Rapid advances in minimally invasive and catheter cardiovascular technologies have created a growing need for the development of effective adhesives that facilitate the deployment of these technologies while adequately controlling blood-clotting and bleeding risks, said Marvin J. Slepian, MD, a cardiologist at the University of Arizona Sarver Heart Center who has expertise in interventional cardiology device procedures and biomedical engineering.
Dr. Slepian and Danny Bluestein, PhD, professor of bioengineering at Stony Brook University in New York, co-authored a review article in the New England Journal of Medicine (April 17, 2014), citing the benefits of hydrophobic light-activated adhesive (HLAA), a fluid, blood-resistant tissue glue that can be applied as a liquid before a procedure is performed and activated on demand to adhere, cure and bond.
Increasingly, stent valves and stent grafts, and the use of clips, patches, occluders, endoluminal paving (the coating of the inside surface of the vessel), and ventricular-assist devices are being used to treat heart disease. With these internally implanted technologies on the rise, new biocompatible bioadhesives will impact hundreds of thousands of patients over time.
“Traditionally, sutures and staples have been used for tissue and device positioning, securing and closure. Despite their basic efficacy, these tools and traditional approaches have limitations that include the added trauma to tissue during placement and the difficulty of deployment in small spaces and tight geometries that are integral to minimally invasive procedures,” said Dr. Slepian, who is a professor of medicine and biomedical engineering at the UA.
Drs. Slepian and Bluestein were invited to write the review for the NEJM in response to a recent publication in the journal Science Translational Medicine by a group of Harvard University and Massachusetts Institute of Technology scientists who developed a promising new bioadhesive. In the 1990s, Dr. Slepian developed a method known as “polymer paving,” which is a precursor of present-day biodegradable stent technology and led to the first synthetic sealant in use today that is FDA approved.
“In contrast to current sealants that have existed for more than 60 years, HLAA is an advanced sealant that offers many desirable properties. It acts as an effective seal and barrier, preventing the flow of fluid, blood and inflammatory cells into the bonded zone,” said Dr. Slepian.