Amine-functionalized surface modification accelerates endothelialization of intracranial stents

BACKGROUND AND PURPOSE: Durable outcomes with neurovascular stents require balancing antithrombotic performance with rapid endothelialization. We previously developed an amine-functionalized surface modification (Anti-thrombus formation, Endothelial-growth promotion, tissue Integration, and Surface; AEGiS Technology) with antithrombotic behavior. In this study we evaluated its pro-endothelialization properties and explore the mechanism. METHODS: Adsorption of extracellular matrix proteins from human plasma was profiled on AEGiS-modified versus control NiTi surfaces with an a priori focus on vitronectin. Human umbilical vein endothelial cell (HUVEC) adhesion was quantified by attached cell numbers and post-wash retention as a measure of adhesion strength. Migration and surface coverage were assessed in an in vitro endothelialization model designed to mimic stents on vessel walls. For translation, self-expanding stents bearing AEGiS or control coatings were deployed in a porcine model and endothelial coverage at 1 week was quantified by angiography and histology. RESULTS: The AEGiS surface selectively increased vitronectin adsorption compared with the control surface. Consistent with this shift, AEGiS supported greater HUVEC adhesion and stronger retention. In the endothelialization model, AEGiS accelerated coverage of the substrate compared with the control. In vivo, AEGiS-modified stents showed greater endothelial coverage at 1 week than control stents. CONCLUSIONS: Amine functionalization enriched vitronectin adsorption and supported early endothelial coverage, indicating its potential to promote endothelialization of neurovascular stents.