Advances in Surface Biofunctionalization and Intelligent Monitoring of Vascular Devices

Vascular scaffolds are fundamental devices in managing vascular occlusions, aneurysms, and hemodialysis access. However, their long-term efficacy is often compromised by two major pathophysiological responses: acute thrombosis and intimal hyperplasia, underscoring the need for effective antithrombotic treatment and intensive surveillance. This review highlights the emerging approaches used to address such challenges in polymeric vascular scaffolds: surface biofunctionalization and intelligent monitoring systems. We first introduce the biodegradable elastic polymers applied for vascular scaffolds, followed by a comprehensive overview of surface biofunctionalization techniques aimed at preventing thrombosis and promoting endothelialization. Then, the review explores the cutting-edge advances in integrated flexible bioelectronics that enable real-time, remote hemodynamic monitoring of cardiovascular implants. The review concludes with an outlook on the remaining challenges and future research directions, providing a roadmap for developing next-generation smart vascular scaffolds.