Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector1922610.17816/KMJ2020-232ReviewsОбзорыReview ArticleApproaches to antithrombotic modification of vascular implantsПодходы к антитромботической модификации сосудистых имплантатов6536-6068SevostyanovaV VСевостьяноваВиктория Владимировна
Russian Federation
leonora92@mail.ru4560-0906KrivkinaE OКривкинаЕвгения Олеговна
Russian Federation
leonora92@mail.ru57189593385I-8624-20178634-3286AntonovaL VАнтоноваЛариса Валерьевна
Russian Federation
leonora92@mail.ruResearch Institute for Complex Issues of Cardiovascular DiseasesНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний1304202010122322422901202014022020Copyright ©; 2020, Sevostyanova V.V., Krivkina E.O., Antonova L.V.Copyright ©; 2020, Севостьянова В.В., Кривкина Е.О., Антонова Л.В.2020Sevostyanova V.V., Krivkina E.O., Antonova L.V.Севостьянова В.В., Кривкина Е.О., Антонова Л.В.http://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/19226

Vascular implants in contact with blood must have high thrombotic resistance. However, in some cases, their implantation is associated with thrombosis and subsequent impaired patency of the blood vessel. Most often, this problem affects implants intended for reconstruction of small diameter vessels, which is associated with hemodynamic features in this part of the bloodstream. These include blood vessel prostheses, tissue-engineered vascular grafts, and endovascular stents. The features of the implant material are of great importance when choosing a method for its modification in order to improve biocompatibility and thromboresistance. The review analyzes current experience in using various methods of immobilizing drugs to the surface of vascular prostheses and endovascular stents made from stable and biodegradable polymers. The prospects of creating thromboresistant vascular grafts and stents by joint immobilization on the surface of the polymer material of drugs with antithrombogenic activity and biologically active molecules that regulate the reaction to a foreign body and implant remodeling were evaluated. Numerous studies in the review demonstrating a wide range of ways to modify blood vessel prostheses, tissue-engineered vascular grafts, and endovascular stents with antithrombotic drugs to increase their thrombosis resistance. The main approaches of antithrombotic modification include conjugation of drugs and biologically active molecules on the implant surface. At the same time, new technologies are aimed not only at inhibiting the process of thrombus formation, but also at reducing the intensity of the inflammation process and stimulating the reparation of vascular tissue.

Сосудистые имплантаты, контактирующие с кровью, должны обладать высокой тромборезистентностью. Однако в некоторых случаях их имплантация сопряжена с тромбообразованием и последующим нарушением проходимости кровеносного сосуда. Наиболее часто эта проблема затрагивает имплантаты, предназначенные для реконструкции сосудов малого диаметра, что связано с особенностями гемодинамики в данной части кровеносного русла. К ним можно отнести протезы кровеносных сосудов, тканеинженерные сосудистые графты и эндоваскулярные стенты. Особенности материала имплантата имеют большое значение при выборе способа его модификации с целью улучшения биосовместимости и тромборезистентности. В настоящем обзоре проанализирован современный опыт по использованию различных способов иммобилизации лекарственных препаратов к поверхности сосудистых протезов и эндоваскулярных стентов, изготовленных из стабильных и биодеградируемых полимеров. Оценена перспективность создания тромборезистентных сосудистых протезов и стентов путём совместной иммобилизации на поверхности полимерного материала лекарственных препаратов с атромбогенными свойствами и биологически активных молекул, регулирующих реакцию на инородное тело и ремоделирование имплантата. Многочисленные исследования, приведённые в настоящем обзоре, демонстрируют широкий спектр способов модификации протезов кровеносных сосудов, тканеинженерных сосудистых графтов и эндоваскулярных стентов антитромботическими препаратами для увеличения их тромборезистентности. К основным подходам антитромботической модификации можно отнести конъюгирование лекарственных средств и биологически активных молекул на поверхности имплантата. При этом новые технологии направлены не только на ингибирование процесса тромбообразования, но и на снижение интенсивности воспаления и стимуляцию восстановления сосудистой ткани.

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