Advancements in nanomaterials for the treatment and management of vascular surgeries: from drug delivery to biomedical implants

Vascular surgery is an important procedure that is carried out to treat diseases of the entire vascular system. Intraoperative hemostasis, precise vision of intricate vascular anatomy, restenosis, implant-associated infection, and inadequate endothelium regeneration are among the enduring difficulties that continue to limit vascular surgery. Advanced biomaterial techniques are required since conventional materials and imaging technologies often fail to meet these multifactorial limitations. By enabling synthetic nanomaterials with programmable physicochemical qualities that directly interact with biological systems at the molecular and cellular levels, recent developments in nanotechnology have sparked a paradigm shift in vascular surgery. The limitations of conventional contrast media are addressed by nanostructured contrast agents, such as superparamagnetic iron oxide nanoparticles, which significantly improve vascular imaging resolution and diagnostic sensitivity across magnetic resonance modalities. Biodegradable polymers and surface-engineered coatings are examples of controlled-release nanocarriers that enable targeted administration of antiproliferative and antithrombotic drugs, lowering systemic toxicity and minimizing restenosis. In addition to providing long-lasting antibacterial action to avoid surgical site infections, nano-engineered surface topographies and coatings on grafts and stents accelerate endothelialization and reduce thrombogenicity. Additionally, some nanomaterials’ inherent catalytic and redox modulation properties aid in better wound healing and inflammation resolution. With a focus on mechanistic insights into hemostasis, imaging enhancement, drug transport, implant integration, and regenerative processes, this review thoroughly summarizes recent preclinical and translational studies on the use of nanomaterials in vascular surgery. Furthermore, we outline the present obstacles to clinical translation, such as biocompatibility, long-term safety, and manufacturing scalability, and suggest future paths for incorporating nano-enabled techniques into evidence-based surgical practice.