Is there an alternative to systemic anticoagulation, as related to interventional biomedical devices?

Expert Rev Med Devices

Biomaterials & Tissue Engineering Centre, Academic Division of Surgical and Interventional Sciences, University College London, Rowland Hill Street, Hampstead, London NW3 2PF, UK.

Published: March 2006

To reduce the toxic effects, related clinical problems and complications such as bleeding disorders associated with systemic anticoagulation, it has been hypothesized that by coating the surfaces of medical devices, such as stents, bypass grafts, extracorporeal circuits, guide wires and catheters, there will be a significant reduction in the requirement for systemic anticoagulation or, ideally, it will no longer be necessary. However, current coating processes, even covalent ones, still result in leaching followed by reduced functionality. Alternative anticoagulants and related antiplatelet agents have been used for improvement in terms of reduced restenosis, intimal hyperphasia and device failure. This review focuses on existing heparinization processes, their application in clinical devices and the updated list of alternatives to heparinization in order to obtain a broad overview, it then highlights, in particular, the future possibilities of using heparin and related moieties to tissue engineer scaffolds.

Download full-text PDF

Source
http://dx.doi.org/10.1586/17434440.3.2.245DOI Listing

Publication Analysis

Top Keywords

systemic anticoagulation
12
alternative systemic
4
anticoagulation interventional
4
interventional biomedical
4
biomedical devices?
4
devices? reduce
4
reduce toxic
4
toxic effects
4
effects clinical
4
clinical problems
4

Similar Publications

Article Synopsis
  • Clinical atrial fibrillation (AF) significantly raises the risk of stroke and systemic embolism, but treatment with oral anticoagulants can lower this risk while increasing the chance of major bleeding.
  • Device-detected atrial fibrillation (DDAF) also poses a stroke risk, though lower than clinical AF, with studies showing that direct oral anticoagulation can reduce stroke risk for DDAF patients but similarly heightens bleeding risk.
  • The challenge persists in determining how to effectively manage the balance between reducing thromboembolic risk and the increased risk of bleeding for DDAF patients, as well as identifying those who would benefit most from anticoagulant therapy.
View Article and Find Full Text PDF

Unlabelled: Upper extremity deep vein thrombosis (UEDVT) is relatively rare, and much less as an initial presentation of systemic lupus erythematosus (SLE). Primary UEDVT should be considered in individuals with unilateral arm swelling where the brachial, axillary, and subclavian veins are frequently involved. SLE is a chronic autoimmune disease that predominantly affects women of childbearing age and of African descent.

View Article and Find Full Text PDF

Introduction: The efficacy and safety of statins for secondary prevention in patients who have experienced a cardioembolic stroke are not well-defined. However, previous observational data reported hyperlipidemia as a risk factor for both ischemic and bleeding complications in patients with AF and previous stroke. Based on these premises, we conducted a sub-analysis of the RAF and RAF-NOAC studies to evaluate the efficacy and safety of statins in secondary prevention in patients with acute ischemic stroke and AF.

View Article and Find Full Text PDF

Development and validation of a five-year cardiovascular risk assessment tool for Asian adults aged 75 years and older.

BMC Geriatr

January 2025

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, No. 33, Linsen S. Rd., Zhongzheng Dist., Taipei, 100025, Taiwan.

Background: To identify cardiovascular (CV) risk factors in Asian elderly aged 75 years and older and subsequently develop and validate a sex-specific five-year CV risk assessment tool for this population.

Methods: This study included 12,174 patients aged ≥ 75 years without a prior history of cardiovascular disease at a single hospital in Taiwan. Electronic health records were linked to the National Health Insurance Research Database and the National Death Registry to ensure comprehensive health information.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!