consecutive linear pattern in the HA-Pep and Pep/SRL groups, suggesting that WKYMVm promotes endothelialization. These results indicate that the WKYMVm coating could promote endothelial healing, and consecutive coatings of WKYMVm and sirolimus onto bare-metal stents have a potential role in re-endothelialization and neointimal suppression.     

Multivariate analysis applied to the study of spatial distributions found in drug-eluting stent coatings by confocal Raman microscopy

Multivariate data analysis was applied to confocal Raman measurements on stents coated with the polymers and drug used in the CYPHER Sirolimus-eluting Coronary Stents. Partial least-squares (PLS) regression was used to establish three independent calibration curves for the coating constituents: sirolimus, poly(n-butyl methacrylate) [PBMA], and poly(ethylene-co-vinyl acetate) [PEVA]. The PLS calibrations were based on average spectra generated from each spatial location profiled. The PLS models were tested on six unknown stent samples to assess accuracy and precision. The wt % difference between PLS predictions and laboratory assay values for sirolimus was less than 1 wt % for the composite of the six unknowns, while the polymer models were estimated to be less than 0.5 wt % difference for the combined samples. The linearity and specificity of the three PLS models were also demonstrated with the three PLS models. In contrast to earlier univariate models, the PLS models achieved mass balance with better accuracy. This analysis was extended to evaluate the spatial distribution of the three constituents. Quantitative bitmap images of drug-eluting stent coatings are presented for the first time to assess the local distribution of components.     

Systematic Processing of β‐Tricalcium Phosphate for Efficient Protein Loading and In Vitro Analysis of Antigen Uptake

Microparticulate calcium phosphate (CaP) powders are promising drug carriers because of their biocompatibility and degradability under physiological conditions. The adsorption capability of CaP microparticles makes them interesting candidates, within the inorganic carrier materials, for delivering protein antigens to professional antigen presenting cells (APC) for vaccination purpose. However, in order to bind and deliver a sufficient amount of protein, the challenge is to effectively increase the binding capacity of this material. In this study, β‐tricalcium phosphate (β‐TCP) powder is engineered to obtain microparticles with increased protein loading, using bovine serum albumin as a model antigen. The decrease in particle size and increase in specific surface area of carrier is shown to strongly affect protein adsorption. Finally, we demonstrate that the processed β‐TCP is capable of delivering its protein payload in vitro to dendritic cells, which are professional APCs and the target cell population for microparticulate vaccines.     

Sustained-release pellets prepared by combination of wax matrices and double-layer coatings for extremely water-soluble drugs

This study was performed in order to develop a sustained-release pellet formulation containing venlafaxine hydrochloride (VEN), an extremely water-soluble drug, prepared by combination of wax matrices and double-layer coatings. The influence of both double-layer polymeric coats and wax matrices on the release of VEN from sustained-release pellets was investigated. The pellets were prepared by wet mass extrusion spheronization methods and then coated with a fluidized bed coater. For the pellets coated with Eudragit NE30D alone, a coating level of nearly 40% was required to pass the dissolution test compared with commercial product, and it was accompanied by an unacceptable lag time. The application of an alcohol-soluble polymeric subcoat, Opadry I, was added before the Eudragit NE30D coating process, which resulted in a marked delay in drug release. However, a faster release was observed for the formulation coated with a high subcoat level (10%) at the end of the dissolution test. A further delay in drug release was observed when a wax matrix, octadecanol, was added to the core pellet formulation. The kinetics of drug release changed from the Higuchi model to a zero order model and the predominant mechanism controlling drug release changed from diffusion to dissolution upon increasing the amount of octadecanol within the matrix pellets. In addition, the drug release was markedly influenced by the drug to matrix ratio. In conclusion, the 40% drug-loaded core pellets with double-layer coatings (8% Opadry I and 12% Eudragit NE30D) and 20% octadecanol matrix produced the desired profile for once-daily sustained release compared with the commercial product, and these pellets remained stable during storage.     

Corrosion resistance studies on grain-boundary etched drug-eluting stents

In this paper we compare the influence of different microstructures on the corrosion resistance of new drug-eluting stainless steel stents, which have been produced by grain-boundary-selective electrochemical etching processes. The morphology of the stent surfaces was analysed by scanning electron microscopy (SEM), and the surface composition was investigated with Auger electron spectroscopy (AES) as well as with energy dispersive X-ray analysis (EDX). The passivity of the different microstructured stents was studied by cyclovoltammetry in Ringer solution. Release of nickel and chromium was assessed after potentiostatic experiments in Ringer solution by analysing the collected electrolyte with AAS. For stents produced by different two-step etching procedures bringing about ideal morphologies regarding the mechanical and biological properties of the surface, no significant differences in the passivation behaviour could be observed. A two-step process using first nitric acid and oxalic acid in a second step produces stent surfaces with very good corrosion properties: electrochemical analysis shows that the range of stable passivity is the same as for conventional stent surfaces, and low rates of nickel and chromium release are observed. The etching procedures do not seem to change the surface oxide layer composition.     

In-vitro release of anti-proliferative paclitaxel from novel balloon-expandable polycaprolactone stents

This report investigated the in-vitro release characteristics of paclitaxel from novel balloon-expandable polycaprolactone stents. Polycaprolactone stents were first manufactured by a lab-made micro-injection molding machine. Paclitaxel and polylactide–polyglycolide (PLGA) copolymer were dissolved in acetonitrile and were coated onto the surface of the stents by a spray coating device, which was designed and built especially for this study. An elution method was utilized to characterize the in-vitro release characteristics of paclitaxel. The high performance liquid chromatography (HPLC) analysis showed that biodegradable stents could provide sustained release of paclitaxel for more than 70 days. Various process parameters that controlled the release rate of paclitaxel were studied. The experimental results suggested that the total period of drug release could be prolonged by adopting 75:25 PLGA copolymers, employing multi-layer coatings, and increasing the drug loading. In addition, the effectiveness of eluted paclitaxel on cell behavior was examined. The results showed that the eluted drug could effectively inhibit the proliferation of smooth muscle cells.     

In vitro study of dual drug-eluting stents with locally focused sirolimus and atorvastatin release

Within the context of novel stent designs we developed a dual drug-eluting stent (DDES) with an abluminally focussed release of the potent anti-proliferative drug sirolimus and a luminally focussed release of atorvastatin with stabilizing effect on atherosclerotic deposits and stimulating impact on endothelial function, both from biodegradable poly(l-lactide)-based stent coatings. With this concept we aim at simultaneous inhibition of in-stent restenosis as a result of disproportionally increased smooth muscle cell proliferation and migration as well as thrombosis due to failed or incomplete endothelialisation. The especially adapted spray-coating processes allowed the formation of smooth form-fit polymer coatings at the abluminal and luminal side with 70 % respectively 90 % of the drug/polymer solution being deposited at the intended stent surface. The impacts of tempering, sterilization, and layer composition on drug release are thoroughly discussed making use of a semi-empirical model. While tempering at 80 °C seems to be necessary for the achievement of adequate and sustained drug release, the coating sequence for DDES should be rather abluminal–luminal than luminal–abluminal, as reduction of the amount of sirolimus eluted luminally could then potentially minimize the provocation of endothelial dysfunction. In vitro proliferation and viability assays with smooth muscle and endothelial cells underline the high potential of the developed DDES.