Internal medicine

Biotechnology

In vivo

Neointimal hyperplasia

Stent

Intimal hyperplasia

Smooth muscle

Biology

Cardiology

Composite material

Materials science

Inflammation

Endothelium

Restenosis

Vascular smooth muscle

Adhesion

Nitric oxide

Medicine

Nature Communications

Vascular stent is viewed as one of the greatest advancements in interventional cardiology. However, current approved stents suffer from in-stent restenosis associated with neointimal hyperplasia or stent thrombosis. Herein, we develop a nitric oxide-eluting (NOE) hydrogel coating for vascular stents inspired by the biological functions of nitric oxide for cardiovascular system. Our NOE hydrogel is mechanically tough and could selectively facilitate the adhesion of endothelial cells. Besides, it is non-thrombotic and capable of inhibiting smooth muscle cells. Transcriptome analysis unravels the NOE hydrogel could modulate the inflammatory response and induce the relaxation of smooth muscle cells. In vivo study further demonstrates vascular stents coated with it promote rapid restoration of native endothelium, and persistently suppress inflammation and neointimal hyperplasia in both leporine and swine models. We expect such NOE hydrogel will open an avenue to the surface engineering of vascular implants for better clinical outcomes.

A tough nitric oxide-eluting hydrogel coating suppresses neointimal hyperplasia on vascular stent