Evolution of the degradation mechanism of pure zinc stent in the one-year study of rabbit abdominal aorta model

Feasibility evaluation of a Zn-Cu alloy for intrauterine devices: In vitro and in vivo studies

The comprehensively adopted copper-containing intrauterine devices (Cu-IUDs) present typical adverse effects such as bleeding and pain at the initial stage of post-implantation. The replacement of Cu material is demanded. Zinc and its alloys, the emerging biodegradable materials, exhibited contraceptive effects since 1969. In this work, we evaluated the feasibility of bulk Zn alloys as IUD active material. Using pure Cu and pure Zn as control groups, we investigated the contraceptive performance of Zn-0.5Cu and Zn-1Cu alloys via in vitro and in vivo tests. The results showed that the main corrosion product of Zn-Cu alloys is ZnO from both in vitro and in vivo studies. CaZn₂(PO₄)₂·2H₂O is formed atop after long-term immersion in simulated uterine fluid, whereas CaCO₃ is generally formed atop after implantation in the rat uterine environment. The cytocompatibility of the Zn-1Cu alloy was significantly higher than that of the pure Zn and pure Cu to the human endometrial epithelial cell lines. Furthermore, the in vivo results showed that the Zn-1Cu alloy presented much improved histocompatibility, least damage and the fastest recovery on endometrium structure in comparison to pure Zn, Zn-0.5Cu and pure Cu. The systematic and comparing studies suggest that Zn-1Cu alloy can be considered as a possible candidate for IUD with great biochemical and biocompatible properties as well as high contraceptive effectiveness. STATEMENT OF SIGNIFICANCE: The existing adverse effects with the intrinsic properties of copper materials for copper-containing intrauterine devices (Cu-IUD) are of concerns in their employment. Such as burst release of cupric ions (Cu²⁺) at the initial stage of the Cu-IUD. Zinc and its alloys which have been emerging as a potential biodegradable material exhibited contraceptive effects since 1969. In this study, Zn-1Cu alloys displayed significantly improved biocompatibility with human uterus cells and a decreased inflammatory response within the uterus. Therefore, high antifertility efficacy of the Zn-1Cu alloy was well maintained, while the adverse effects are significantly eased, suggesting that the Zn-1Cu alloy is promising for IUD.

Facile fabrication of biodegradable endothelium-mimicking coatings on bioabsorbable zinc-alloy stents by one-step electrophoretic deposition

The zinc-alloy stent is one of the best potential candidates for bioabsorbable metal stents because of its appropriate corrosion rate aligned to the duration of the healing process of the surrounding vessel tissues. However, excessive release of zinc ions, causing cytotoxicity of endothelial cells, and insufficient surface bio-functions of Zn-alloy stents lead to considerable challenge in their application. Herein, one-step electrophoretic deposition was employed to apply a hybrid coating of polycarbonate, tannic acid, and copper ions with tailored functions on Zn-alloy stents to enhance their corrosion resistance and provide an endothelium-mimicking surface. Specifically, the synthesized amino-functionalized aliphatic polycarbonates endowed the hybrid coating with specific surface-erosion properties, resulting in superior corrosion resistance and long-term stability in degradation tests both in vitro and in vivo. The immobilized copper ions enabled the catalytic generation of nitric oxide and promoted the adhesion and proliferation of endothelial cells on zinc alloy. The added tannic acid firmly chelated the copper ions and formed durable phenolic-copper-amine crosslinked networks by electrostatic interaction, resulting in long-term stability of the hybrid coating during the 21 day dynamic immersion test. Tannic acid exerted a synergistic antibacterial effect with copper ions as well as a reduction in the inflammatory response to the zinc substrate. In addition, the hybrid coating improved the in vitro hemocompatibility of zinc alloys. By adjusting the amount of chelated copper in the coating system, the biological function of the corresponding coatings can be controlled, providing a facile surface treatment strategy to promote the progress of zinc-alloy stents in clinical applications.

High-Efficient Vacuum Ultraviolet-Ozone Assist-Deposited Polydopamine for Poly(lactic-co-glycolic acid)-Coated Pure Zn toward Biodegradable Cardiovascular Stent Applications

Zinc is a prospective metal for biodegradable cardiovascular stent applications, but the excessively released Zn²⁺ during degradation remains a huge challenge in biocompatibility. Considerable efforts have been made to develop a high-efficient surface modification method, while maintaining adhesion strength, mechanical support, and vascular compatibility. Biomimetic polydopamine (PDA) can adhere to Zn tightly, subsequently achieving robust chemical bonds with poly(lactic-co-glycolic acid) (PLGA) coating. However, the deposition of PDA on Zn depends on the controlled conditions such as a sensitive pH and a long period of time. Herein, we introduce vacuum ultraviolet-ozone (VUV/O₃) assist-deposition technology to accelerate the polymerization of PDA on pure Zn, which shortens the process to 40 min at a moderate pH of 8.5 and improves the deposition rate by 1-2 orders of magnitude under sufficient active oxygen species (ROS). Additionally, PLGA/PDA coating enhances the corrosion resistance, and their effective protection maintains the mechanical properties after long-term corrosion. Moreover, the controlled Zn²⁺ release contributes to the superior in vitro biocompatibility, which inhibits the hemolysis rate and smooth muscle cell (SMC) proliferation. The enhanced endothelial cell (EC) proliferation is promising to promote the re-endothelialization, avoiding in-stent restenosis and neointimal hyperplasia. Such modified Zn might be a viable candidate for the treatment of cardiovascular diseases.

Biodegradable Zn-Cu-Mn alloy with suitable mechanical performance and in vitro degradation behavior as a promising candidate for vascular stents

Recently, zinc (Zn) alloy has been considered as a promising biodegradable material due to its excellent physiological degradable behavior and acceptable biocompatibility. However, poor mechanical performance limits its application as vascular stents. In this study, novel biodegradable Zn-2.2Cu-xMn (x = 0.4, 0.7, and 1.0 wt%) alloys with suitable mechanical performance were investigated. The effects of Mn addition on microstructure, mechanical properties, and in vitro degradation of Zn-2.2Cu-xMn alloys were systematically investigated. After adding Mn, dynamic recrystallization (DRX) during hot extrusion was promoted, resulting in slightly finer grain size, higher DRXed regions ratio, and weaker texture. And volume fraction and number density of second phase precipitates (micron, submicron, and nano-sized ε and MnZn₁₃ phase) and the concentration of (Cu, Mn) in the matrix were increased. Therefore, Zn-2.2Cu-xMn alloys exhibited suitable mechanical performances (strength >310 MPa, elongation >30%) mainly due to the combination effects of grain refinement, solid solution strengthening, second phase precipitation hardening, and texture weakening. Moreover, the alloys maintained good stability of mechanical properties within 18 months and good elongation over 15% even at a high strain rate of 0.1 s^-1. In addition, the alloys presented appropriate in vitro degradation rates in a basically uniform degradation mode and acceptable in vitro cytocompatibility. The above results indicated that the newly designed biodegradable Zn-2.2Cu-0.4Mn alloy with suitable comprehensive mechanical properties, appropriate degradation behavior, and acceptable cytocompatibility is a promising candidate for vascular stents.

Design, mechanical and degradation requirements of biodegradable metal mesh for pelvic floor reconstruction

Pelvic organ prolapse (POP) is the herniation of surrounding tissue and organs into the vagina and or rectum, and is a result of weakening of pelvic floor muscles, connective tissue,...

A review on current research status of the surface modification of Zn-based biodegradable metals

Recently, zinc and its alloys have been proposed as promising candidates for biodegradable metals (BMs), owning to their preferable corrosion behavior and acceptable biocompatibility in cardiovascular, bone and gastrointestinal environments, together with Mg-based and Fe-based BMs. However, there is the desire for surface treatment for Zn-based BMs to better control their biodegradation behavior. Firstly, the implantation of some Zn-based BMs in cardiovascular environment exhibited intimal activation with mild inflammation. Secondly, for orthopedic applications, the biodegradation rates of Zn-based BMs are relatively slow, resulting in a long-term retention after fulfilling their mission. Meanwhile, excessive Zn2+ release during degradation will cause in vitro cytotoxicity and in vivo delayed osseointegration. In this review, we firstly summarized the current surface modification methods of Zn-based alloys for the industrial applications. Then we comprehensively summarized the recent progress of biomedical bulk Zn-based BMs as well as the corresponding surface modification strategies. Last but not least, the future perspectives towards the design of surface bio-functionalized coatings on Zn-based BMs for orthopedic and cardiovascular applications were also briefly proposed.

Zn-Mg-WC Nanocomposites for Bioresorbable Cardiovascular Stents: Microstructure, Mechanical Properties, Fatigue, Shelf Life, and Corrosion

Zinc (Zn) and Zn alloys have been studied as potential materials for bioresorbable stents (BRSs) in the last decade due to their favorable biodegradability and biocompatibility. However, most Zn alloys lack the necessary combination of strength, ductility, fatigue resistance, corrosion rate (CR), and thermal stability needed for such applications. In this study, nanoparticles made of tungsten carbide (WC) were successfully incorporated into Zn alloyed with 0.5 wt % magnesium (Mg) and evaluated for their suitability for BRS applications. Specifically, the resulting Zn-0.5Mg-WC nanocomposite's microstructure, mechanical properties, in vitro CR, and thermal stability were evaluated. The Zn-0.5Mg-WC nanocomposite had excellent mechanical strength [ultimate tensile strength (UTS) > 250 MPa], elongation to failure (>30%), and a suitable in vitro CR (∼0.02 mm/y) for this clinical application. Moreover, the Zn-0.5Mg-WC nanocomposite survived 10 million cycles of tensile loading (stress ratio, R = 0.053) when the maximum stress was 80% of the yield stress. Its ductility was also retained during a 90-day thermal stability study, indicating an excellent shelf life. Stent prototypes were fabricated using this composition and were successfully deployed during bench testing without fracture. These results show that the Zn-0.5Mg-WC nanocomposite is a promising material for BRS applications. In vivo studies are underway to validate both biocompatibility, stent function, and degradation.

Current status and outlook of biodegradable metals in neuroscience and their potential applications as cerebral vascular stent materials

Over the past two decades, biodegradable metals (BMs) have emerged as promising materials to fabricate temporary biomedical devices, with the purpose of avoiding potential side effects of permanent implants. In this review, we first surveyed the current status of BMs in neuroscience, and briefly summarized the representative stents for treating vascular stenosis. Then, inspired by the convincing clinical evidence on the in vivo safety of Mg alloys as cardiovascular stents, we analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for treating ischemic stroke. For these novel applications, some key factors should also be considered in designing BM brain stents, including the anatomic features of the cerebral vasculature, hemodynamic influences, neuro-cytocompatibility and selection of alloying elements. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents.

•

The current status of the application of biodegradable metals (BM) in neuroscience was presented.

•

We analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for ischemic stroke treatment.

•

Key factors in designing BM brain stents were discussed.

•

This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents.

Zinc-nutrient element based alloys for absorbable wound closure devices fabrication: Current status, challenges, and future prospects

The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.

Nutrient alloying elements in biodegradable metals: a review

As a new generation of biomedical metallic materials, biodegradable metals have become a hot research topic in recent years because they can completely degrade in the human body, thus preventing secondary surgery, and reducing the pain and economic burden for patients. Clinical applications require biodegradable metals with adequate mechanical properties, corrosion resistance, and biocompatibility. Alloying is an important method to create biodegradable metals with required and comprehensive performances. Since nutrient elements already have important effects on various physiological functions of the human body, the alloying of nutrient elements with biodegradable metals has attracted much attention. The present review summarizes and discusses the effects of nutrient alloying elements on the mechanical properties, biodegradation behavior, and biocompatibility of biodegradable metals. Moreover, future research directions of biodegradable metals with nutrient alloying elements are suggested.

Two-stage degradation and novel functional endothelium characteristics of a 3-D printed bioresorbable scaffold

Bioresorbable scaffolds have emerged as a new generation of vascular implants for the treatment of atherosclerosis, and designed to provide a temporary scaffold that is subsequently absorbed by blood vessels over time. Presently, there is insufficient data on the biological and mechanical responses of blood vessels accompanied by bioresorbable scaffolds (BRS) degradation. Therefore, it is necessary to investigate the inflexion point of degradation, the response of blood vessels, and the pathophysiological process of vascular, as results of such studies will be of great value for the design of next generation of BRS. In this study, abdominal aortas of SD rats were received 3-D printed poly-l-actide vascular scaffolds (PLS) for various durations up to 12 months. The response of PLS implanted aorta went through two distinct processes: (1) the neointima with desirable barrier function was obtained in 1 month, accompanied with slow degradation, inflammation, and intimal hyperplasia; (2) significant degradation occurred from 6 months, accompanied with decreasing inflammation and intimal hyperplasia, while the extracellular matrix recovered to normal vessels which indicate the positive remodeling. These in vivo results indicate that 6 months is a key turning point. This “two-stage degradation and vascular characteristics” is proposed to elucidate the long-term effects of PLS on vascular repair and demonstrated the potential of PLS in promoting endothelium function and positive remodeling, which highlights the benefits of PLS and shed some light in the future researches, such as drug combination coatings design.

•

Proposed two-stage degradation of a PLLA BRS to reveal distinct neointimal recovery and vascular responsive processes.

•

Revealed novel benefits of BRS, including fine endothelium function, anti-thrombosis, and anti-inflammatory.

•

Drug combination coatings should be designed concerning special degradation of BRS and the key turning point, 6 months.

Surface engineering and the application of laser-based processes to stents - A review of the latest development

Late in-stent thrombus and restenosis still represent two major challenges in stents’ design. Surface treatment of stent is attracting attention due to the increasing importance of stenting intervention for coronary artery diseases. Several surface engineering techniques have been utilised to improve the biological response in vivo on a wide range of biomedical devices. As a tailorable, precise, and ultra-fast process, laser surface engineering offers the potential to treat stent materials and fabricate various 3D textures, including grooves, pillars, nanowires, porous and freeform structures, while also modifying surface chemistry through nitridation, oxidation and coatings. Laser-based processes can reduce the biodegradable materials' degradation rate, offering many advantages to improve stents’ performance, such as increased endothelialisation rate, prohibition of SMC proliferation, reduced platelet adhesion and controlled corrosion and degradation. Nowadays, adequate research has been conducted on laser surface texturing and surface chemistry modification. Laser texturing on commercial stents has been also investigated and a promotion of performance of laser-textured stents has been proved.

In this critical review, the influence of surface texture and surface chemistry on stents performance is firstly reviewed to understand the surface characteristics of stents required to facilitate cellular response. This is followed by the explicit illustration of laser surface engineering of stents and/or related materials. Laser induced periodic surface structure (LIPSS) on stent materials is then explored, and finally the application of laser surface modification techniques on latest generation of stent devices is highlighted to provide future trends and research direction on laser surface engineering of stents.

•

Compared conventional surface engineering with laser-based methods for biomedical devices.

•

Explained the influence of texture geometry and surface chemistry on stents biological response.

•

Reviewed state of the art in laser surface engineering of stents for improved biological response.

•

Reviewed state of the art in laser surface engineering to control degradation of bioresorbable stents.

•

Highlighted novel laser surface engineering designs for improved stents'performance.

Bioabsorbable metal zinc differentially affects mitochondria in vascular endothelial and smooth muscle cells

Zinc is an essential trace element having various structural, catalytic and regulatory interactions with an estimated 3000 proteins. Zinc has drawn recent attention for its use, both as pure metal and alloyed, in arterial stents due to its biodegradability, biocompatibility, and low corrosion rates. Previous studies have demonstrated that zinc metal implants prevent the development of neointimal hyperplasia, which is a common cause of restenosis following coronary intervention. This suppression appears to be smooth muscle cell-specific, as reendothelization of the neointima is not inhibited. To better understand the basis of zinc's differential effects on rat aortic smooth muscle (RASMC) versus endothelial (RAENDO) cells, we conducted a transcriptomic analysis of both cell types following one-week continuous treatment with 5 µM or 50 µM zinc. This analysis indicated that genes whose protein products regulate mitochondrial functions, including oxidative phosphorylation and fusion/fission, are differentially affected by zinc in the two cell types. To better understand this, we performed Seahorse metabolic flux assays and quantitative imaging of mitochondrial networks in both cell types. Zinc treatment differently affected energy metabolism and mitochondrial structure/function in the two cell types. For example, both basal and maximal oxygen consumption rates were increased by zinc in RASMC but not in RAENDO. Zinc treatment increased apparent mitochondrial fusion in RASMC cells but increased mitochondrial fission in RAENDO cells. These results provide some insight into the mechanisms by which zinc treatment differently affects the two cell types and this information is important for understanding the role of zinc treatment in vascular cells and improving its use in biodegradable metal implants.

Improved mechanical, degradation, and biological performances of Zn–Fe alloys as bioresorbable implants

Zinc (Zn) is a promising bioresorbable implant material with more moderate degradation rate compared to magnesium (Mg) and iron (Fe). However, the low mechanical strength and localized degradation behavior of pure Zn limit its clinical applications. Alloying is one of the most effective ways to overcome these limitations. After screening the alloying element candidates regarding their potentials for improvement on the degradation and biocompatibility, we proposed Fe as the alloying element for Zn, and investigated the in vitro and in vivo performances of these alloys in both subcutaneous and femoral tissues. Results showed that the uniformly distributed secondary phase in Zn–Fe alloys significantly improved the mechanical property and facilitated uniform degradation, which thus enhanced their biocompatibility, especially the Zn-0.4Fe alloy. Moreover, these Zn–Fe alloys showed outstanding antibacterial property. Taken together, Zn–Fe alloys could be promising candidates as bioresorbable medical implants for various cardiovascular, wound closure, and orthopedic applications.

•

Zn-0.4Fe alloy significantly improved the mechanical strength and ductility.

•

Zn-0.4Fe alloy showed a uniform degradation behavior.

•

Subcutaneous and femoral implantations to compare in vivo performances.

•

Zn-0.4Fe alloy showed superior hemocompatibility and in vivo osteointegration.

Impact of sterilization treatments on biodegradability and cytocompatibility of zinc-based implant materials

Biodegradable zinc (Zn) and Zn-based alloys have been recognized as promising biomaterials for biomedical implants. Sterilization is an essential step in handling Zn-based implants before their use in clinical practice and there are various sterilization methods are available. However, how these treatments influence the Zn-based biomaterials remains unknown and is of critical relevance. In this study, three commonly-applied standard sterilization methods, namely gamma irradiation, hydrogen peroxide gas plasma and steam autoclave, were used on pure Zn and Zn3Cu (wt%) alloy. The treated Zn and ZnCu alloy were investigated to compare the different influences of sterilizations on surface characteristics, transient and long-term degradation behavior and cytotoxicity of Zn and Zn alloy. Our results indicate that autoclaving brought about apparently a formation of inhomogeneous zinc oxide film whereas the other two methods produced no apparent alterations on the material surfaces. Consequently, the samples after autoclaving showed significantly faster degradation rates and more severe localized corrosion, especially for the ZnCu alloy, owing to the incomplete covering and unstable zinc oxide layer. Moreover, the autoclave-treated Zn and ZnCu alloy exhibited apparent cytotoxic effects towards fibroblasts, which may be due to the excessive Zn ion releasing and its local concentration exceeds the cellular tolerance capacity. In contrast, gamma irradiation and hydrogen peroxide gas plasma had no apparent adverse effects on the biodegradability and cytocompatibility of Zn and ZnCu alloy. Our findings may have significant implications regarding the selection of suitable sterilization methods for Zn-based implant materials among others.

Limitation of Water-Soluble Tetrazolium Salt for the Cytocompatibility Evaluation of Zinc-Based Metals

Zinc (Zn) and its alloys have been regarded as promising biodegradable metals. The standardized cytotoxicity evaluation is a mandatory step to screen the biocompatibility of novel Zn and its alloys. Nevertheless, the suitability of the tetrazolium-based assay in the direct contact test for some metallic biomaterials (i.e., magnesium and manganese) is questionable. In this study, our results demonstrate an obvious inconsistency between qualitative observation via fluorescence staining and quantitative assessment using water-soluble tetrazolium salt (CCK-8). Subsequent experiments revealed that Zn and pre-treated Zn can directly convert tetrazolium salts to formazan, falsifying the cytotoxicity results. Therefore, we conclude that the CCK-8 assay is not suitable for evaluating the cytotoxicity of biodegradable Zn-based metals in the direct contact test.

Electrodeposited dopamine/strontium-doped hydroxyapatite composite coating on pure zinc for anti-corrosion, antimicrobial and osteogenesis

Zinc-based biometal is expected to become a new generation of biodegradable implants. Due to its antibacterial and biocompatibility in vivo, zinc metals is recently considered to be the most promising biodegradable metal, However, cytotoxicity is the thorny problem that currently restrict its application, due to the excessive Zn ions released during degradation. In order to solve these problems, dopamine modified strontium-doped hydroxyapatite coating (SrHA/PDA) was fabricated on alkali-treated pure zinc to improve its corrosion rate and cytocompatibility by electrodeposition for the first time. The obtained coating showed a dense structure and high crystallinity, which was attributed to the attraction of Ca²⁺ ions by polydopamine. The results showed that the SrHA/PDA coating delayedthe degradation rate of zinc metal, which reduced the release of Zn²⁺, thereby reducing its cytotoxicity. Additionally, electrochemical tests showed that SrHA/PDA coating can reduce the corrosion rate of pure zinc. In vitro cell viability showed that even at high Zn²⁺ concentrations (3.11 mg/L), preosteoblasts (MC3T3-E1) cells proliferated at a high rate on SrHA/PDA, thus confirming that Sr²⁺ counteracted the cytotoxic effects of Zn²⁺ and promoted cell differentiation. Moreover, the SrHA/PDA coating still maintained excellent antibacterial effects against pathogenic bacterial strains (Escherichia coli and Staphylococcus aureus). Mild pH changes had no significant effect on the viability of cells and bacterias. Collectively, the present study elucidated that by coating SrHA/PDA/Zn(OH)₂ on Zn, a controllable corrosion rate, original antibacterial properties and better cell compatibility can be achieved. This provided a new strategy for the surface modification of biodegradable Zn.

Influence of bovine serum albumin on corrosion behaviour of pure Zn in phosphate buffered saline

Zinc (Zn) and its alloys have received increasing attention as new alternative biodegradable metals. However, consensus has not been reached on the corrosion behaviour of Zn. As cardiovascular artery stent material, Zn is supposed to contact with plasma that contains inorganic salts and organic components. Protein is one of the most important constitute in the plasma and could adsorb on the material surface. In this paper, bovine serum albumin (BSA) was used as a typical protein. Influences of BSA on pure Zn corrosion in phosphate buffered saline is investigated as a function of BSA concentrations and immersion durations by electrochemical techniques and surface analysis. Results showed that pure Zn corrosion was progressively accelerated with BSA concentrations (ranging from 0.05 to 5 g L^-1) at 0.5 h. With time evolves, formation of phosphates as corrosion product was delayed by BSA adsorption, especially at concentration of 2 g L^-1. Within 48 h, the corrosion of pure Zn was alleviated by BSA at concentration of 0.1 g L^-1, whereas the corrosion was enhanced after 168 h. Addition of 2 g L^-1 BSA has opposite influence on the pure Zn corrosion. Furthermore, schematic corrosion behaviour at protein/Zn interfaces was proposed. This work encourages us to think more about the influence of protein on the material corrosion and helps us to better understand the corrosion behaviour of pure Zn.

Antibacterial metals and alloys for potential biomedical implants

Metals and alloys, including stainless steel, titanium and its alloys, cobalt alloys, and other metals and alloys have been widely used clinically as implant materials, but implant-related infection or inflammation is still one of the main causes of implantation failure. The bacterial infection or inflammation that seriously threatens human health has already become a worldwide complaint. Antibacterial metals and alloys recently have attracted wide attention for their long-term stable antibacterial ability, good mechanical properties and good biocompatibility in vitro and in vivo. In this review, common antibacterial alloying elements, antibacterial standards and testing methods were introduced. Recent developments in the design and manufacturing of antibacterial metal alloys containing various antibacterial agents were described in detail, including antibacterial stainless steel, antibacterial titanium alloy, antibacterial zinc and alloy, antibacterial magnesium and alloy, antibacterial cobalt alloy, and other antibacterial metals and alloys. Researches on the antibacterial properties, mechanical properties, corrosion resistance and biocompatibility of antibacterial metals and alloys have been summarized in detail for the first time. It is hoped that this review could help researchers understand the development of antibacterial alloys in a timely manner, thereby could promote the development of antibacterial metal alloys and the clinical application.

Surface Treatment of Zn-Mn-Mg Alloys by Micro-Arc Oxidation in Silicate-Based Solutions with Different NaF Concentrations

Newly developed Zn-Mn-Mg alloys can be invoked as biomedical materials because of their excellent mechanical properties. However, the corrosion behavior of Zn-Mn-Mg alloys was still lacking in research. It had grown to be a hot research topic to improve the corrosion behavior of Zn alloys by surface treatment to meet the application of degradable Zn alloys in biomedical applications. Micro arc oxidation (MAO) is a simple and effective method to improve the corrosion behavior of the alloy. MAO coatings were successfully prepared on the surface of Zn-Mn-Mg alloys by MAO in silicate-based solutions with different NaF concentrations. The microstructure and phase composition of MAO coatings prepared on Zn-Mn-Mg alloys with different NaF concentrations in the electrolyte was examined by a scanning electron microscope and X-ray diffraction. The results showed that the MAO coatings are porous and mainly composed of ZnO. With the increasing NaF concentration in the electrolyte, the average thickness increases. The distribution of the micro/nanopores was uniform, and the pore size ranged from the submicron scale to several micrometers after MAO treatment in the electrolyte containing different concentrations of NaF. Potential dynamic polarization curves and electrochemical impedance spectroscopy were employed to assess the corrosion behavior of MAO coatings in Hank’s solution. The highest corrosion rate can be achieved after MAO treatment, with an electrolyte concentration of 1.5 g/L NaF in Hank’s solution. These results indicated that MAO coating can accelerate the corrosion resistance of a Zn-Mn-Mg alloy.

Influence of bovine serum albumin on biodegradation behavior of pure Zn

Zinc is emerging as a promising biodegradable metal for temporary implant applications. In this work, we investigate the influence of bovine serum albumin (BSA)-the most abundant blood protein in simulated body fluid (SBF) on degradation of pure Zn via electrochemical measurements and long-term immersion. Electrochemical experiments indicate a decrease of the corrosion rate of bare Zn with increasing BSA concentration in solution for short-term exposures. Samples were characterized with scanning electron microscope (SEM) (including energy dispersive spectroscopy [EDS], X-ray photoelectron spectroscopy [XPS], Fourier transform infrared spectroscopy [FTIR], and time-of-flight secondary ion mass spectrometry [TOF-SIMS]) after immersion up to 21 days. Presence of BSA in the electrolyte, decrease the amount of Ca-phosphate precipitation on Zn surface. However, a more compact surface layer formed in the presence of BSA in solution. Most noteworthy, in long-term exposures, BSA enhances localized corrosion of Zn-such detrimental localized attack was not observed in BSA-free solution. We suggest that a sealed space forming between the Zn substrate and a protein adsorption layer restricts mass transport, thus triggering localized corrosion of Zn.

Recent advances and directions in the development of bioresorbable metallic cardiovascular stents: Insights from recent human and in vivo studies

Over the past two decades, significant advancements have been made regarding the material formulation, iterative design, and clinical translation of metallic bioresorbable stents. Currently, magnesium-based (Mg) stent devices have remained at the forefront of bioresorbable stent material development and use. Despite substantial advances, the process of developing novel absorbable stents and their clinical translation is time-consuming, expensive, and challenging. These challenges, coupled with the continuous refinement of alternative bioresorbable metallic bulk materials such as iron (Fe) and zinc (Zn), have intensified the search for an ideal absorbable metallic stent material. Here, we discuss the most recent pre-clinical and clinical evidence for the efficacy of bioresorbable metallic stents and material candidates. From this perspective, strategies to improve the clinical performance of bioresorbable metallic stents are considered and critically discussed, spanning material alloy development, surface manipulations, material processing techniques, and preclinical/biological testing considerations. STATEMENT OF SIGNIFICANCE: Recent efforts in using Mg, Fe, and Zn based materials for bioresorbable stents include elemental profile changes as well as surface modifications to improve each of the three classes of materials.  Although a variety of alloys for absorbable metallic stents have been developed, the ideal absorbable stent material has not yet been discovered. This review focuses on the state of the art for bioresorbable metallic stent development. It covers the three bulk materials used for degradable stents (Mg, Fe, and Zn), and discusses their advances from a translational perspective. Strategies to improve the clinical performance of bioresorbable metallic stents are considered and critically discussed, spanning material alloy development, surface manipulations, material processing techniques, and preclinical/biological testing considerations.

PDLLA-Zn-nitrided Fe bioresorbable scaffold with 53-μm-thick metallic struts and tunable multistage biodegradation function

Balancing the biodegradability and mechanical integrity of a bioresorbable scaffold (BRS) with time after implantation to match the remodeling of the scaffolded blood vessel is important, but a key challenge in doing so remains. This study presents a novel intercalated structure of a metallic BRS by introducing a nanoscale Zn sacrificial layer between the nitrided Fe platform and the sirolimus-carrying poly(d,l-lactide) drug coating. The PDLLA-Zn-FeN BRS shows a multistage biodegradation behavior, maintaining mechanical integrity at the initial stage and exhibiting accelerated biodegradation at the subsequent stage in both rabbit abdominal aortas and human coronary arteries, where complete biodegradation was observed about 2 years after implantation. The presence of the nanoscale Zn sacrificial layer with an adjustable thickness also contributes to the tunable biodegradation of BRS and allows the reduction of the metallic strut thickness to 53 μm, with radial strength as strong as that of the current permanent drug-eluting stents.

New Zn3Mg-xY Alloys: Characteristics, Microstructural Evolution and Corrosion Behavior

Zinc biodegradable alloys attracted an increased interest in the last few years in the medical field among Mg and Fe-based materials. Knowing that the Mg element has a strengthening influence on Zn alloys, we analyze the effect of the third element, namely, Y with expected results in mechanical properties improvement. Ternary ZnMgY samples were obtained through induction melting in Argon atmosphere from high purity (Zn, Mg, and Y) materials and MgY (70/30 wt%) master alloys with different percentages of Y and keeping the same percentage of Mg (3 wt%). The corrosion resistance and microhardness of ZnMgY alloys were compared with those of pure Zn and ZnMg binary alloy. Materials were characterized using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), linear and cyclic potentiometry, and immersion tests. All samples present generalized corrosion after immersion and electro-corrosion experiments in Dulbecco solution. The experimental results show an increase in microhardness and indentation Young Modulus following the addition of Y. The formation of YZn12 intermetallic phase elements with a more noble potential than pure Zinc is established. A correlation is obtained between the appearance of new Y phases and aggressive galvanic corrosion.

Cardiovascular Stents: A Review of Past, Current, and Emerging Devices

One of the leading causes of morbidity and mortality worldwide is coronary artery disease, a condition characterized by the narrowing of the artery due to plaque deposits. The standard of care for treating this disease is the introduction of a stent at the lesion site. This life-saving tubular device ensures vessel support, keeping the blood-flow path open so that the cardiac muscle receives its vital nutrients and oxygen supply. Several generations of stents have been iteratively developed towards improving patient outcomes and diminishing adverse side effects following the implanting procedure. Moving from bare-metal stents to drug-eluting stents, and recently reaching bioresorbable stents, this research field is under continuous development. To keep up with how stent technology has advanced in the past few decades, this paper reviews the evolution of these devices, focusing on how they can be further optimized towards creating an ideal vascular scaffold.

Estimation of degradation velocity of biocompatible damaged stents due to blood flow

OBJECTIVE

Bioresorbable materials represent a promising technology for the treatment of coronary disease. Among the different materials employed, magnesium stents display favourable mechanical properties. One of the main uncertainties regarding use is their behaviour when deployed on coronary bifurcations, especially when their retardant coating has been damaged during the implantation process. This paper analyses the temporal evolution of the degradation of a damaged magnesium stent inserted into a coronary bifurcation.

METHODS

The rate of erosion-corrosion and the effect of the flow configuration on the mass transfer coefficient were estimated on the basis of previous experimental studies and numerical simulations. This coefficient has been employed to reproduce the conditions that can appear in real stent configurations, and computational fluid dynamics simulations were performed.

RESULTS

The diffusion coefficient for this particular case has been calculated from the mass transfer coefficient and the Sherwood number. The results of the simulation show how the presence of the inner artery wall has a positive effect, preventing a premature degradation of the stent, and how the distal strut is protected by the presence of the proximal struts.

CONCLUSIONS

This study demonstrates the usefulness of the proposed methodology to evaluate the temporal evolution of the degradation of struts made of magnesium alloys. In addition, this methodology can be applied to a study of different materials and geometric configurations.

SIGNIFICANCE

The proposed technique can contribute to expanding existing knowledge concerning bioresorbable stent flow-corrosion, thus improving their design and implantation.

Biodegradable ZnLiCa ternary alloys for critical-sized bone defect regeneration at load-bearing sites: In vitro and in vivo studies

A novel biodegradable metal system, ZnLiCa ternary alloys, were systematically investigated both in vitro and in vivo. The ultimate tensile strength (UTS) of Zn0.8Li0.1Ca alloy reached 567.60 ± 9.56 MPa, which is comparable to pure Ti, one of the most common material used in orthopedics. The elongation of Zn0.8Li0.1Ca is 27.82 ± 18.35%, which is the highest among the ZnLiCa alloys. The in vitro degradation rate of Zn0.8Li0.1Ca alloy in simulated body fluid (SBF) showed significant acceleration than that of pure Zn. CCK-8 tests and hemocompatibility tests manifested that ZnLiCa alloys exhibit good biocompatibility. Real-time PCR showed that Zn0.8Li0.1Ca alloy successfully stimulated the expressions of osteogenesis-related genes (ALP, COL-1, OCN and Runx-2), especially the OCN. An in vivo implantation was conducted in the radius of New Zealand rabbits for 24 weeks, aiming to treat the bone defects. The Micro-CT and histological evaluations proved that the regeneration of bone defect was faster within the Zn0.8Li0.1Ca alloy scaffold than the pure Ti scaffold. Zn0.8Li0.1Ca alloy showed great potential to be applied in orthopedics, especially in the load-bearing sites.

•

The first research work of ZnLiCa alloys to be used as biodegradable metals.

•

The ultimate tensile strength (UTS) of Zn0.8Li0.1Ca alloy reached 567.60 ± 9.56 MPa, which is comparable to pure Ti, one of the most common material used in orthopedics.

•

Porous scaffolds made of Zn0.8Li0.1Ca showed superior bone-defect-treating effects to pure Ti scaffolds in New Zealand rabbits.

Recent research and progress of biodegradable zinc alloys and composites for biomedical applications: Biomechanical and biocorrosion perspectives

Biodegradable metals (BMs) gradually degrade in vivo by releasing corrosion products once exposed to the physiological environment in the body. Complete dissolution of biodegradable implants assists tissue healing, with no implant residues in the surrounding tissues. In recent years, three classes of BMs have been extensively investigated, including magnesium (Mg)-based, iron (Fe)-based, and zinc (Zn)-based BMs. Among these three BMs, Mg-based materials have undergone the most clinical trials. However, Mg-based BMs generally exhibit faster degradation rates, which may not match the healing periods for bone tissue, whereas Fe-based BMs exhibit slower and less complete in vivo degradation. Zn-based BMs are now considered a new class of BMs due to their intermediate degradation rates, which fall between those of Mg-based BMs and Fe-based BMs, thus requiring extensive research to validate their suitability for biomedical applications. In the present study, recent research and development on Zn-based BMs are reviewed in conjunction with discussion of their advantages and limitations in relation to existing BMs. The underlying roles of alloy composition, microstructure, and processing technique on the mechanical and corrosion properties of Zn-based BMs are also discussed.

Cancellous bone-like porous Fe@Zn scaffolds with core-shell-structured skeletons for biodegradable bone implants

Three-dimensional (3D) porous zinc (Zn) with a moderate degradation rate is a promising candidate for biodegradable bone scaffolds. However, fabrication of such scaffolds with adequate mechanical properties remains a challenge. Moreover, the composition, crystallography and microstructure of the in vivo degradation products formed at or near the implant-bone interface are still not precisely known. Here, we have fabricated porous Fe@Zn scaffolds with skeletons consisting of an inner core layer of Fe and an outer shell layer of Zn using template-assisted electrodeposition technique, and systematically evaluated their porous structure, mechanical properties, degradation mechanism, antibacterial ability and in vitro and in vivo biocompatibility. In situ site-specific focused ion beam micromilling and transmission electron microscopy were used to identify the in vivo degradation products at the nanometer scale. The 3D porous Fe@Zn scaffolds show similar structure and comparable mechanical properties to human cancellous bone. The degradation rates can be adjusted by varying the layer thickness of Zn and Fe. The antibacterial rates reach over 95% against S. aureus and almost 100% against E. coli. A threshold of released Zn ion concentration (~ 0.3 mM) was found to determine the in vitro biocompatibility. Intense new bone formation and ingrowth were observed despite with a slight inflammatory response. The in vivo degradation products were identified to be equiaxed nanocrystalline zinc oxide with dispersed zinc carbonate. This study not only demonstrates the feasibility of porous Fe@Zn for biodegradable bone implants, but also provides significant insight into the degradation mechanism of porous Zn in physiological environment.

Microstructural, mechanical, in vitro corrosion and biological characterization of an extruded Zn-0.8Mg-0.2Sr (wt%) as an absorbable material

Zinc (Zn) alloys seem to be promising candidates for application in orthopaedic or cardiovascular medical implants. In this area, high standards are required regarding the biocompatibility as well as excellent mechanical and tailored degradation properties. In the presented study, a novel Zn-0.8Mg-0.2Sr (wt%) alloy has been fabricated by the combination of casting, homogenization annealing and extrusion at 200 °C. As a consequence of its fine-grained homogenous microstructure, the prepared material is characterized by an excellent combination of tensile yield strength, ultimate tensile strength and elongation corresponding to 244 MPa, 324 MPa and 20% respectively. The in vitro corrosion rates of the Zn-0.8Mg-0.2Sr alloy in the physiological solution and the simulated body fluid were 244 μm/a and 69.8 μm/a, respectively. Furthermore, an extract test revealed that Zn-0.8Mg-0.2Sr extracts diluted to 25% had no adverse effects towards L929 fibroblasts, TAg periosteal cells and Saos-2 osteoblasts. Moreover, the Zn-0.8Mg-0.2Sr surface showed effective inhibition of initial Streptococcus gordonii adhesion and biofilm formation. These results indicated the Zn-0.8Mg-0.2Sr alloy, which has superior mechanical properties, might be a promising candidate for materials used for load-bearing applications.

Designing Better Cardiovascular Stent Materials - A Learning Curve

Cardiovascular stents are life-saving devices and one of the top 10 medical breakthroughs of the 21st century. Decades of research and clinical trials have taught us about the effects of material (metal or polymer), design (geometry, strut thickness, and the number of connectors), and drug-elution on vasculature mechanics, hemocompatibility, biocompatibility, and patient health. Recently developed novel bioresorbable stents are intended to overcome common issues of chronic inflammation, in-stent restenosis, and stent thrombosis associated with permanent stents, but there is still much to learn. Increased knowledge and advanced methods in material processing have led to new stent formulations aimed at improving the performance of their predecessors but often comes with potential tradeoffs. This review aims to discuss the advantages and disadvantages of stent material interactions with the host within five areas of contrasting characteristics, such as 1) metal or polymer, 2) bioresorbable or permanent, 3) drug elution or no drug elution, 4) bare or surface-modified, and 5) self-expanding or balloon-expanding perspectives, as they relate to pre-clinical and clinical outcomes and concludes with directions for future studies.

Additively manufactured functionally graded biodegradable porous zinc

Topological design provides additively manufactured (AM) biodegradable porous metallic biomaterials with a unique opportunity to adjust their biodegradation behavior and mechanical properties, thereby satisfying the requirements for ideal bone substitutes. However, no information is available yet concerning the effect of topological design on the performance of AM porous zinc (Zn) that outperforms Mg and Fe in biodegradation behavior. Here, we studied one functionally graded and two uniform AM porous Zn designs with diamond unit cell. Cylindrical specimens were fabricated from pure Zn powder by using a powder bed fusion technique, followed by a comprehensive study on their static and dynamic biodegradation behaviors, mechanical properties, permeability, and biocompatibility. Topological design, indeed, affected the biodegradation behavior of the specimens, as evidenced by 150% variations in biodegradation rate between the three different designs. After in vitro dynamic immersion for 28 days, the AM porous Zn had weight losses of 7-12%, relying on the topological design. The degradation rates satisfied the desired biodegradation time of 1-2 years for bone substitution. The mechanical properties of the biodegraded specimens of all the groups maintained within the range of those of cancellous bone. As opposed to the trends observed for other biodegradable porous metals, after 28 days of in vitro biodegradation, the yield strengths of the specimens of all the groups (σy = 7-14 MPa) increased consistently, as compared to those of the as-built specimens (σy = 4-11 MPa). Moreover, AM porous Zn showed excellent biocompatibility, given that the cellular activities in none of the groups differed from the Ti controls for up to 72 h. Using topological design of AM porous Zn for controlling its mechanical properties and degradation behavior is thus clearly promising, thereby rendering flexibility to the material to meet a variety of clinical requirements.

Arsenic trioxide-eluting electrospun nanofiber-covered self-expandable metallic stent reduces granulation tissue hyperplasia in rabbit trachea

Stent-related granulation tissue hyperplasia is a major complication that limits the application of stents in airways. In this study, an arsenic trioxide-eluting electrospun nanofiber-covered self-expandable metallic stent (ATO-NFCS) was developed. Poly-L-lactide-caprolactone (PLCL) was selected as the drug-carrying polymer. Stents with two different ATO contents (0.4% ATO/PLCL and 1.2% ATO/PLCL) were fabricated. The in vitro release in simulated airway fluid suggested that the total ATO release time was 1 d. The growth of human embryonic pulmonary fibroblasts (CCC-HPF-1), normal human bronchial epithelial cells and airway smooth muscle cells was inhibited by ATO. When embedded in paravertebral muscle, the nanofiber membrane showed good short-term and long-term biological effects. In an animal study, placement of the ATO-NFCS in the trachea through a delivery system under fluoroscopy was feasible. The changes in liver and kidney function 1 and 7 d after ATO-NFCS placement were within the normal range. On pathological examination, the heart, liver, spleen, lungs and kidneys were normal. The effectiveness of the ATO-NFCS in reducing granulation tissue hyperplasia and collagen deposition was demonstrated in the rabbit airway (n = 18) at 4 weeks. The present study preliminarily investigated the efficacy of the ATO-NFCS in reducing granulation tissue formation in the trachea of rabbits. The results suggest that the ATO-NFCS is safe in vivo, easy to place, and effective for the suppression of granulation tissue formation.

Investigating the stress corrosion cracking of a biodegradable Zn-0.8 wt%Li alloy in simulated body fluid

Stress corrosion cracking (SCC) may lead to brittle, unexpected failure of medical devices. However, available researches are limited to Mg-based biodegradable metals (BM) and pure Zn. The stress corrosion behaviors of newly-developed Zn alloys remain unclear. In the present work, we conducted slow strain rate testing (SSRT) and constant-load immersion test on a promising Zn-0.8 wt%Li alloy in order to investigate its SCC susceptibility and examine its feasibility as BM with pure Zn as control group. We observed that Zn-0.8 wt%Li alloy exhibited low SCC susceptibility. This was attributed to variations in microstructure and deformation mechanism after alloying with Li. In addition, both pure Zn and Zn-0.8 wt%Li alloy did not fracture over a period of 28 days during constant-load immersion test. The magnitude of applied stress was close to physiological condition and thus, we proved the feasibility of both materials as BM.

•

The deformation mechanisms of pure Zn and Zn-0.8 wt%Li alloy were different.

•

For pure Zn, surface curvatures provided sites for SCC initiation.

•

Only shallow cracks on corrosion layer were observed for Zn-0.8 wt%Li alloy.

•

Both materials did not fracture after constant-load immersion test.

Biodegradable Zn-Cu alloys show antibacterial activity against MRSA bone infection by inhibiting pathogen adhesion and biofilm formation

Bone and joint-related infections remain the primary and most critical complications of orthopedic surgery. We have innovatively prepared Zn-Cu alloys to achieve outstanding material and antibacterial properties. In this study, we systematically assessed the material properties and antibacterial activity of these Zn-Cu alloys. Our results showed that the Zn-2Cu alloy had the best mechanical properties, biocompatibility, and osteogenic properties. Findings of microbial cultures, CLSM, SEM, and TEM indicated that Zn-2Cu alloy can inhibit both coagulase-positive and coagulase-negative staphylococci, as well as antibiotic-resistant strains (MRSA and MRSE), by preventing the bacteria adhesion and the biofilm formation. Zn-2Cu alloy could broadly affect the expression of MRSA genes associated with adhesion, autolysis, biofilm formation, virulence, and drug resistance. A rat femur intramedullary nail infection-prevention model was established and the Zn-2Cu alloy-treated group showed significant antibacterial activity against MRSA and reduced the inflammatory toxic side-effects and infection-related bone loss. Collectively, our results indicate the potential utility of Zn-Cu alloy implants with 2 wt% Cu in treating orthopedic infections. Statement of significance: Osteomyelitis is a serious complication of orthopedic surgeries. Wide use of antibiotics contributes to the appearance of multi-drug resistant strains like methicillin-resistant staphylococcus aureus (MRSA). Alternatively, anti-osteomyelitis implants with broad-spectrum antibacterial properties can be favorable. Here, the antibacterial performance of biodegradable Zn-Cu alloys was evaluated with four different bacteria strains including antibiotic-resistant strains (MRSA and MRSE). Zn-Cu alloys exert excellent bacterial killing capability in all strains. In a rat femur infection model, the alloy showed significant antibacterial activity against MRSA and reduced inflammatory toxic side-effects as well as infection-related bone loss. The antibacterial property of Zn-2Cu alloy was associated with inhibition of gene expression related to wall synthesis, adhesion, colonization, biofilm formation, autolysis, and secretion of virulence factors in MRSA.

Effects of different positions of intravascular stent implantation in stenosed vessels on in-stent restenosis: An experimental and numerical simulation study

Percutaneous coronary intervention (PCI) has been widely used in the treatment of atherosclerosis, while in-stent restenosis (ISR) has not been completely resolved. Studies have shown that changes in intravascular mechanical environment are related to ISR. Hence, an in-depth understanding of the effects of stent intervention on vascular mechanics is important for clinically optimizing stent implantation and relieving ISR. Nine rabbits with stenotic carotid artery were collected by balloon injury. Intravascular stents were implanted into different longitudinal positions (proximal, middle and distal relative to the stenotic area) of the stenotic vessels for numerical simulations. Optical coherence tomography (OCT) scanning was performed to reconstruct the three-dimensional configuration of the stented carotid artery and blood flow velocity waveforms were collected by Doppler ultrasound. The numerical simulations were performed through direct solution of Naiver-Stokes equation in ANSYS. Results showed that the distributions of time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) and relative residual time (RRT) in near-end segment were distinctively different from other regions of the stent which considered to promote restenosis for all three models. Spearman rank-correlation analysis showed a significant correlation between hemodynamic descriptors and the stent longitudinal positions (r_TAWSS = -0.718, r_OSI = 0.898, r_RRT = 0.818, p < 0.01). Histology results of the near-end segment showed neointima thickening deepened with the longitudinal positions of stent which was consistent with the numerical simulations. The results suggest that stent implantation can promote restenosis at the near-end segment. As the stenting position moves to distal end, the impact on ISR is more significant.

Analysis of vascular inflammation against bioresorbable Zn-Ag based alloys

Zinc (Zn) has emerged as a promising bioresorbable stent material due to its satisfactory corrosion behavior and excellent biocompatibility. However, for load bearing implant applications, alloying is required to boost its mechanical properties as pure Zn exhibits poor strength. Unfortunately, an increase in inflammation relative to pure Zn is a commonly observed side-effect of Zn alloys. Consequently, the development of a Zn-based alloy that can simultaneously feature improved mechanical properties and suppress inflammatory responses is a big challenge. Here, a bioresorbable, biocompatible Zn-Ag-based quinary alloy was comprehensively evaluated in vivo, in comparison to reference materials. The inflammatory and smooth muscle cellular response was characterized and correlated to metrics of neointimal growth. We found that implantation of the quinary alloy was associated with significantly improved inflammatory activities relative to the reference materials. Additionally, we found that inflammation, but not smooth muscle cell hyperplasia, significantly correlates to neointimal growth for Zn alloys. The results suggest that inflammation is the main driver of neointimal growth for Zn-based alloys and that the quinary Zn-Ag-Mn-Zr-Cu alloy may impart inflammation-resistance properties to arterial implants.

Microstructure, mechanical properties, and in vitro behavior of biodegradable Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca

In the present study, the microstructure, mechanical properties, corrosion behavior, wettability, haemocompatibility, and cytocompatibility of the as-cast and as-rolled biodegradable Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca have been systematically investigated to evaluate their feasibility as potential biodegradable materials. The results demonstrated that the Zn-1Mg-0.1Ca have significantly improved mechanical properties, with the yield strength (YS), ultimate tensile strength (UTS), and elongation of as-rolled Zn-1Mg-0.1Ca are (209.04 ± 28.31) MPa, (331.51 ± 40.06) MPa, and (35.43 ± 3.53)%, respectively. Wettability test results demonstrated that the Zn-1Mg-0.1Ca and Zn-1Mg-0.5Ca have hydrophilic surfaces that can enhance cell responses and tissue-implant interactions. The haemocompatibility evaluation showed that the hemolysis ratio of Zn-1Mg-0.1Ca have a low hemolysis ratio of 0.6%; the platelets remain sphere morphology and are not activated. High cell viability indicates the cytocompatibility of the as-rolled Zn-1Mg-0.1Ca alloy. The Zn-1Mg-0.1Ca alloy can be considered as new suitable biodegradable Zn-based alloys for further biomedical applications.

Chandler-Loop surveyed blood compatibility and dynamic blood triggered degradation behavior of Zn-4Cu alloy and Zn

Zinc (Zn) and its alloys have been considered promising absorbable metals for medical implants. However, the dynamic interaction between Zn-based materials and human blood after implantation remains unclear. In this study, a modified Chandler-Loop system was applied to assess the blood compatibility and initial degradation behavior of a Zn-4.0Cu (wt%) alloy (Zn-4Cu) and Zn with human peripheral blood under circulation conditions. In this dynamic in vitro model, the Zn-4Cu and Zn showed sufficient blood compatibility. The numbers of erythrocytes, platelets, and leukocytes were not significantly altered, and appropriate activations of the coagulation and complement system were observed. Concerning initial degradation behavior, the product layers formed on the surfaces comprise a mixture of organic and inorganic compounds while the inorganic constituents decrease toward the outer surface. Considering the corrosion morphology and electrochemical behaviors, Zn-4Cu exhibited milder and more uniform degradation than Zn. Additionally, long-term degradation tests of 28 days in human peripheral blood, human serum, and Dulbecco's phosphate-buffered saline (DPBS) demonstrated that the Zn-4Cu showed relatively uniform degradation in blood and serum. On the contrary, in DPBS, severe localized corrosion appeared along the grain boundary of the secondary phase, which was likely attributed to the acceleration of galvanic corrosion. The Zn was found with localized corrosion impeded in the blood albeit with apparently developed deep pitting holes in the serum and DPBS.

Effect of strain on degradation behaviors of WE43, Fe and Zn wires

The biodegradable metallic devices undergo stress/strain-induced corrosion when they are used for load-bearing applications. The stress/strain induced-corrosion behavior causes differences in corrosion rate, corrosion morphology, strain distribution and mechanical performance of the devices. One representative example is the biodegradable stent. Biodegradable stents undergo complex inhomogeneous deformation that can cause dramatic non-uniform stent degradation, resulting in stress concentration and stents failure. The degradation of biodegradable devices requires special attention to the mutual effect between the applied strain and degradation. The quantitative relationship between strain and corrosion of the sample alloys (WE43, Fe and Zn), selected from three typical biodegradable metals, is firstly investigated and compared in this study. The in vitro degradation and the strength retention of WE43, Fe and Zn wires were investigated under different elastic and plastic strain levels ranging from 0.1% to 30%. The results indicated that the applied strain could bring down the corrosion potential, increase corrosion current and accelerate the degradation of three biodegradable metals. Specifically, remarkable enhanced localized corrosion was observed for plastic strained WE43 compared with those with elastic strains. This localized corrosion morphology significantly accelerated the strength decline at first, while the differences diminished with longer immersion period. Fe and Zn exhibited increased degradation with plastic strain applications than those under elastic strains. However, the degradation was not further increased with the increasing magnitude of plastic strains. Moreover, the bended wires were subcutaneously implanted in the dorsal aspect of the rats and the effect of bending deformation on in vitro and in vivo degradation of three metallic wires were also compared. The U-bended WE43 wires suffered more severe in vitro degradation at the stress concentrated region. Surprisingly, the early fracture of the undeformed regions was observed in the in vivo test. In conclusion, the corrosion rate, corrosion morphology and mechanical properties of WE43, Fe and Zn was sensitive to magnitude of the applied strains. The quantification results provided new insights into understanding the strain-dependent corrosion of three biodegradable metals both in vitro and in vivo. STATEMENT OF SIGNIFICANCE: Biodegradable implants are subjected to various mechanical environment during the deployment and subsequent physiological activity. It is necessary to have a clear understanding of the effects of the applied stress on degradation. This study addresses the quantitative effects of applied strain/stress on the in vitro and in vivo degradation of three typical biodegradable metals (Mg, Fe and Zn). These quantification results provide new insights into understanding the strain-induced corrosion of three metals.

Biodegradable Zn-1.5Cu-1.5Ag alloy with anti-aging ability and strain hardening behavior for cardiovascular stents

Zn and its alloys are considered as a new class of biodegradable metals due to their moderate degradation rates and acceptable biocompatibility. However, inadequate mechanical properties limit their further applications, especially for cardiovascular stents. In this study, a novel biodegradable Zn-1.5Cu-1.5Ag (wt%) alloy with excellent mechanical properties was developed, and then its in vitro degradation and cytotoxicity were characterized. Microstructural characterization showed that hot extrusion produced a bimodal distribution of grain size and much finer secondary phase precipitates. The as-extruded alloy exhibited a satisfactory combination of strength and plasticity (yield strength: 162.0 ± 2.94 MPa, ultimate tensile strength: 220.3 ± 1.70 MPa and elongation: 44.13 ± 1.09%). After being aged at room temperature for 8 months, its mechanical properties increased about 10%, implying its good anti-aging ability. The strain hardening exponent (n) calculated from true stress-strain curve showed that this alloy has evident strain hardening. Immersion tests in c-SBF solution revealed that this alloy has a moderate corrosion rate (48.6 ± 4.14 μm/year) and slightly localized corrosion behavior. Electrochemical tests showed that a weak passive film formed on surface during degradation, which has a limited protective effect. The cytotoxicity tests exhibited that this alloy possesses acceptable in vitro biocompatibility, which is comparable to pure Zn. According to the results of mechanical properties, corrosion behavior and cytotoxicity, the Zn-1.5Cu-1.5Ag alloy can be regarded as a potential candidate for cardiovascular stent applications.

A study of degradation behaviour and biocompatibility of Zn-Fe alloy prepared by electrodeposition

Zinc is a biodegradable metal, which exhibits more moderate biodegradability than magnesium and iron, so that it has great application potential in the field of biomedical materials. Alloying of zinc and iron may lead to producing a new type of implant material Zn-Fe alloy, which might be able to meet the requirements for a moderate degradation rate. However, due to the huge difference in the melting point between zinc and iron, the preparation of Zn-Fe alloy is quite challenging and hence rarely reported. In this study, we show that Zn-Fe alloys can be successfully prepared by electrodeposition technology. The microstructures, composition, degradation properties and biocompatibility of the Zn-Fe alloys were systematically studied. The results showed that the content of iron in the alloys ranged from 0 to 8 wt%, depending on the concentration of Fe ions and the current density. In the alloys, the major's phases were η, δ and Г₁, and they were mainly affected by the ion concentration in the electrolyte. In the in vitro immersion tests, the Zn-Fe alloy ZF2-1 showed the highest immersion corrosion rate, while ZF3-1 showed the highest electrochemical corrosion rate. Moreover, we found that the corrosion rates of the alloys were significantly higher than that of the pure Fe. In the in vivo experiments, we confirmed that the Zn-Fe alloy possessed good biocompatibility. These results demonstrate that the electrodeposition technology is a good method to prepare Zn-Fe alloys, and the Zn-Fe alloys prepared by this method are potentially promising materials for biomedical applications.

Zn2+-dependent suppression of vascular smooth muscle intimal hyperplasia from biodegradable zinc implants

Biodegradable arterial implants based on zinc have been found to suppress neointimal hyperplasia, suggesting that biodegradable materials containing zinc may be used to construct vascular implants with a reduced rate of restenosis. However, the molecular mechanism has remained unclear. In this report, we show that zinc-containing materials can be used to prevent neointimal formation when implanted into the rat aorta. Indeed, neointimal cells were significantly more TUNEL positive and alpha-actin negative at the interface of biodegradable zinc vs. biostable platinum implants, in association with greater caspase-3 activity. Although zinc stimulated extensive neointimal smooth muscle cell (SMC) death, macrophage and proinflammatory markers CD68 and iNOS were not increased in neointimal tissue relative to biostable platinum control implants. Using arterial explants, ionic zinc was confirmed to promote SMC apoptosis by activating the caspase apoptotic signaling pathway. These observations suggest that zinc-containing materials can be used to construct vascular implants such as stents with reduced neointimal hyperplasia.

Magnetic resonance (MR) safety and compatibility of a novel iron bioresorbable scaffold

Fully bioresorbable scaffolds have been designed to overcome the limitations of traditional drug-eluting stents (DESs), which permanently cage the native vessel wall and pose possible complications. The ultrathin-strut designed sirolimus-eluting iron bioresorbable coronary scaffold system (IBS) shows comparable mechanical properties to traditional DESs and exhibits an adaptive degradation profile during target vessel healing, which makes it a promising candidate in all-comers patient population. For implanted medical devices, magnetic resonance (MR) imaging properties, including MR safety and compatibility, should be evaluated before its clinical use, especially for devices with intrinsic ferromagnetism. In this study, MR safety and compatibility of the IBS scaffold were evaluated based on a series of well-designed in-vitro, ex-vivo and in-vivo experiments, considering possible risks, including scaffold movement, over-heating, image artifact, and possible vessel injury, under typical MR condition. Traditional ASTM standards for MR safety and compatibility evaluation of intravascular devices were referred, but not only limited to that. The unique time-relevant MR properties of bioresorbable scaffolds were also discussed. Possible forces imposed on the scaffold during MR scanning and MR image artifacts gradually decreased along with scaffold degradation/absorption. Rigorous experiments designed based on a scientifically based rationale revealed that the IBS scaffold is MR conditional, though not MR compatible before complete absorption. The methodology used in the present study can give insight into the MR evaluation of magnetic scaffolds (bioresorbable) or stents (permanent).

Porous zinc scaffolds for bone tissue engineering applications: A novel additive manufacturing and casting approach

As a degradable metal, zinc (Zn) has attracted an immense amount of interest as the next generation of bioresorbable implants thanks to its modest corrosion rate and its vital role in bone remodeling, yet very few studies have thoroughly investigated its functionality as a porous implant for bone tissue engineering purposes. Zn bone scaffolds with two different pore sizes of 900 μm and 2 mm were fabricated using additive manufacturing-produced templates combined with casting. The compressive properties, corrosion rates, biocompatibility, and antibacterial performance of the bioscaffolds were examined and compared to a non-porous control. The resulting textured and porous Zn scaffolds exhibit a fully interconnected pore structure with precise control over topology. As pore size and porosity increased, mechanical strength decreased, and corrosion rate accelerated. Cell adhesion and growth on scaffolds were enhanced after an ex vivo pretreatment method. In vitro cellular tests confirmed good biocompatibility of the scaffolds. As porosity increased, potent antibacterial rates were also observed. Taken together, these results demonstrate that Zn porous bone scaffolds are promising for orthopedic applications.