Cardiovascular implants, especially vascular grafts made of synthetic polymers, find wide clinical applications in the treatment of cardiovascular diseases. However, cases of failure still exist, notably caused by restenosis and thrombus formation. Aiming to solve these problems, various approaches to surface modification of synthetic vascular grafts have been used to improve both the hemocompatibility and long-term patency of artificial vascular grafts. Surface modification using hydrophilic molecules can enhance hemocompatibility, but this may limit the initial vascular endothelial cell adhesion. Therefore, the improvement of endothelialization on these grafts with specific peptides and biomolecules is now an exciting field of research. In this review, several techniques to improve surface modification and endothelialization on vascular grafts, mainly polyurethane (PU) grafts, are summarized, together with the recent development and evolution of the different strategies: from the use of PEG, zwitterions, and polysaccharides to peptides and other biomolecules and genes; from in vitro endothelialization to in vivo endothelialization; and from bio-inert and bio-active to bio-mimetic approaches.

The presented study describes a method for the preparation and modification of cylindrical polyurethane structures with polyvinylpyrrolidone (PVP) hydrogel coating. The modified polyurethane scaffolds were fabricated using the phase-inversion technique and intended to be used as a vascular prosthesis. The proposed modification method involves a two-step Fenton-type reaction. Physicochemical analysis (Fourier transform infrared spectroscopy, scanning electron microscopy) confirmed the presence of the hydrogel coating. The influence of PVP and polymerization initiator (cumene hydroperoxide) concentrations on hydrogel's properties were examined. The higher concentrations of reagent were used, the thicker coating was obtained. After modification, the material's surface becomes more hydrophilic in comparison to pristine polyurethane. Cytotoxicity assay (MTT test) confirmed that PVP-coating is not toxic. The introduction of hydrogel coating resulted in a significant decrease in the fibrinogen adsorbed to the material's surface as compared to a non-modified polymer. Platelet adhesion assay demonstrated almost no platelet adhesion to the modified surfaces.

Sterilization of a material carries the risk of unwanted changes in physical and chemical structure. The choice of method is a challenge—the process must be efficient, without significantly changing the properties of the material. In the presented studies, we analyzed the effect of selected sterilization/disinfection techniques on the properties of nanofibrous polyurethane biomaterial. Both radiation techniques (UV, gamma, e-beam) and 20 minutes’ contact with 70% EtOH were shown not to achieve 100% sterilization efficiency. The agar diffusion test showed higher sterilization efficiency when using an antimicrobial solution (AMS). At the same time, none of the analyzed techniques significantly altered the morphology and distribution of fiber diameters. EtOH and e-beam sterilization resulted in a significant reduction in material porosity together with an increase in the Young’s modulus. Similarly, AMS sterilization increased the value of Young’s modulus. In most cases, the viability of cells cultured in contact with the sterilized materials was not affected by the sterilization process. Only for UV sterilization, cell viability was significantly lower and reached about 70% of control after 72 h of culture.