UNAIR NEWS – Lifestyle changes such as increased fast food consumption and decreased physical activity during the Covid-19 pandemic have led to an increase in cardiovascular diseases. One of them is a stroke caused by a blockage of fat in the blood vessels, known as an ischemic stroke.
Based on the World Health Organization (WHO) report in 2016, 67.5 million people have experienced an ischemic stroke, and 70 percent of stroke sufferers come from developing countries. In Indonesia, stroke is one of the highest causes of death, with the highest risk factor in Southeast Asia (0.34 percent).
Carotid Endarterectomy (CEA) is a procedure to remove fat from the arteries to prevent stroke. However, the removal of this fat can cause narrowing of the diameter of the blood vessel walls. Therefore, patches or membranes are generally used. It is known as patch angioplasty. The membrane helps to close and widen the diameter of blood vessels to reduce the risk of further stroke.
However, there have been reports on infection, blockage, enlargement, or protrusion of blood vessels in some commercial use cases due to weakening vessel wall and venous disorders. Such cases happen because the material used as a patch angioplasty is less than ideal.
Is there any other material that can be used as an alternative? Of course, there is. The team members of UNAIR undergraduate students of Biomedical Engineering and Medicine (Dhea Saphira Salsabila, Edric Hernando, Indira Maretta Hulu, and Tarissa Dianda Putri Wibowo) under the guidance of Dr. Prihartini Widiyanti, drg, M.Kes, S.Bio proposed a membrane innovation in the form of a PLLA-Chitosan nanofiber scaffold with heparin modification through cross-linking with genipin on its surface as a candidate for patch angioplasty.
“Scaffold made from PLLA is used because it has good mechanical properties. Then, we combine it with chitosan to improve its characteristics which are difficult to interact with water and quite fragile. Furthermore, the antibacterial properties of chitosan can reduce the chances of infection. And heparin is used to prevent blood clots,” said Dhea, as the team leader.
The team has conducted research for five months at the Institute of Tropical Disease (ITD) Universitas Airlangga offline because the equipment for making nanofibers, electrospinning equipment, and testing equipment are only available in the laboratory.
According to Indira, as a team member, offline research is quite complicated because the Imposition of Restrictions towards Community Activities (PPKM) policy requires the team to pay attention to strict health protocols and carry out several parts of the research at homes.
The research was included in the 2021 Student Creativity Program (PKM) and received research funding from the Directorate General of Higher Education, Ministry of Research and Technology (KEMENRISTEK DIKTI).
A series of tests such as contact angle tests, degradation tests, fibrinogen adsorption tests, anti-coagulation tests, and mechanical properties tests showed promising potential for clinical applications in vascular tissue.
“This research has great potential for handling stroke cases, which currently have a higher prevalence in Indonesia. The results of in-vitro studies in this research show the potential for the development of other vascular applications such as stent devices and artificial blood vessels (hollow fiber),” said dr. Nur Setiawan Suroto, Sp.BS(K), a Neurosurgeon, supporting this research.
Hopefully, in the future, this research can support the research in the field of Advanced Materials in the National Research Master Plan (RIRN) 2017-2045 by KEMENRISTEK DIKTI and be implemented in the procedures for handling stroke patients. (*)
