Thermo-responsive Copolymers with Enzyme-dependent Lower Critical Solution: Temperatures for Endovascular Embolization

Minimally invasive endovascular embolization procedures decrease surgery time, speed up recovery, and provide the possibility for more comprehensive treatment of aneurysms, arteriovenous malformations (AVMs), and hypervascular tumors. Liquid embolic agents (LEAs) are preferred over mechanical embolic agents, such as coils, because they achieve homogeneous filling of aneurysms and more complex angioarchitectures. The gold standard of commercially available LEAs is dissolved in dimethyl sulfoxide (DMSO), which has been associated with vasospasm and angiotoxicity. The aim of this study was to investigate amino acid substitution in an enzyme-degradable side group of an N-isopropylacrylamide (NIPAAm) copolymer for the development of a LEA that would be delivered in water and degrade at the rate that tissue is regenerated. NIPAAm copolymers have a lower critical solution temperature (LCST) due to their amphiphilic nature. This property enables them to be delivered as liquids through a microcatheter below their LCST and to solidify in situ above the LCST, which would result in the successful selective occlusion of blood vessels. Therefore, in this work, a series of poly(NIPAAm-co-peptide) copolymers with hydrophobic side groups containing the Ala-Pro-Gly-Leu collagenase substrate peptide sequence were synthesized as in situ forming, injectable copolymers.. The Gly-Leu peptide bond in these polypeptides is cleaved by collagenase, converting the side group into the more hydrophilic Gly-Ala-Pro-Gly-COOH (GAPG-COOH), thus increasing the LCST of the hydrogel after enzyme degradation. Enzyme degradation property and moderate mechanical stability convinces the use of these copolymers as liquid embolic agents.