Introduction: The currently available flow diverting stents (FDS) to treat intracranial aneurysms (IAs) all require the patient to remain on at least one antiplatelet drug to prevent thromboembolic complications in the postoperative period. Antiplatelet use in this population of patients can be dangerous. For this reason, there has been a significant push in the field to modify the surfaces of FDS to develop thromboresistance and eliminate the need for postoperative antiplatelet administration. There are currently four FDS with surface modifications to inhibit thrombosis. In the United States, none have been widely adopted as efficacy has not been demonstrated. We suspect that the continued thromboembolic complications that have been observed with the currently available surface modifications is that many of these physiological coatings (e.g. cell membrane components and fibrin) are not effective or minimally effective. Based on previous successful applications of a carboxybetaine copolymer we propose this polymer to protect against adsorption of thrombosis-activating proteins and inhibit adhesion of platelets and monocytes. . This coating is robust, durable, and easy to manufacture.
Methods: The stability and uniformity of the carboxybetaine copolymer coating on the FDS was assessed using scanning electron microscopy, x-ray photoelectron spectroscopy and time-of-flight secondary ion mass spectrometry.
Results: The carboxybetaine copolymer coating was present along the surface of the FDS and had demonstrated uniformity. Data will be presented on the efficacy of coatings of this type.
Conclusion : Here, we show a new antithrombotic coating for the FDS that is stable on the surface of the stent. This new coating holds promise for more robust and longer-term blood compatibility with the aim of eliminating the need for antiplatelet agents in the postoperative period. Future work will focus assessment of protein adsorption, platelet and complement activation within an in vitro flow model of a candidate aneurysm.
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