Hydrogel-Impregnated Robust Interlocking Nano Connector (HiRINC) for Noninvasive Anti-Migration of Esophageal Stent.

Abstract

Migration of implanted self-expandable metallic stent (SEMS) in the malignant or benign esophageal stricture is a common complication but not yet resolved. Herein, this research develops a hydrogel-impregnated robust interlocking nano connector (HiRINC) to ensure adhesion and reduce the mechanical mismatch between SEMSs and esophageal tissues. Featuring a network-like porous layer, HiRINC significantly enhances adhesion and energy dissipation during esophageal peristalsis by utilizing mechanical interlocking and increasing hydrogen bonding sites, thereby securing SEMS to tissues. The anti-swelling property of HiRINC prevents excessive hydrogel expansion, avoiding esophageal blockage. Ex vivo and in vivo adhesion tests confirm that the HiRINC outperforms flat surfaces without RINC structures and effectively prevents stent migration. HiRINC-coated SEMS maintains its position and luminal patency, minimizing stent-induced tissue hyperplasia and inflammatory responses in rat and porcine esophageal models during the 4-week follow-up. This novel HiRINC-SEMS can ensure anti-migration and prolonged stent patency in the rat and porcine esophagus and seems to be expanded to other nonvascular luminal organs and various implantable metallic devices.