Electrospun Poly(ε-caprolactone) scaffolds loaded with Rivaroxaban for small-diameter arteriovenous grafts

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) requiring hemodialysis are major global health concerns. Arteriovenous (AV) grafts are essential for these patients, yet high failure rates due to thrombosis persist. Developing vascular scaffolds capable of localized, sustained anticoagulant delivery offers a potential solution. Rivaroxaban (RIV), a selective Factor Xa inhibitor, is a reliable anticoagulant for hemodialysis patients, offering superior safety and efficacy compared with heparin and warfarin. This study presents RIV-loaded electrospun poly(ε-caprolactone) (PCL) tubular scaffolds as drug-delivery AV grafts. Electrospinning parameters were adjusted to produce fibers ranging from ∼600 nm to 1 μm, resulting in randomly oriented fibers with homogeneous drug distribution. Scanning electron microscopy (SEM) and mechanical testing demonstrated that RIV incorporation did not alter scaffold architecture or mechanical integrity. The scaffolds exhibited mechanical properties comparable to native vascular tissue. RIV was encapsulated with 99% efficiency, and release studies revealed a tunable, triphasic release profile: larger fibers released 74% of the drug over 144 hours, while smaller fibers released 96%. Cytocompatibility testing confirmed scaffold safety, with optimal fibroblast adhesion and proliferation observed across fiber sizes. These results highlight the potential of RIV-loaded electrospun PCL scaffolds as small-diameter vascular grafts (SDVGs) with integrated anticoagulant functionality, offering sustained drug release and high encapsulation efficiency. This approach may enhance long-term patency and clinical outcomes in AV graft applications. • Rivaroxaban-loaded electrospun Poly(ε-caprolactone) scaffolds were developed as arteriovenous grafts. • Fiber diameter tuning enabled precise control of drug release behavior. • Scaffolds exhibited mechanical strength comparable to native vascular tissue. • 99% drug encapsulation achieved, with high cytocompatibility supporting fibroblast growth. • Rivaroxaban-eluting grafts show promise to improve arteriovenous graft patency and outcomes in hemodialysis patients.