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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:1168.)
© 2000 American Heart Association, Inc.

Thrombosis

Reduced Thrombus Formation by Hyaluronic Acid Coating of Endovascular Devices

Stefan Verheye; Christos P. Markou; Mahomed Y. Salame; Barbara Wan; Spencer B. King, III; Keith A. Robinson; Nicolas A. F. Chronos; Stephen R. Hanson

From the Division of Molecular Medicine(S.V., C.P.M., K.A.R., N.A.F.C., S.R.H.), Yerkes Regional Primate Research Center, Departments of Medicine (S.V., M.Y.S., S.B.K., S.R.H.) and Biomedical Engineering (C.P.M., S.R.H.), Emory University School of Medicine, Atlanta, Ga; Genzyme Corporation (B.W.), Cambridge, Mass; and The Atlanta Cardiovascular Research Institute (K.A.R., N.A.F.C.), Atlanta, Ga.

Correspondence to Stephen R. Hanson, PhD, 1639 Pierce Dr, Room 1129 WMB, Emory University, Atlanta, GA 30322. E-mail shanson{at}emory.edu

Abstract—Biocompatible stent coatings may alleviate problems of increased (sub)acute thrombosis after stent implantation. Hyaluronic acid (HA), a ubiquitous, nonsulfated glycosaminoglycan, inhibits platelet adhesion and aggregation and prolongs bleeding when administered systemically. However, the effects of immobilized HA for reducing stent platelet deposition in vivo are unknown. We therefore quantified the antithrombotic effects of coating stainless steel stents and tubes with HA using an established baboon thrombosis model under physiologically relevant blood flow conditions. HA-coated and uncoated (control) stents (3.5 mm in diameter, n=32) and stainless steel tubes (4.0 mm in diameter, n=18) were deployed into exteriorized arteriovenous shunts of conscious, nonanticoagulated baboons. Accumulation of ¹¹¹In-radiolabeled platelets was quantified by continuous gamma-camera imaging during a 2-hour blood exposure period. HA coating resulted in a significant reduction in platelet deposition in long (4 cm) tubes (0.24±0.15x10⁹ versus 6.12±0.49x10⁹ platelets; P<0.03), short (2 cm) stainless steel tubes (0.18±0.06x10⁹ versus 3.03±0.56x10⁹ platelets; P<0.008), and stents (0.82±0.20x10⁹ versus 1.83±0.23x10⁹ platelets; P<0.02) compared with uncoated control devices. Thus, HA coating reduces platelet thrombus formation on stainless steel stents and tubes in primate thrombosis models. These results indicate that immobilized HA may represent an attractive strategy for improving the thromboresistance of endovascular devices.

Key Words: thrombosis • stents • hyaluronic acid • baboon

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