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Saxena et al. Mini-invasive Surg 2020;4:62 I http://dx.doi.org/10.20517/2574-1225.2020.68 Page 3 of 15

Table 1. Recent advances in hydrogel-based PCIs in cardiac repair
S. N. Materials Major components Salient features Remarks Ref.
1. Alginate dialdehyde- Alginate and gelatin 3D orienting of cell-laden hydrogel Suitable for 3D printing [22]
gelatin hydrogel Homogenous cell distribution in cardiac tissue
High cell viability engineering
2. VentriGel ECM from A first-in-man clinical trial of ECM-hydrogel Efficient for the [23]
decellularized Safe and feasible in post-MI patients with left treatment of post-early
porcine myocardium ventricular dysfunction and -late MI
Improvements in left ventricular remodeling > 1
year and vice versa for < 1 year of treatment
3. Collagen-based Transglutaminase Stem cell-based therapy for ischemic heart Dual functionality, [6]
hydrogel cross-linked gelatin disease suitable for the
Improved retention and cardioprotection treatment of MI and
Combination therapy may protect against cardiac repair
cardiac injury after MI
4. Thrombin-coagulated Decellularized Inclusion of cells due to thrombin Suitable for cardiac cell [20]
fibrin hydrogels ECM from porcine 3D embedding enhanced cellular differentiation differentiation
ventricular tissue and Recovery, frequency, synchrony and spontaneous
fibrinogen beating
5. Alginate/ECM ECM from porcine Enhanced rheological and mechanical properties Cell-free treatment of [24]
hydrogel heart into alginate > 80% viability with > 100% metabolic activity MI
Non-invasive delivery
6. PEG-based injectable Triblock copolymers A triblock polymer- formed gel Suitable as a scaffold for [25]
hydrogels (PDEGMA-b- Reversible sol-gel transformation tissue engineering
PPEGMA-b- 20 wt% formed strong gel in 5 seconds
PDEGMA)
7. Polydopamine- Polydopamine- Stable coating for a non-invasive approach Non-invasive treatment [26]
containing hydrogel containing hydrogel Improved HUVEC viability/proliferation and of MI due to blockage
membrane coating membrane- and suppressed SMC viability
over the metallic stent acrylamide Acrylamide enhanced mechanical strength
8. H 2 S releasing peptide Peptides FBA-IAVEE Inhibited proliferation and migration of VSMCs Suitable as a coating [27]
hydrogel and FBA-IAVEEEE Reduced intimal hyperplasia material for stents
Proliferation of human umbilical endothelial cells
9. Hyaluronic acid Hyaluronic acid Sustained miRNA-302 delivery by hydrogels miRNA-based therapy [28]
hydrogel Local clonal proliferation at injection within 2 for cardiac tissue
weeks engineering
Decreased cardiac end diastolic and end-systolic
volumes, with improved ejection fraction and
fractional shortening
10. Silk fibroin Alginate containing Sustained delivery of insulin-like growth factor 1 Suitable for cardiac [29]
microsphere-based silk fibroin hydrogels via hydrogel tissue engineering
alginate hydrogel Reduction in infarct size within 28 days
Improved cardiac function

PDEGMA: poly (diethylene glycol methyl ether methacrylate); PPEGMA: poly (polyethylene glycol methyl ether methacrylate); PCI:
percutaneous coronary intervention; ECM: extracellular matrix; MI: myocardial infarction; SMC: smooth muscle cell; VSMCs: vascular
smooth muscle cells; PEG: polyethylene glycol; FBA-IAVEE: 4-Formylbenzoic acid-(Isoleucine-Alanine-Valine-Glutamic acid-Glutamic
acid); FBA-IAVEEEE: 4-Formylbenzoic acid-(Isoleucine-Alanine-Valine-Glutamic acid-Glutamic acid- Glutamic acid- Glutamic acid);
HUVEC: Human umbilical vein endothelial cells

[21]
important for the working efficiency as well as the acceptance/rejection of the hydrogels as stents .
Furthermore, various modifications have also been made on hydrogels for creating multi-functionality such
[31]
as stent materials with imaging properties to track the exact location and the site of action . Similarly,
various drug delivery applications of hydrogel-based materials have also been utilized in the treatment
of the MI. Hence, the tunable properties for the site-specific applications make hydrogels materials very
specific in the design as well as the applications. Recent developments using chitosan-, alginate-, PEG and
ECM-based hydrogels for the treatment of MI are discussed in the upcoming sections.

CHITOSAN-BASED HYDROGELS FOR PCI
Chitosan is one of the most studied materials for the treatment of MI using PCI. Its cross-linking properties
make it a promising candidate for creating 2D and 3D stents to be used for PCI. Chitin and chitosan
(deacetylated derivative of chitin) are natural polymers and found abundant in nature (approx. 1000 t/year).