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Drelich AJ, Zhao S, Guillory RJ, Drelich JW, Goldman J. Long-term surveillance of zinc implant in murine artery: Surprisingly steady biocorrosion rate. Acta Biomater 2017; 58:539-549. [PMID: 28532901 PMCID: PMC5553077 DOI: 10.1016/j.actbio.2017.05.045] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 05/03/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
Abstract
Metallic zinc implanted into the abdominal aorta of rats out to 6months has been demonstrated to degrade while avoiding responses commonly associated with the restenosis of vascular implants. However, major questions remain regarding whether a zinc implant would ultimately passivate through the production of stable corrosion products or via a cell mediated fibrous encapsulation process that prevents the diffusion of critical reactants and products at the metal surface. Here, we have conducted clinically relevant long term in vivo studies in order to characterize late stage zinc implant biocorrosion behavior and products to address these critical questions. We found that zinc wires implanted in the murine artery exhibit steady corrosion without local toxicity for up to at least 20months post-implantation, despite a steady buildup of passivating corrosion products and intense fibrous encapsulation of the wire. Although fibrous encapsulation was not able to prevent continued implant corrosion, it may be related to the reduced chronic inflammation observed between 10 and 20months post-implantation. X-ray elemental and infrared spectroscopy analyses confirmed zinc oxide, zinc carbonate, and zinc phosphate as the main components of corrosion products surrounding the Zn implant. These products coincide with stable phases concluded from Pourbaix diagrams of a physiological solution and in vitro electrochemical impedance tests. The results support earlier predictions that zinc stents could become successfully bio-integrated into the arterial environment and safely degrade within a time frame of approximately 1-2years. STAEMENT OF SIGNIFICANCE Previous studies have shown zinc to be a promising candidate material for bioresorbable endovascular stenting applications. An outstanding question, however, is whether a zinc implant would ultimately passivate through the production of stable corrosion products or via a cell mediated tissue encapsulation process that prevented the diffusion of critical reactants and products at the metal surface. We found that zinc wires implanted in the murine artery exhibit steady corrosion for up to at least 20months post-implantation. The results confirm earlier predictions that zinc stents could safely degrade within a time frame of approximately 1-2years.
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Affiliation(s)
- Adam J Drelich
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Shan Zhao
- Department of Material Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Roger J Guillory
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Jaroslaw W Drelich
- Department of Material Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA
| | - Jeremy Goldman
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA.
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52
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Naseem R, Zhao L, Liu Y, Silberschmidt VV. Experimental and computational studies of poly-L-lactic acid for cardiovascular applications: recent progress. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s40759-017-0028-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractStents are commonly used in medical procedures to alleviate the symptoms of coronary heart disease, a prevalent modern society disease. These structures are employed to maintain vessel patency and restore blood flow. Traditionally stents are made of metals such as stainless steel or cobalt chromium; however, these scaffolds have known disadvantages. An emergence of transient scaffolds is gaining popularity, with the structure engaged for a required period whilst healing of the diseased arterial wall occurs. Polymers dominate a medical device sector, with incorporation in sutures, scaffolds and screws. Thanks to their good mechanical and biological properties and their ability to degrade naturally. Polylactic acid is an extremely versatile polymer, with its properties easily tailored to applications. Its dominance in the stenting field increases continually, with the first polymer scaffold gaining FDA approval in 2016. Still some challenges with PLLA bioresorbable materials remain, especially with regard to understanding their mechanical response, assessment of its changes with degradation and comparison of their performance with that of metallic drug-eluting stent. Currently, there is still a lack of works on evaluating both the pre-degradation properties and degradation performance of these scaffolds. Additionally, there are no established material models incorporating non-linear viscoelastic behaviour of PLLA and its evolution with in-service degradation. Assessing these features through experimental analysis accompanied by analytical and numerical studies will provide powerful tools for design and optimisation of these structures endorsing their broader use in stenting. This overview assesses the recent studies investigating mechanical and computational performance of poly(l-lactic) acid and its use in stenting applications.
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53
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Polimeni A, Anadol R, Münzel T, Indolfi C, De Rosa S, Gori T. Long-term outcome of bioresorbable vascular scaffolds for the treatment of coronary artery disease: a meta-analysis of RCTs. BMC Cardiovasc Disord 2017; 17:147. [PMID: 28592227 PMCID: PMC5463321 DOI: 10.1186/s12872-017-0586-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/01/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Coronary bioresorbable scaffolds (BRS) were developed to overcome the limitations of standard metallic stents, especially to address late events after percutaneous coronary interventions. The aim of this meta-analysis was to evaluate the efficacy and safety of BRS, compared with Everolimus-eluting stents (EES), using the data available from randomized trials, with a focus on long-term outcomes. METHODS Published randomized trials comparing BRS to EES for the treatment of coronary artery disease were searched for within PubMed, Cochrane Library and Scopus electronic databases up to April 4th 2017. The summary measure used was odds ratio (OR) with 95% confidence intervals. RESULTS A total of 5 studies were eligible, including 5219 patients. At 2 years, BRS was associated with higher rates of target lesion failure (9.4% vs 7.2%; OR = 1.33; 95% CI 1.07 to 1.63; p = 0.008) and device thrombosis (2.3% vs 0.7%; OR = 3.22; 95% CI 1.86 to 5.57; p < 0.0001) compared with EES. The incidence of both early (within 30 days after implantation, 1.1% vs 0.5%, OR 1.97, 95% CI 1.02 to 3.81; p = 0.05) and very-late device thrombosis (>1 year, 0.6% vs 0.1%, OR 4.03, 95% CI 1.37 to 11.82; p = 0.01) was higher with BRS compared with EES. CONCLUSIONS BRS may be associated with worse two-years clinical outcomes compared with EES in patients with coronary artery disease.
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Affiliation(s)
- Alberto Polimeni
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany.,Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Remzi Anadol
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany
| | - Thomas Münzel
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy.,URT-CNR, Department of Medicine, Consiglio Nazionale delle Ricerche of IFC, Viale Europa S/N, 88100, Catanzaro, Italy
| | - Salvatore De Rosa
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Tommaso Gori
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany. .,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany.
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54
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Houston KR, Brosnan SM, Burk LM, Lee YZ, Luft JC, Ashby VS. Iodinated polyesters as a versatile platform for radiopaque biomaterials. ACTA ACUST UNITED AC 2017. [DOI: 10.1002/pola.28596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Katelyn R. Houston
- Department of ChemistryUniversity of North Carolina at Chapel HillChapel Hill North Carolina27599
| | - Sarah M. Brosnan
- Department of ChemistryUniversity of North Carolina at Chapel HillChapel Hill North Carolina27599
| | - Laurel M. Burk
- Department of Physics and AstronomyUniversity of North Carolina at Chapel HillChapel Hill North Carolina27599
| | - Yueh Z. Lee
- Department of Physics and AstronomyUniversity of North Carolina at Chapel HillChapel Hill North Carolina27599
- Department of RadiologyThe University of North Carolina at Chapel HillChapel Hill North Carolina27599
| | - J. C. Luft
- Department of Pharmacoengineering and Molecular PharmaceuticsEshelman School of Pharmacy, University of North CarolinaChapel Hill North Carolina27599
| | - Valerie S. Ashby
- Department of ChemistryUniversity of North Carolina at Chapel HillChapel Hill North Carolina27599
- Department of ChemistryDuke UniversityDurham North Carolina27708
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55
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Swain SK, Gotman I, Unger R, Gutmanas EY. Bioresorbable β-TCP-FeAg nanocomposites for load bearing bone implants: High pressure processing, properties and cell compatibility. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 78:88-95. [PMID: 28576063 DOI: 10.1016/j.msec.2017.04.051] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/01/2017] [Accepted: 04/03/2017] [Indexed: 01/28/2023]
Abstract
In this paper, the processing and properties of iron-toughened bioresorbable β-tricalcium phosphate (β-TCP) nanocomposites are reported. β-TCP is chemically similar to bone mineral and thus a good candidate material for bioresorbable bone healing devices; however intrinsic brittleness and low bending strength make it unsuitable for use in load-bearing sites. Near fully dense β-TCP-matrix nanocomposites containing 30vol% Fe, with and without addition of silver, were produced employing high energy attrition milling of powders followed by high pressure consolidation/cold sintering at 2.5GPa. In order to increase pure iron's corrosion rate, 10 to 30vol% silver were added to the metal phase. The degradation behavior of the developed composite materials was studied by immersion in Ringer's and saline solutions for up to 1month. The mechanical properties, before and after immersion, were tested in compression and bending. All the compositions exhibited high mechanical strength, the strength in bending being several fold higher than that of polymer toughened β-TCP-30PLA nanocomposites prepared by the similar procedure of attrition milling and cold sintering, and of pure high-temperature sintered β-TCP. Partial substitution of iron with silver led to an increase in both strength and ductility. Furthermore, the galvanic action of silver particles dispersed in the iron phase significantly accelerated in vitro degradation of β-TCP-30(Fe-Ag) nanocomposites. After 1month immersion, the composites retained about 50% of their initial bending strength. In cell culture experiments, β-TCP-27Fe3Ag nanocomposites exhibited no signs of cytotoxicity towards human osteoblasts suggesting that they can be used as an implant material.
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Affiliation(s)
- S K Swain
- Department of Materials Science and Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel
| | - I Gotman
- Department of Materials Science and Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel; National Research Tomsk Polytechnic University, Tomsk 634050, Russian Federation
| | - R Unger
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University, 55101 Mainz, Germany
| | - E Y Gutmanas
- Department of Materials Science and Engineering, Technion-Israel Institute of Technology, Haifa 32000, Israel; National Research Tomsk Polytechnic University, Tomsk 634050, Russian Federation.
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56
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Zhao F, Xue W, Wang F, Yu C, Xu H, Hao Y, Wang L. A new approach to improve the local compressive properties of PPDO self-expandable stent. J Mech Behav Biomed Mater 2017; 68:318-326. [PMID: 28237687 DOI: 10.1016/j.jmbbm.2017.02.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 02/07/2023]
Abstract
The radial performance of bioabsorbable polymeric intravascular stents is extremely important in assessing the efficiency of these devices in expanding narrow lumen, reducing stent recoil, and recovering to their original states after suffering from pulsating pressure. However, these stents remain inferior to metallic stents. Several thermal treatment conditions (60°C, 80°C, and 100°C for 1h) were investigated to improve the characteristics of poly(p-dioxanone) (PPDO) self-expandable stents. The local compressive force, stiffness, and viscoelasticity of these stents were also evaluated. Wide-angle X-ray diffraction and different scanning calorimetry measurements were performed to evaluate the recrystalline and thermodynamic changes of molecular chains. The declining conformer entropy of PPDO monofilaments was examined via energy analysis. The untreated stents had compressive modules of 514.80±70.59mN/mm, which was much higher than those of 80°C and 100°C treated stents (332.35±66.08mN/mm and 394.31±64.71mN/mm, respectively). Nevertheless, 100°C annealing stents had less stress relaxation and prior elastic recovery rate of 82.32±3.43mN and 92.55±1.61%, respectively, showing a much better shape stability than untreated stents (139.51±16.67mN and 86.18±3.57%, respectively). These findings present important clinical implications in the stent manufacturing process and warrant further study to develop new bioabsorbable stents with outstanding clinical efficacy.
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Affiliation(s)
- Fan Zhao
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China
| | - Wen Xue
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China
| | - Fujun Wang
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China.
| | - Chenglong Yu
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Haiyan Xu
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Yi Hao
- College of Textiles, Donghua University, Shanghai 201620, China
| | - Lu Wang
- College of Textiles, Donghua University, Shanghai 201620, China; Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China.
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57
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Cabrera MS, Sanders B, Goor OJ, Driessen-Mol A, Oomens CW, Baaijens FP. Computationally Designed 3D Printed Self-Expandable Polymer Stents with Biodegradation Capacity for Minimally Invasive Heart Valve Implantation: A Proof-of-Concept Study. 3D PRINTING AND ADDITIVE MANUFACTURING 2017; 4:19-29. [PMID: 32953940 PMCID: PMC7500013 DOI: 10.1089/3dp.2016.0052] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The evolution of minimally invasive implantation procedures and the in vivo remodeling potential of decellularized tissue-engineered heart valves require stents with growth capacity to make these techniques available for pediatric patients. By means of computational tools and 3D printing technology, this proof-of-concept study demonstrates the design and manufacture of a polymer stent with a mechanical performance comparable to that of conventional nitinol stents used for heart valve implantation in animal trials. A commercially available 3D printing polymer was selected, and crush and crimping tests were conducted to validate the results predicted by the computational model. Finally, the degradability of the polymer was assessed via accelerated hydrolysis.
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Affiliation(s)
- María Sol Cabrera
- Department of Biomedical Engineering, Group of Soft Tissue Biomechanics and Tissue Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Bart Sanders
- Department of Biomedical Engineering, Group of Soft Tissue Biomechanics and Tissue Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
- Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Olga J.G.M. Goor
- Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
- Department of Biomedical Engineering, Group of Biomedical Chemistry, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Anita Driessen-Mol
- Department of Biomedical Engineering, Group of Soft Tissue Biomechanics and Tissue Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Cees W.J Oomens
- Department of Biomedical Engineering, Group of Soft Tissue Biomechanics and Tissue Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
- Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Frank P.T. Baaijens
- Department of Biomedical Engineering, Group of Soft Tissue Biomechanics and Tissue Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
- Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
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58
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Ang HY, Bulluck H, Wong P, Venkatraman SS, Huang Y, Foin N. Bioresorbable stents: Current and upcoming bioresorbable technologies. Int J Cardiol 2017; 228:931-939. [DOI: 10.1016/j.ijcard.2016.11.258] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 12/24/2022]
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59
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Finotti PFM, Costa LC, Capote TSO, Scarel-Caminaga RM, Chinelatto MA. Immiscible poly(lactic acid)/poly(ε-caprolactone) for temporary implants: Compatibility and cytotoxicity. J Mech Behav Biomed Mater 2017; 68:155-162. [PMID: 28171812 DOI: 10.1016/j.jmbbm.2017.01.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/27/2017] [Accepted: 01/29/2017] [Indexed: 11/28/2022]
Abstract
This manuscript focuses on the effect of the addition of a low molecular weight triblock copolymer derived from ε-caprolactone and tetrahydrofuran (CT) on the compatibility and cytotoxicity of immiscible poly(lactic acid) (PLA) and poly(ε-caprolactone) (PCL) blends. Binary and tertiary PLA/PCL blends were prepared by melt mixing in a twin-screw extruder and their morphological, mechanical and thermal behaviors were investigated by scanning electron microscopy (SEM), tensile and Izod impact test, dynamic mechanical analysis (DMA) and differential scanning calorimetry (DSC). SEM micrographs showed the CT copolymer suppressed the coalescence phenomena and maintained the size of dispersed PCL domains at approximately 0.35µm. Bioresorbable PLA/PCL blends containing 5wt% of CT copolymer exhibited a remarkable increase in ductility and improved toughness at room temperature. Although the CT copolymer increased the interfacial adhesion, the DMA results suggest it also acts as a plasticizer exclusively for the PCL phase. The cell viability evaluated by the XTT assay confirmed PLA/PCL blends compatibilized by CT copolymer exerted no cytotoxic effect.
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Affiliation(s)
- Pablo F M Finotti
- Department of Materials Engineering, Engineering School of São Carlos, University of São Paulo - USP, São Carlos, São Paulo 13563-120, Brazil
| | - Lidiane C Costa
- Department of Materials Engineering, Federal University of São Carlos - UFSCar, São Carlos, São Paulo 13565-905, Brazil
| | - Ticiana S O Capote
- Department of Morphology, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo 14801-603, Brazil
| | - Raquel M Scarel-Caminaga
- Department of Morphology, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo 14801-603, Brazil
| | - Marcelo A Chinelatto
- Department of Materials Engineering, Engineering School of São Carlos, University of São Paulo - USP, São Carlos, São Paulo 13563-120, Brazil.
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60
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Lin ST, Kimble L, Bhattacharyya D. Polymer Blends and Composites for Biomedical Applications. SPRINGER SERIES IN BIOMATERIALS SCIENCE AND ENGINEERING 2017. [DOI: 10.1007/978-3-662-53574-5_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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61
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Ware HOT, Farsheed AC, Baker E, Ameer G, Sun C. Fabrication Speed Optimization for High-resolution 3D-printing of Bioresorbable Vascular Scaffolds. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.procir.2017.04.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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62
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Farhan Khan M, Brackett D, Ashcroft I, Tuck C, Wildman R. A Novel Approach to Design Lesion-Specific Stents for Minimum Recoil. J Med Device 2016. [DOI: 10.1115/1.4034880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Stent geometries are obtained by topology optimization for minimized compliance under different stenosis levels and plaque material types. Three levels of stenosis by cross-sectional area, i.e., 30%, 40%, and 50% and three different plaque material properties, i.e., calcified, cellular, and hypocellular, were studied. The raw optimization results were converted to clear design concepts and their performance was evaluated by implanting them in their respective stenosed artery types using finite element analysis. The results were compared with a generic stent in similar arteries, which showed that the new designs showed less recoil. This work provides a concept that stents could be tailored to specific lesions in order to minimize recoil and maintain a patent lumen in stenotic arteries.
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Affiliation(s)
- Muhammad Farhan Khan
- Mem. ASME Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG72RD, UK e-mail:
| | - David Brackett
- Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG72RD, UK e-mail:
| | - Ian Ashcroft
- Professor Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG72RD, UK e-mail:
| | - Christopher Tuck
- Professor Department of Mechanical, Materials and Manufacturing Engineering, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG72RD, UK e-mail:
| | - Ricky Wildman
- Professor Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG72RD, UK e-mail:
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63
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Tyler B, Gullotti D, Mangraviti A, Utsuki T, Brem H. Polylactic acid (PLA) controlled delivery carriers for biomedical applications. Adv Drug Deliv Rev 2016; 107:163-175. [PMID: 27426411 DOI: 10.1016/j.addr.2016.06.018] [Citation(s) in RCA: 521] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/25/2016] [Accepted: 06/23/2016] [Indexed: 12/25/2022]
Abstract
Polylactic acid (PLA) and its copolymers have a long history of safety in humans and an extensive range of applications. PLA is biocompatible, biodegradable by hydrolysis and enzymatic activity, has a large range of mechanical and physical properties that can be engineered appropriately to suit multiple applications, and has low immunogenicity. Formulations containing PLA have also been Food and Drug Administration (FDA)-approved for multiple applications making PLA suitable for expedited clinical translatability. These biomaterials can be fashioned into sutures, scaffolds, cell carriers, drug delivery systems, and a myriad of fabrications. PLA has been the focus of a multitude of preclinical and clinical testing. Three-dimensional printing has expanded the possibilities of biomedical engineering and has enabled the fabrication of a myriad of platforms for an extensive variety of applications. PLA has been widely used as temporary extracellular matrices in tissue engineering. At the other end of the spectrum, PLA's application as drug-loaded nanoparticle drug carriers, such as liposomes, polymeric nanoparticles, dendrimers, and micelles, can encapsulate otherwise toxic hydrophobic anti-tumor drugs and evade systemic toxicities. The clinical translation of these technologies from preclinical experimental settings is an ever-evolving field with incremental advancements. In this review, some of the biomedical applications of PLA and its copolymers are highlighted and briefly summarized.
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Affiliation(s)
- Betty Tyler
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - David Gullotti
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Antonella Mangraviti
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Tadanobu Utsuki
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States
| | - Henry Brem
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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64
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Thakkar AS, Dave BA. Revolution of Drug-Eluting Coronary Stents: An Analysis of Market Leaders. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10314703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Percutaneous coronary intervention with drug-eluting stents (DES) is a well-established and widely-accepted treatment approach in patients with coronary artery disease. Although the underlying principle of DES remains constant for different stents available on the market, certain factors may offer variations with respect to deliverability (ease of placement), efficacy (preventing restenosis), and safety (thrombosis rates). These factors may include the type of drug (sirolimus, everolimus, biolimus, zotarolimus, novolimus, paclitaxel, docetaxel), type of stent platforms (stainless steel, platinum, cobalt-chromium, cobalt-nickel, platinum-chromium), type of polymers (permanent, biodegradable, polymer-free), thickness of stent struts (thick, thin, ultra-thin), type of coating (abluminal, conformal), and type of stent design (open-cell, closed-cell, combination of open-closed cell). In this context, we present a review on characteristic features of several of the most widely used coronary stents worldwide. Furthermore, the advancements of completely biodegradable stents are discussed. In addition, the future directions for the development of creating an ideal or perfect DES are debated.
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Affiliation(s)
| | - Bhargav A. Dave
- Manish Therapy Services, Madison Heights, Texas, USA; Department of Physical Therapy, Srinivas University, Mangaluru, Karnataka, India
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65
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Development of a New Hybrid Biodegradable Drug-Eluting Stent for the Treatment of Peripheral Artery Disease. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6915789. [PMID: 27999810 PMCID: PMC5143697 DOI: 10.1155/2016/6915789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/03/2016] [Indexed: 11/17/2022]
Abstract
This study aimed to develop a new biodegradable stent for peripheral artery disease (PAD) that could provide sufficient radial force to maintain long-term patency and flexibility. All self-expandable hybrid biodegradable stents were designed by using a knitting structure composed of poly-L-lactic acid (PLLA) and nitinol. Four different types of stents were implanted in 20 iliac arteries in 10 mini pigs as follows: a bare-metal stent (BMS) (group 1, n = 5), a drug-free hybrid stent (group 2, n = 5), a 50% (50 : 100, w/w) paclitaxel (PTX)/poly-lactide-co-glycolic acid (PLGA; fast PTX-releasing form) hybrid stent (group 3, n = 5), and a 30% (30 : 100, w/w) PTX/PLGA (slow PTX-releasing form) hybrid stent (group 4, n = 5). We performed follow-up angiography and intravascular ultrasonography (IVUS) at 4 and 8 weeks. In a comparison of groups 1, 2, 3, and 4, less diameter stenosis was observed in the angiographic analysis for group 4 at the 4-week follow-up (19.0% ± 12.7% versus 39.3% ± 18.1% versus 46.8% ± 38.0% versus 4.8% ± 4.2%, resp.; p = 0.032). IVUS findings further suggested that the neointima of the patients in group 4 tended to be lesser than those of the others. Our new biodegradable 30% PTX/PLGA (slow-releasing form) stent showed more favorable results for patency than the other stent types.
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Løvdal ALV, Calve S, Yang S, Van Alstine W, Binkert CA, Klausen K. Evaluation of a Bioabsorbable Self-Expandable Vein Stent-Base Made of Poly(l-lactide) In Vitro and In Vivo. Cardiovasc Intervent Radiol 2016; 40:112-119. [DOI: 10.1007/s00270-016-1491-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/26/2016] [Indexed: 11/30/2022]
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Amber KI, Hadi NR, Muhammad-Baqir BM, Jamil DA, Al-Aubaidy HA. Trimetazidine attenuates the acute inflammatory response induced by Novolimus eluting bioresorbable coronary scaffold implantation. Int J Cardiol 2016; 220:514-9. [DOI: 10.1016/j.ijcard.2016.06.172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/24/2016] [Indexed: 11/28/2022]
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Abstract
The introduction of percutaneous treatment of coronary artery stenosis with balloon angioplasty was the first revolution in interventional cardiology; the advent of metallic coronary stents (bare and drug-eluting) marked the second and third revolutions. However, the latest generation of drug-eluting stents is limited by several factors. Permanent vessel caging impairs arterial physiology, and the incidence of very late stent thrombosis - although lower with the second generation than with the first generation of drug-eluting stents - remains a major concern. This complication is mainly related to the presence of permanent metallic implants, chronic degeneration triggered by an inflammatory response to the coating polymer, and/or adverse effects of antiproliferative drugs on endothelial regeneration. In 2011, self-degrading coronary stents - the bioresorbable vascular scaffolds (BVS) - were introduced into clinical practice, showing good short-term results owing to their adequate strength. The advantage of these devices is the transient nature of vascular scaffolding, which avoids permanent vessel caging. In this Review, we summarize the latest research on BVS, with a particular emphasis on the implantation technique (which is different from that used with metallic stents) to outline the concept that BVS deployment methods have a major effect on procedural success and prognosis of patients with coronary artery stenosis. Furthermore, the clinical outcome of BVS in randomized clinical trials and in phase IV studies are discussed in different pathophysiological settings, such as stable or acute coronary disease. Finally, all the available data on the safety profile of BVS regarding scaffold thrombosis are discussed.
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Barra ME, Fanikos J, Gerhard-Herman MD, Bhatt DL. Bridging Experience With Eptifibatide After Stent Implantation. Crit Pathw Cardiol 2016; 15:82-88. [PMID: 27465001 DOI: 10.1097/hpc.0000000000000084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Patients who have undergone intracoronary stent implantation often require surgery within the first year after the procedure. Planned or emergent surgical intervention requires interruption of antiplatelet therapy and is associated with an increased risk of stent thrombosis. Eptifibatide, an intravenous glycoprotein IIb/IIIa inhibitor (GPIIb/IIIa), can be considered for antiplatelet bridging of high-risk patients in the periprocedural period. OBJECTIVES The aim of this report is to describe the management of antiplatelet therapy and outcomes of patients who were bridged with eptifibatide perioperatively within 1 year of intracoronary stent implantation. METHODS We performed a retrospective analysis of patients identified through the hospital's computer system consecutively from January 1, 2011 to December 31, 2014. We included 18 patients who were bridged from an oral P2Y12-receptor antagonist with eptifibatide before surgery. Outcome measures were the incidence of thromboembolic events or stent thrombosis within 30 days of surgery and death within 90 days of hospital discharge. Safety measures were the incidence of thrombolysis in myocardial infarction major, minor, or minimal bleeding. RESULTS Of the 18 patients assessed, no patients experienced thromboembolic events or stent thrombosis. There was one major bleeding event and one minimal bleeding event postoperatively. Antiplatelet therapy management was highly variable in the perioperative period with 72.2% receiving the recommended GPIIb/IIIa loading dose, 50% of patients not continuing aspirin throughout the surgery, 27.8% of patients stopping antiplatelet therapy less than 5 days before surgery, and 50% not receiving a loading dose of an oral P2Y12-receptor antagonist postoperatively. CONCLUSIONS Within a limited sample size, bridging with an intravenous GPIIb/IIIa inhibitor appeared feasible. Further study is needed on the optimal strategy to manage patients with recent stenting who need surgical procedures.
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Affiliation(s)
- Megan E Barra
- From the Department of Pharmacy and Heart and Vascular Center, Brigham and Women's Hospital, Boston, MA
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Gu X, Mao Z, Ye SH, Koo Y, Yun Y, Tiasha TR, Shanov V, Wagner WR. Biodegradable, elastomeric coatings with controlled anti-proliferative agent release for magnesium-based cardiovascular stents. Colloids Surf B Biointerfaces 2016; 144:170-179. [DOI: 10.1016/j.colsurfb.2016.03.086] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 01/16/2023]
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Abstract
The coronary stent has propelled our understanding of the term "biocompatibility." Stents are expanded at sites of arterial blockage and mechanically reestablish blood flow. This simplicity belies the complex reactions that occur when a stent contacts living substrates. Biocompatible seek to elicit the intended response; stents should perform rather than merely exist. Because performance is assessed in the patient, stent biocompatibility is the multiscale examination of material and cell, and of material, structure, and device in the context of cell, tissue, and organism. This review tracks major biomaterial advances in coronary stent design and discusses biocompatibility clinical performance.
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Affiliation(s)
- Kumaran Kolandaivelu
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | - Farhad Rikhtegar
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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Samami H, Pan J. Detection of degradation in polyester implants by analysing mode shapes of structure vibration. J Mech Behav Biomed Mater 2016; 62:299-309. [PMID: 27235780 DOI: 10.1016/j.jmbbm.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/29/2016] [Accepted: 05/02/2016] [Indexed: 11/27/2022]
Abstract
This paper presents a numerical study on using vibration analysis to detect degradation in degrading polyesters. A numerical model of a degrading plate sample is considered. The plate is assumed to degrade following the typical behaviour of amorphous copolymers of polylactide and polyglycolide. Due to the well-known autocatalytic effect in the degradation of these polyesters, the inner core of the plate degrades faster than outer surface region, forming layers of materials with varying Young׳s modulus. Firstly the change in molecular weight and corresponding change in Young׳s modulus at different times are calculated using the mathematical models developed in our previous work. Secondly the first four mode shapes of transverse vibration of the plate are calculated using the finite element method. Finally the curvature of the mode shapes are calculated and related to the spatial distribution of the polymer degradation. It is shown that the curvature of the mode shapes can be used to detect the onset and distribution of polymer degradation. The level of measurement accuracy required in an experiment is presented to guide practical applications of the method. At the end of this paper a demonstration case of coronary stent is presented showing how the method can be used to detect degradation in an implant of sophisticated structure.
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Affiliation(s)
- Hassan Samami
- Department of Engineering, University of Leicester, Leicester, UK
| | - Jingzhe Pan
- Department of Engineering, University of Leicester, Leicester, UK.
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Ormiston JA, Webber B, Ubod B, Darremont O, Webster MWI. An independent bench comparison of two bioresorbable drug-eluting coronary scaffolds (Absorb and DESolve) with a durable metallic drug-eluting stent (ML8/Xpedition). EUROINTERVENTION 2016; 11:60-7. [PMID: 25680225 DOI: 10.4244/eijy15m02_03] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS We compared the mechanical and physical properties and the safety from strut fracture of side branch and post-dilatation strategies for the Absorb and DESolve bioresorbable scaffolds with the durable metallic drug-eluting XIENCE Xpedition stent using largely independent bench testing. METHODS AND RESULTS The strut thickness and crossing profile of the polymeric scaffolds was greater than those of the metallic drug-eluting stent. While all three devices recoiled after deployment, the DESolve enlarged between 10 mins and one hour returning to the immediate post-deployment diameter ("self-correction"). In 3.0 mm stents/scaffolds, the main branch post-dilatation safe threshold without fracture for Absorb was 3.8 mm at 20 atm, for DESolve was 5.0 mm at 20 atm whereas the ML8 did not fracture. For side branch dilatation with a 3.0 mm non-compliant balloon, the threshold before the Absorb fractured was 10 atm whereas the DESolve and ML8 did not fracture at 22 atm. The safe threshold for mini-kissing balloon post-dilatation in 3.0 mm scaffolds/stents with 3.0 mm non-compliant balloons was 5 atm for the Absorb whereas the DESolve and ML8 did not fracture up to 20 atm. CONCLUSIONS The metallic stent has thinner struts, lower profile, and greater radial strength than the polymeric scaffolds. Different safe pressure thresholds exist for different scaffolds/stents. Unlike the others, the DESolve showed "self-correction" or enlargement after initial recoil.
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Schmidt W, Behrens P, Brandt-Wunderlich C, Siewert S, Grabow N, Schmitz KP. In vitro performance investigation of bioresorbable scaffolds - Standard tests for vascular stents and beyond. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2016; 17:375-83. [PMID: 27266902 DOI: 10.1016/j.carrev.2016.05.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/04/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND/PURPOSE Biodegradable polymers are the main materials for coronary scaffolds. Magnesium has been investigated as a potential alternative and was successfully tested in human clinical trials. However, it is still challenging to achieve mechanical parameters comparative to permanent bare metal (BMS) and drug-eluting stents (DES). As such, in vitro tests are required to assess mechanical parameters correlated to the safety and efficacy of the device. METHODS/MATERIALS In vitro bench tests evaluate scaffold profiles, length, deliverability, expansion behavior including acute elastic and time-dependent recoil, bending stiffness and radial strength. The Absorb GT1 (Abbott Vascular, Temecula, CA), DESolve (Elixir Medical Corporation, Sunnyvale, CA) and the Magmaris (BIOTRONIK AG, Bülach, Switzerland) that was previously tested in the BIOSOLVE II study, were tested. RESULTS Crimped profiles were 1.38±0.01mm (Absorb GT1), 1.39±0.01mm (DESolve) and 1.44±0.00mm (Magmaris) enabling 6F compatibility. Trackability was measured depending on stiffness and force transmission (pushability). Acute elastic recoil was measured at free expansion and within a mock vessel, respectively, yielding results of 5.86±0.76 and 5.22±0.38% (Absorb), 7.85±3.45 and 9.42±0.21% (DESolve) and 5.57±0.72 and 4.94±0.31% (Magmaris). Time-dependent recoil (after 1h) was observed for the Absorb and DESolve scaffolds but not for the Magmaris. The self-correcting wall apposition behavior of the DESolve did not prevent time-dependent recoil under vessel loading. CONCLUSIONS The results of the suggested test methods allow assessment of technical feasibility based on objective mechanical data and highlight the main differences between polymeric and metallic bioresorbable scaffolds.
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Affiliation(s)
- Wolfram Schmidt
- Institute for Biomedical Engineering, University Medicine Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
| | - Peter Behrens
- Institute for Biomedical Engineering, University Medicine Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
| | - Christoph Brandt-Wunderlich
- Institute for ImplantTechnology and Biomaterials - IIB e.V., Associated Institute of the University of Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
| | - Stefan Siewert
- Institute for ImplantTechnology and Biomaterials - IIB e.V., Associated Institute of the University of Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
| | - Niels Grabow
- Institute for Biomedical Engineering, University Medicine Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
| | - Klaus-Peter Schmitz
- Institute for ImplantTechnology and Biomaterials - IIB e.V., Associated Institute of the University of Rostock, Friedrich-Barnewitz-Strasse 4, D-18119 Rostock-Warnemünde, Germany.
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Kamdar F, Das G. Treatment of focal transplant vasculopathy with a bioresorbable coronary artery stent. J Heart Lung Transplant 2016; 35:943-4. [PMID: 27095002 DOI: 10.1016/j.healun.2016.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/16/2016] [Accepted: 02/26/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Forum Kamdar
- Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
| | - Gladwin Das
- Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
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Brie D, Penson P, Serban MC, Toth PP, Simonton C, Serruys PW, Banach M. Bioresorbable scaffold - A magic bullet for the treatment of coronary artery disease? Int J Cardiol 2016; 215:47-59. [PMID: 27111160 DOI: 10.1016/j.ijcard.2016.04.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 12/18/2022]
Abstract
Today, drug-eluting metal stents are considered the gold standard for interventional treatment of coronary artery disease. While providing inhibition of neointimal hyperplasia, drug-eluting metal stents have many limitations such as the risk of late and very late stent thrombosis, restriction of vascular vasomotion and chronic local inflammatory reaction due to permanent implantation of a 'metallic cage', recognized as a foreign body. Bioresorbable scaffold stents (BRS) are a new solution, which is trying to overcome the limitation of the 'metallic cage'. This structure provides short-term scaffolding of the vessel and then disappears, leaving nothing behind. The purpose of this review is to present the theoretical rationale for the use of BRS and to outline the clinical outcomes associated with their use in terms of data obtained from RCTs, clinical trials, registries and real life use. We have also tried to answer all questions on this intervention based on available data, with a focus on ABSORB BVS (Abbott Vascular, Santa Clara, USA). We consider that this new technology can be the "magic bullet" to treat coronary artery disease.
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Affiliation(s)
- Daniel Brie
- Institute for Cardiovascular Medicine Timisoara, Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Peter Penson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maria-Corina Serban
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Peter P Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MA, USA; Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | | | - Patrick W Serruys
- International Centre for Cardiovascular Health, Imperial College, London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
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Miyazaki T, Latib A, Ruparelia N, Kawamoto H, Sato K, Figini F, Colombo A. The use of a scoring balloon for optimal lesion preparation prior to bioresorbable scaffold implantation: a comparison with conventional balloon predilatation. EUROINTERVENTION 2016; 11:e1580-8. [DOI: 10.4244/eijv11i14a308] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Drug delivering technology for endovascular management of infrainguinal peripheral artery disease. JACC Cardiovasc Interv 2016; 7:827-39. [PMID: 25147028 DOI: 10.1016/j.jcin.2014.05.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/07/2014] [Accepted: 05/08/2014] [Indexed: 11/21/2022]
Abstract
Endovascular intervention has become a well-recognized treatment modality for peripheral artery disease; however, mid- and long-term outcomes have been plagued by limited durability. Plain balloon angioplasty and bare-metal stents have historically suffered from high restenosis rates leading to the need for frequent repeat revascularization procedures. The innovation of locally administered, drug-delivering balloons and stents has been a direct result of technological innovations directed toward prevention and treatment of this limitation. Over the last 5 years, numerous clinical trials investigating the use of drug-coated stents and drug-coated balloons indicate a significant improvement in endovascular treatment durability and outcomes. This review provides an up-to-date assessment of the current evidence for the use of drug-coated stents and drug-coated balloons in the treatment of femoropopliteal and infrapopliteal peripheral artery disease. Additionally, it provides an overview of the development of this technology, highlights landmark ongoing and completed clinical trials, examines evidence to support the use of drug-coated technologies in combination with other modalities, and examines promising new technological developments. Last, it summarizes the challenges and safety concerns that have delayed U.S. Food and Drug Administration approval of these devices.
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Suwannasom P, Sotomi Y, Tateishi H, Tenekecioglu E, Zeng Y, Kraak RP, Wykrzykowska JJ, De Winter RJ, Serruys PW, Onuma Y. Bioresorbable drug-eluting scaffolds for treatment of vascular disease. Expert Opin Drug Deliv 2016; 13:725-39. [PMID: 26865247 DOI: 10.1517/17425247.2016.1153062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Theoretical advantages of fully bioresorbable scaffold (BRS) stem from transient vessel support without rigid caging. Therefore, it could reduce long-term adverse events associated with the presence of foreign materials. AREAS COVERED This article will provide an overview of: drug-eluting BRS for various applications in the treatment of vascular disease; The mechanisms of active agent release from such scaffolds; currently available drug-eluting BRS and their future applications are also discussed. EXPERT OPINION The current BRS have been developed in order to achieve optimal vascular patency while providing long-term safety. The clinical efficacy and safety of BRS in coronary treatment have been reported as equal to that of the current metallic drug eluting stents in simple lesions. The application of BRS can potentially be expanded to other vascular beds. The research in bioengineering for the appropriate materials should not only focus on biocompatibility but also should be tailored according to the sites of implantation, which may require different strength and supporting period. The ultimate goal in this field is to develop a biocompatible device that provides equivalent and complementary therapy to other devices, and is able to disappear when the mechanical support and drug delivery are no longer required.
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Affiliation(s)
- Pannipa Suwannasom
- a AMC Heartcenter, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands.,b ThoraxCenter , Erasmus Medical Center , Rotterdam , The Netherlands.,c Northern Region Heart Center, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand
| | - Yohei Sotomi
- a AMC Heartcenter, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Hiroki Tateishi
- b ThoraxCenter , Erasmus Medical Center , Rotterdam , The Netherlands
| | | | - Yaping Zeng
- b ThoraxCenter , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Robin P Kraak
- a AMC Heartcenter, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Joanna J Wykrzykowska
- a AMC Heartcenter, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Robbert J De Winter
- a AMC Heartcenter, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Patrick W Serruys
- d International Centre for Circulatory Health, NHLI , Imperial College London , London , UK
| | - Yoshinobu Onuma
- b ThoraxCenter , Erasmus Medical Center , Rotterdam , The Netherlands
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A Computational Framework to Model Degradation of Biocorrodible Metal Stents Using an Implicit Finite Element Solver. Ann Biomed Eng 2015; 44:382-90. [DOI: 10.1007/s10439-015-1530-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 12/03/2015] [Indexed: 11/26/2022]
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83
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Vannozzi L, Ricotti L, Filippeschi C, Sartini S, Coviello V, Piazza V, Pingue P, La Motta C, Dario P, Menciassi A. Nanostructured ultra-thin patches for ultrasound-modulated delivery of anti-restenotic drug. Int J Nanomedicine 2015; 11:69-91. [PMID: 26730191 PMCID: PMC4694686 DOI: 10.2147/ijn.s92031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
This work aims to demonstrate the possibility to fabricate ultra-thin polymeric films loaded with an anti-restenotic drug and capable of tunable drug release kinetics for the local treatment of restenosis. Vascular nanopatches are composed of a poly(lactic acid) supporting membrane (thickness: ~250 nm) on which 20 polyelectrolyte bilayers (overall thickness: ~70 nm) are alternatively deposited. The anti-restenotic drug is embedded in the middle of the polyelectrolyte structure, and released by diffusion mechanisms. Nanofilm fabrication procedure and detailed morphological characterization are reported here. Barium titanate nanoparticles (showing piezoelectric properties) are included in the polymeric support and their role is investigated in terms of influence on nanofilm morphology, drug release kinetics, and cell response. Results show an efficient drug release from the polyelectrolyte structure in phosphate-buffered saline, and a clear antiproliferative effect on human smooth muscle cells, which are responsible for restenosis. In addition, preliminary evidences of ultrasound-mediated modulation of drug release kinetics are reported, thus evaluating the influence of barium titanate nanoparticles on the release mechanism. Such data were integrated with quantitative piezoelectric and thermal measurements. These results open new avenues for a fine control of local therapies based on smart responsive materials.
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Affiliation(s)
- Lorenzo Vannozzi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Carlo Filippeschi
- Center for MicroBioRobotics at SSSA, Istituto Italiano di Tecnologia, Pontedera, Italy
| | | | - Vito Coviello
- Department of Pharmacy, University of Pisa, Pisa, Italy
| | - Vincenzo Piazza
- Center for Nanotechnology Innovation at NEST, Istituto Italiano di Tecnologia, Pisa, Italy
| | | | | | - Paolo Dario
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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McCrossan B, McMahon C, Walsh K. First reported use of drug-eluting bioabsorbable vascular scaffold in congenital heart disease. Catheter Cardiovasc Interv 2015; 87:324-8. [DOI: 10.1002/ccd.25768] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/26/2014] [Accepted: 11/30/2014] [Indexed: 11/11/2022]
Affiliation(s)
- B.A. McCrossan
- Department of Paediatric Cardiology; Our Lady's Children's Hospital; Crumlin Dublin Ireland
| | - C.J. McMahon
- Department of Paediatric Cardiology; Our Lady's Children's Hospital; Crumlin Dublin Ireland
| | - K.P. Walsh
- Department of Paediatric Cardiology; Our Lady's Children's Hospital; Crumlin Dublin Ireland
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Uddin MS, Hall C, Murphy P. Surface treatments for controlling corrosion rate of biodegradable Mg and Mg-based alloy implants. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2015; 16:053501. [PMID: 27877829 PMCID: PMC5070015 DOI: 10.1088/1468-6996/16/5/053501] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 05/22/2023]
Abstract
Due to their excellent biodegradability characteristics, Mg and Mg-based alloys have become an emerging material in biomedical implants, notably for repair of bone as well as coronary arterial stents. However, the main problem with Mg-based alloys is their rapid corrosion in aggressive environments such as human bodily fluids. Previously, many approaches such as control of alloying materials, composition and surface treatments, have been attempted to regulate the corrosion rate. This article presents a comprehensive review of recent research focusing on surface treatment techniques utilised to control the corrosion rate and surface integrity of Mg-based alloys in both in vitro and in vivo environments. Surface treatments generally involve the controlled deposition of thin film coatings using various coating processes, and mechanical surfacing such as machining, deep rolling or low plasticity burnishing. The aim is to either make a protective thin layer of a material or to change the micro-structure and mechanical properties at the surface and sub-surface levels, which will prevent rapid corrosion and thus delay the degradation of the alloys. We have organised the review of past works on coatings by categorising the coatings into two classes-conversion and deposition coatings-while works on mechanical treatments are reviewed based on the tool-based processes which affect the sub-surface microstructure and mechanical properties of the material. Various types of coatings and their processing techniques under two classes of coating and mechanical treatment approaches have been analysed and discussed to investigate their impact on the corrosion performance, biomechanical integrity, biocompatibility and cell viability. Potential challenges and future directions in designing and developing the improved biodegradable Mg/Mg-based alloy implants were addressed and discussed. The literature reveals that no solutions are yet complete and hence new and innovative approaches are required to leverage the benefit of Mg-based alloys. Hybrid treatments combining innovative biomimetic coating and mechanical processing would be regarded as a potentially promising way to tackle the corrosion problem. Synergetic cutting-burnishing integrated with cryogenic cooling may be another encouraging approach in this regard. More studies focusing on rigorous testing, evaluation and characterisation are needed to assess the efficacy of the methods.
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Affiliation(s)
- M S Uddin
- School of Engineering, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Colin Hall
- Mawson Institute, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Peter Murphy
- Mawson Institute, University of South Australia, Mawson Lakes, SA 5095, Australia
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86
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Sotomi Y, Suwannasom P, Tenekecioglu E, Tateishi H, Abdelghani M, Serruys PW, Onuma Y. Differential aspects between cobalt-chromium everolimus drug-eluting stent and Absorb everolimus bioresorbable vascular scaffold: from bench to clinical use. Expert Rev Cardiovasc Ther 2015; 13:1127-45. [DOI: 10.1586/14779072.2015.1089172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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87
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Hiebl B, Nennig E, Schiestel S, Kovacs A, Jung F, Fischer H. Biocompatibility of a novel zinc stent with a closed-cell-design. Clin Hemorheol Microcirc 2015; 61:205-11. [DOI: 10.3233/ch-151983] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bernhard Hiebl
- Center for Medical Basic Research, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Ernst Nennig
- OPTIMED Medizinische Instrumente GmbH, Ettlingen, Germany
| | | | | | - Friedrich Jung
- Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Kantstrasse, Teltow, Germany
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88
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Everolimus-eluting Bioresorbable Vascular Scaffold Implantation in Real World and Complex Coronary Disease: Procedural and 30-day Outcomes at Two Australian Centres. Heart Lung Circ 2015; 24:854-9. [DOI: 10.1016/j.hlc.2015.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 01/12/2015] [Accepted: 02/16/2015] [Indexed: 11/19/2022]
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89
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A Review of Material Degradation Modelling for the Analysis and Design of Bioabsorbable Stents. Ann Biomed Eng 2015; 44:341-56. [DOI: 10.1007/s10439-015-1413-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/30/2015] [Indexed: 12/20/2022]
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90
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Danzi GB, Sesana M, Arieti M, Villa G, Rutigliano S, Aprile A, Nicolino A, Moshiri S, Valenti R. Does optimal lesion preparation reduce the amount of acute recoil of the absorbe BVS? Insights from a real-world population. Catheter Cardiovasc Interv 2015; 86:984-91. [DOI: 10.1002/ccd.26148] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/08/2015] [Accepted: 07/21/2015] [Indexed: 11/10/2022]
Affiliation(s)
| | - Marco Sesana
- Division of Cardiology; Ospedale Di Desenzano del Garda, Desenzano del Garda; Italy
| | - Mario Arieti
- Division of Cardiology; Ospedale Di Desenzano del Garda, Desenzano del Garda; Italy
| | - Giuliano Villa
- Division of Cardiology; Ospedale Di Desenzano del Garda, Desenzano del Garda; Italy
| | - Sergio Rutigliano
- Division of Cardiology; Ospedale Di Desenzano del Garda, Desenzano del Garda; Italy
| | - Alessandro Aprile
- Division of Cardiology; Ospedale Di Desenzano del Garda, Desenzano del Garda; Italy
| | | | - Shahram Moshiri
- Division of Cardiology, Ospedale Santa Corona; Pietra Ligure Italy
| | - Renato Valenti
- Division of Cardiology; Ospedale Careggi; Florence Italy
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91
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Suárez de Lezo J, Martín P, Mazuelos F, Nóvoa J, Ojeda S, Pan M, Segura J, Hernández E, Romero M, Melián F, Medina A, Suárez de Lezo J. Direct bioresorbable vascular scaffold implantation: Feasibility and midterm results. Catheter Cardiovasc Interv 2015; 87:E173-82. [DOI: 10.1002/ccd.26133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 04/24/2015] [Accepted: 07/11/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Javier Suárez de Lezo
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - Pedro Martín
- Department of Cardiology; Dr. Negrin Hospital, University of Las Palmas; Las Palmas De Gran Canaria Spain
| | - Francisco Mazuelos
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - José Nóvoa
- Department of Cardiology; Dr. Negrin Hospital, University of Las Palmas; Las Palmas De Gran Canaria Spain
| | - Soledad Ojeda
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - Manuel Pan
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - José Segura
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - Enrique Hernández
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - Miguel Romero
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
| | - Francisco Melián
- Department of Cardiology; Dr. Negrin Hospital, University of Las Palmas; Las Palmas De Gran Canaria Spain
| | - Alfonso Medina
- Department of Cardiology; Dr. Negrin Hospital, University of Las Palmas; Las Palmas De Gran Canaria Spain
| | - José Suárez de Lezo
- Department of Cardiology; Reina Sofia Hospital, University of Córdoba (IMIBIC); Spain
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92
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Albuquerque FN, Bortnick A, Iqbal J, Ishibashi Y, Stone GW, Serruys PW. Dual antiplatelet therapy, drug-eluting stents and bioresorbable vascular scaffolds: Evolutionary perspectives. Catheter Cardiovasc Interv 2015; 87:909-19. [DOI: 10.1002/ccd.26099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/14/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Felipe N. Albuquerque
- Division of Cardiovascular Diseases-Montefiore Medical Center; Albert Einstein College of Medicine; New York New York
| | - Anna Bortnick
- Division of Cardiovascular Diseases-Montefiore Medical Center; Albert Einstein College of Medicine; New York New York
| | - Javaid Iqbal
- ThoraxCenter; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Yuki Ishibashi
- ThoraxCenter; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Gregg W. Stone
- Columbia University Medical Center/New York-Presbyterian Hospital; New York New York
| | - Patrick W. Serruys
- ThoraxCenter; Erasmus University Medical Center; Rotterdam The Netherlands
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93
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Computational Bench Testing to Evaluate the Short-Term Mechanical Performance of a Polymeric Stent. Cardiovasc Eng Technol 2015; 6:519-32. [DOI: 10.1007/s13239-015-0235-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
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94
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Törne K, Larsson M, Norlin A, Weissenrieder J. Degradation of zinc in saline solutions, plasma, and whole blood. J Biomed Mater Res B Appl Biomater 2015; 104:1141-51. [PMID: 26061136 DOI: 10.1002/jbm.b.33458] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/30/2015] [Accepted: 05/13/2015] [Indexed: 11/08/2022]
Abstract
The initial degradation of zinc has been investigated through exposures to simulated and real body fluids of increasing complexity: phosphate buffered saline (PBS), Ringer's saline solution, human plasma, and whole blood. Real body fluids were used to close the electrolyte gap between simulated and in vivo environment. Polarization of zinc in whole blood show a passive response not present in other electrolytes. The analysis shows a decrease in corrosion rate with time for plasma and whole blood and an increase for PBS and Ringer's. During exposure to plasma and whole blood a bi-layered corrosion product with poor adherence was formed over a uniformly corroding surface. The corrosion products comprise a mixture of inorganic material and biomolecules. Samples degrading in PBS were prone to localized corrosion and formed thick porous corrosion products of primarily zinc phosphates while in Ringer's solution a gel like layer of zinc carbonate was formed over an interface with shallow pits. The use of whole blood or plasma as electrolytes for short term in vitro evaluation of potential biodegradable metals may provide an improved understanding of the behavior in vivo, while Ringer's solution is preferred over PBS for long term degradation studies of zinc. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1141-1151, 2016.
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Affiliation(s)
- Karin Törne
- Material Physics, KTH Royal Institute of Technology, Electrum 229, 16440, Kista, Sweden.,St Jude Medical Systems AB, Palmbladsgatan, Uppsala, Sweden
| | - Mariann Larsson
- Material Physics, KTH Royal Institute of Technology, Electrum 229, 16440, Kista, Sweden
| | - Anna Norlin
- St Jude Medical Systems AB, Palmbladsgatan, Uppsala, Sweden
| | - Jonas Weissenrieder
- Material Physics, KTH Royal Institute of Technology, Electrum 229, 16440, Kista, Sweden
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95
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Comprehensive characterization of polylactide-layered double hydroxides nanocomposites as packaging materials. JOURNAL OF POLYMER RESEARCH 2015. [DOI: 10.1007/s10965-015-0759-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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96
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Benvenuto P, Neves MAD, Blaszykowski C, Romaschin A, Chung T, Kim SR, Thompson M. Adlayer-mediated antibody immobilization to stainless steel for potential application to endothelial progenitor cell capture. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2015; 31:5423-5431. [PMID: 25955536 DOI: 10.1021/acs.langmuir.5b00812] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This work describes the straightforward surface modification of 316L stainless steel with BTS, S-(11-trichlorosilylundecanyl)-benzenethiosulfonate, a thiol-reactive trichlorosilane cross-linker molecule designed to form intermediary coatings with subsequent biofunctionalization capability. The strategy is more specifically exemplified with the immobilization of intact antibodies and their Fab' fragments. Both surface derivatization steps are thoroughly characterized by means of X-ray photoelectron spectroscopy. The antigen binding capability of both types of biofunctionalized surfaces is subsequently assessed by fluorescence microscopy. It was determined that BTS adlayers achieve robust immobilization of both intact and fragmented antibodies, while preserving antigen binding activity. Another key finding was the observation that the Fab' fragment immobilization strategy would constitute a preferential option over that involving intact antibodies in the context of in vivo capture of endothelial progenitor cells in stent applications.
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Affiliation(s)
- Pasquale Benvenuto
- †Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Miguel A D Neves
- †Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | | | - Alexander Romaschin
- §Clinical Biochemistry, St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada
| | - Timothy Chung
- †Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Sa Rang Kim
- †Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Michael Thompson
- †Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
- ‡Econous Systems Inc., Toronto, Ontario M5S 3H6, Canada
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97
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Ormiston J, Motreff P, Darremont O, Webber B, Guerin P, Webster M. Bioresorbable scaffolds on the bench. EUROINTERVENTION 2015; 11 Suppl V:V166-9. [DOI: 10.4244/eijv11sva40] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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98
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Shen Y, Shen WF. Optimizing the duration of dual antiplatelet therapy after implantation of drug-eluting coronary stents. Chin Med J (Engl) 2015; 128:711-3. [PMID: 25758260 PMCID: PMC4833970 DOI: 10.4103/0366-6999.152446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Wei-Feng Shen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
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99
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Arauz-Garofalo G, López-Domínguez V, Hernàndez JM, Rodríguez-Leor O, Bayés-Genís A, O'Callaghan JM, García-Santiago A, Tejada J. Microwave spectrometry for the evaluation of the structural integrity of metallic stents. Med Phys 2014; 41:041902. [PMID: 24694133 DOI: 10.1118/1.4866881] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To assess the feasibility of a method based on microwave spectrometry to detect structural distortions of metallic stents in open air conditions and envisage the prospects of this approach toward possible medical applicability for the evaluation of implanted stents. METHODS Microwave absorbance spectra between 2.0 and 18.0 GHz were acquired in open air for the characterization of a set of commercial stents using a specifically design setup. Rotating each sample over 360°, 2D absorbance diagrams were generated as a function of frequency and rotation angle. To check our approach for detecting changes in stent length (fracture) and diameter (recoil), two specific tests were performed in open air. Finally, with a few adjustments, this same system provides 2D absorbance diagrams of stents immersed in a water-based phantom, this time over a bandwidth ranging from 0.2 to 1.8 GHz. RESULTS The authors show that metallic stents exhibit characteristic resonant frequencies in their microwave absorbance spectra in open air which depend on their length and, as a result, may reflect the occurrence of structural distortions. These resonances can be understood considering that such devices behave like dipole antennas in terms of microwave scattering. From fracture tests, the authors infer that microwave spectrometry provides signs of presence of Type I to Type IV stent fractures and allows in particular a quantitative evaluation of Type III and Type IV fractures. Recoil tests show that microwave spectrometry seems able to provide some quantitative assessment of diametrical shrinkage, but only if it involves longitudinal shortening. Finally, the authors observe that the resonant frequencies of stents placed inside the phantom shift down with respect to the corresponding open air frequencies, as it should be expected considering the increase of dielectric permittivity from air to water. CONCLUSIONS The evaluation of stent resonant frequencies provided by microwave spectrometry allows detection and some quantitative assessment of stent fracture and recoil in open air conditions. Resonances of stents immersed in water can be also detected and their characteristic frequencies are in good agreement with theoretical estimates. Although these are promising results, further verification in a more relevant phantom is required in order to foresee the real potential of this approach.
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Affiliation(s)
- Gianluca Arauz-Garofalo
- Grup de Magnetisme, Departament de Física Fonamental, Facultat de Física, Universitat de Barcelona, Martí i Franquès 1, planta 4, edifici nou, ES-08028 Barcelona, Spain
| | - Víctor López-Domínguez
- Grup de Magnetisme, Departament de Física Fonamental, Facultat de Física, Universitat de Barcelona, Martí i Franquès 1, planta 4, edifici nou, ES-08028 Barcelona, Spain
| | - Joan Manel Hernàndez
- Grup de Magnetisme, Departament de Física Fonamental, Facultat de Física, Universitat de Barcelona, Martí i Franquès 1, planta 4, edifici nou, ES-08028 Barcelona, Spain and Institut de Nanociència i Nanotecnologia IN2UB, Universitat de Barcelona, Martí i Franquès 1, planta 3, edifici nou, ES-08028 Barcelona, Spain
| | - Oriol Rodríguez-Leor
- Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, ES-08916 Badalona, Spain
| | - Antoni Bayés-Genís
- Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, ES-08916 Badalona, Spain
| | - Juan M O'Callaghan
- Department of Signal Theory and Communications, Universitat Politècnica de Catalunya, Jordi Girona 1, ES-08034 Barcelona, Spain
| | - Antoni García-Santiago
- Grup de Magnetisme, Departament de Física Fonamental, Facultat de Física, Universitat de Barcelona, Martí i Franquès 1, planta 4, edifici nou, ES-08028 Barcelona, Spain and Institut de Nanociència i Nanotecnologia IN2UB, Universitat de Barcelona, Martí i Franquès 1, planta 3, edifici nou, ES-08028 Barcelona, Spain
| | - Javier Tejada
- Grup de Magnetisme, Departament de Física Fonamental, Facultat de Física, Universitat de Barcelona, Martí i Franquès 1, planta 4, edifici nou, ES-08028 Barcelona, Spain and Institut de Nanociència i Nanotecnologia IN2UB, Universitat de Barcelona, Martí i Franquès 1, planta 3, edifici nou, ES-08028 Barcelona, Spain
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100
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Kimble LD, Bhattacharyya D. In VitroDegradation Effects on Strength, Stiffness, and Creep of PLLA/PBS: A Potential Stent Material. INT J POLYM MATER PO 2014. [DOI: 10.1080/00914037.2014.945203] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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