医用介入导丝用疏水和亲水涂层的研究进展OA北大核心CSTPCD

Medical interventional guidewires are widely used in various interventional procedures and are commonly used medical devices in percutaneous transluminal coronary angioplasty(PTCA)and percutaneous transluminal angioplasty(PTA).Although the size of the interventional guidewire is quite small in the whole medical device system,it is used in a large amount in clinical practice.With the rapid development of the medical device industry,medical interventional guidewires are becoming more and more common in clinical applications.The coating on the surface of medical interventional guidewires works as an important support for application promotion and function expansion.The attachment of hydrophilic or hydrophobic coating on the surface of guidewires has received extensive attention from researchers.The addition of hydrophilic or hydrophobic coatings to the surface of medical interventional guidewires can reduce tissue friction and tissue damage in clinical applications,effectively improve the passage,antimicrobial and biocompatibility of the guidewires,and reduce inflammation.The coating may peel off from the surface due to weak bonding,leading to adverse events.In recent years,there have been successive reports focusing on coating shedding,the hazards of which include residual coating debris in patients,local tissue reactions and vascular thrombosis,and can even lead to serious adverse events including embolic stroke,tissue cell necrosis and death,so a more comprehensive and rational means of surface modification is necessary to make the guide wire surface coating with good hydrophilic or hydrophobic premise,not only with good adhesion and the surface modification must be carried out in a more comprehensive manner,so that the surface coating of the guidewire not only has good adhesion and solidity,but also has good biocompatibility and antibacterial and antibacterial properties. This paper firstly introduced the clinical use scenario and application performance requirements of medical interventional guidewires.It not only explained the importance of surface lubricant coating,but also reviewed the different coating materials of hydrophilic and hydrophobic coatings for medical interventional guidewires at home and abroad in recent years from the performance requirements,and conducted research on mechanism exploration,adhesion optimization,and antimicrobial modification for these coatings.The hydrophobic coating repelled water molecules and made the surface of the guidewire wax-like and smooth,which not only reduced the friction of the guidewire,but also improved the tactile feedback of the guidewire during use.PTFE was widely used for hydrophobic coating of medical guidewires due to its good stability and low coefficient of friction.Surface hydrophobic modification was also an excellent means of modification using polyurethane acrylic coating in addition to PTFE.Hydrophilic coating had the advantages of good biocompatibility,good wettability,low protein adsorption,low risk of thrombosis,etc.The modified substrate surface not only showed good hydrophilicity and lubricity,but also showed better anti-fouling properties than the unmodified substrate surface,while the ultra-thin hydrophilic coating did not lead to changes in the hardness and mechanical properties of the substrate.Hydrophilic coatings for medical guidewires were characterized by chemical stability,biocompatibility,and antithrombotic effects,and the main material systems were polyvinylpyrrolidone(PVP),polyacrylamide(PAM),poly(parylene),polyethylene glycol(PEG),and hyaluronic acid(Hyaluronan)etc.The mechanism of action of different material systems in hydrophilic and hydrophobic coating of medical guidewires as well as the preparation processes of the coatings,including layer-by-layer self-assembly,UV grafting,plasma grafting,and chemical vapor deposition,etc.,were also presented,with emphasis on the operability,advantages,and disadvantages of these preparation processes.When introducing hydrophilic and hydrophobic coating materials,some of the actual hydrophobic and hydrophilic coated guide wire models currently available in the market were also introduced,taking guide wires as an example.Finally,on the basis of summarizing the previous research results,the current status and problems faced by hydrophilic and hydrophobic coatings for medical interventional guidewires were discussed.Although hydrophilic and hydrophobic coatings have been widely studied,most of the current studies focus on or are limited to a single treatment or property of hydrophilic and hydrophobic coatings,and there are fewer reports of studies on the composite properties of the coatings,especially the hydrophilic,hydrophobic,and antimicrobial properties that are related to clinical medical treatment.Therefore,the article concludes with an outlook on the future development direction of hydrophilic-hydrophobic coatings for medical interventional guidewires and the improvement of the comprehensive performance of hydrophilic-hydrophobic coatings for medical interventional guidewires.