Recouvrements à base de dextrane pour applications médicales

Abstract : The last decades have witnessed the remarkable growth of biomaterial science and engineering field, especiallyfor cardiovascular applications, for which devices have evolved from simple material to complex structures.This development has stemmed from the necessity for biomaterials to exhibit different properties, related totheir function, which are not always inherently compatible. Historically, the first materials selected for medicaldevices conception were the ones exhibiting the best compromise between all the physicochemical, mechanicaland biological requirements. Nevertheless, while physicochemical and mechanical properties are often handilycombined, the development of materials which also possess suitable biological properties have proved to bemuch more challenging, leading to clinical complications.Surface modification represents a valid solution to improve the biological performances of medical deviceswhile maintaining the bulk properties of the material. Biomaterial coatings may modulate the biologicalresponse at the biomaterial-host interface and decreases the undesirable effects. Coatings have been optimizedin regards to two main aspects: the biological response and the mechanical response. For the biologicalresponse, the two main approaches consist in 1) inducing cell adhesion, proliferation or migration with proactivecoatings and 2) using inert material, mostly, and avoiding the adhesion of any biological componentswith passive coatings.More complex coatings include the two approaches, allowing the adhesion of a specific type of cell whilerepelling other biological components adhesion. This method has been very useful against the restenosisphenomenon which obstructs blood vessels. A common practice is vessel stenting, a procedure that enables thereopening of the vessel and the restoration of the blood flow. Restenosis causes the new narrowing of the vessel,mostly due to uncontrolled smooth muscle cell proliferation. Researchers looked for coatings capable oflimiting the restenosis occurrence by inhibiting this cell proliferation along with facilitating the reendothelialization.Thus, the coatings would be able to improve endothelial cells adhesion and proliferation andto inhibit smooth muscle cells ones as well as avoiding non-specific adhesion.Previous studies showed that a copolymer made of dextran and poly(butyl methacrylate) (PBMA) demonstratedsuch biological properties and a good resistance to deformation, which is an important parameter related to thedeformation implied in a stent implantation. In this work, the approach was to use this copolymer as a stentcoating and to increase its long-term stability by providing covalent bonds with the substrate. To do so, thedextran part of the copolymer firstly needed to be activated in order to be grafted to the surface. Thus, it wasimportant to ascertain the influence of the multiple modifications on the biological and mechanical propertiesof the resulting materials at each step, but also towards a chemical point of view, the influence that thesemodifications may have on the subsequent copolymerization.
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Eléonore Michel. Recouvrements à base de dextrane pour applications médicales. Ingénierie biomédicale. Université Sorbonne Paris Cité, 2016. Français. ⟨NNT : 2016USPCD086⟩. ⟨tel-02161930⟩

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