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Zhao Y, Wang Y, Chen L, Bai L, Guan S. Co-immobilization of natural marine polysaccharides and bioactive peptides on ZE21B magnesium alloy to enhance hemocompatibility and cytocompatibility. Int J Biol Macromol 2024; 272:132747. [PMID: 38821301 DOI: 10.1016/j.ijbiomac.2024.132747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
Degradable magnesium alloy stents are considered to be ideal candidates to replace the traditional non-degradable stents for the treatment of cardiovascular diseases. However, bare magnesium alloy stents usually degrade too fast and show poor hemocompatibility and cytocompatibility, which seriously affects their clinical use. In this study, surface modification based on the MgF2 layer, polydopamine (PDA) coating, fucoidan and CAG peptides was performed on the Mg-Zn-Y-Nd (ZE21B) magnesium alloy with the purpose of improving its corrosion resistance, hemocompatibility and cytocompatibility for vascular stent application. After modification, the ZE21B alloy showed better corrosion resistance. Moreover, the lower hemolysis rate, platelet adhesion and activation, and fibrinogen adsorption and denaturation proved the improved hemocompatibility of modified ZE21B alloy in in vitro blood experiments. Furthermore, the co-immobilization of fucoidan and CAG peptides significantly promoted the adhesion, proliferation, migration and NO release of endothelial cells (ECs) on the modified ZE21B alloy, and meanwhile the modification with fucoidan and CAG peptides inhibited the adhesion and proliferation of smooth muscle cells (SMCs) and suppressed the expression of proinflammatory factors in the macrophages (MAs). The surface modification obviously enhanced the corrosion resistance, hemocompatibility and cytocompatibility of ZE21B alloy, and provided an effective strategy for the development of degradable vascular stents.
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Affiliation(s)
- Yuan Zhao
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China
| | - Yahui Wang
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China
| | - Lan Chen
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China
| | - Lingchuang Bai
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China.
| | - Shaokang Guan
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China; Key Laboratory of Materials Processing and Mold Technology (Ministry of Education), Zhengzhou 450002, China.
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2
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Van Daele L, Chausse V, Parmentier L, Brancart J, Pegueroles M, Van Vlierberghe S, Dubruel P. 3D-Printed Shape Memory Poly(alkylene terephthalate) Scaffolds as Cardiovascular Stents Revealing Enhanced Endothelialization. Adv Healthc Mater 2024; 13:e2303498. [PMID: 38329408 DOI: 10.1002/adhm.202303498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/02/2024] [Indexed: 02/09/2024]
Abstract
Cardiovascular diseases are the leading cause of death and current treatments such as stents still suffer from disadvantages. Balloon expansion causes damage to the arterial wall and limited and delayed endothelialization gives rise to restenosis and thrombosis. New more performing materials that circumvent these disadvantages are required to improve the success rate of interventions. To this end, the use of a novel polymer, poly(hexamethylene terephthalate), is investigated for this application. The synthesis to obtain polymers with high molar masses up to 126.5 kg mol-1 is optimized and a thorough chemical and thermal analysis is performed. The polymers are 3D-printed into personalized cardiovascular stents using the state-of-the-art solvent-cast direct-writing technique, the potential of these stents to expand using their shape memory behavior is established, and it is shown that the stents are more resistant to compression than the poly(l-lactide) benchmark. Furthermore, the polymer's hydrolytic stability is demonstrated in an accelerated degradation study of 6 months. Finally, the stents are subjected to an in vitro biological evaluation, revealing that the polymer is non-hemolytic and supports significant endothelialization after only 7 days, demonstrating the enormous potential of these polymers to serve cardiovascular applications.
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Affiliation(s)
- Lenny Van Daele
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Victor Chausse
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Barcelona, 08019, Spain
| | - Laurens Parmentier
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Joost Brancart
- Physical Chemistry and Polymer Science (FYSC), Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium
| | - Marta Pegueroles
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Engineering, Universitat Politècnica de Catalunya (UPC), EEBE, Barcelona, 08019, Spain
| | - Sandra Van Vlierberghe
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
| | - Peter Dubruel
- Polymer Chemistry and Biomaterials Group (PBM), Centre of Macromolecular Chemistry (CMaC), Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4-bis, Ghent, B-9000, Belgium
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Zhang Y, Dong X, Zhang C, Wu X, Cheng J, Wu G, Sun R, Ni Z, Zhao G. Strengthen oriented poly (L-lactic acid) monofilaments via mechanical training. Int J Biol Macromol 2024; 263:129975. [PMID: 38418283 DOI: 10.1016/j.ijbiomac.2024.129975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
Polymer materials have found extensive applications in the clinical and medical domains due to their exceptional biocompatibility and biodegradability. Compared to metallic counterparts, polymers, particularly Poly (L-lactic acid) (PLLA), are more suitable for fabricating biodegradable stents. As a viscoelastic material, PLLA monofilaments exhibit a creep phenomenon under sustained tensile stress. This study explores the use of creep to enhance the mechanical attributes of PLLA monofilaments. By subjecting the highly oriented monofilaments to controlled, constant force stretching, we achieved notable improvements in their mechanical characteristics. The results, as confirmed by tensile testing and dynamic mechanical analysis, revealed a remarkable 67 % increase in total elongation and over a 20 % rise in storage modulus post-mechanical training. Further microscopic analyses, including Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM), revealed enhanced spacing and cavity formation. These mechanical advancements are attributed to the unraveling and a more orderly arrangement of molecular chains in the amorphous regions. This investigation offers a promising approach for augmenting the mechanical properties of PLLA monofilaments, potentially benefiting their application in biomedical engineering.
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Affiliation(s)
- Yan Zhang
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Xuechun Dong
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Chen Zhang
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Xiongyu Wu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Renhua Sun
- Department of Cardiology, Yancheng First Hospital, Affiliated Hospital of Nangjing University Medical School, Yancheng 224006, China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China.
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China.
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Hu X, Liu Q, Chen L, Cheng J, Liu M, Wu G, Sun R, Zhao G, Yang J, Ni Z. Modified Theoretical Model Predicts Radial Support Capacity of Polymer Braided Stents. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 246:108063. [PMID: 38354577 DOI: 10.1016/j.cmpb.2024.108063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND AND OBJECTIVE Self-expanding polymer braided stents are expected to replace metallic stents in the treatment of Peripheral Arterial Disease, which seriously endangers human health. To restore the patency of blocked peripheral arteries with different properties and functions, the radial supporting capacity of the stent should be considered corresponding to the vessel. A theoretical model can be established as an effective method to study the radial supporting capacity of the stent which can shorten the stent design cycle and realize the customization of the stent according to lesion site. However, the classical model developed by Jedwab and Clerc of radial force is only limited to metallic braided stents, and the predictions for polymer braided stents are deviated. METHODS In this paper, based on the limitation of the J&C model for polymer braided stents, a modified radial force model for polymer braided stents was proposed, which considered the friction between monofilaments and the torsion of the monofilaments. And the modified model was verified by radial force tests of polymer braided stents with different structures and monofilaments. RESULTS Compared with the J&C model, the proposed modified model has better predictability for the radial force of polymer braided stents that prepared with different braided structure and polymer monofilaments. The root mean squared error of modified model is 0.041±0.026, while that of the J&C model is 0.246±0.111. CONCLUSIONS For polymer braided stents, the friction between the polymer monofilaments and the torsion of the monofilaments during the radial compression cannot be ignored. The radial force prediction accuracy of the modified model considering these factors was significantly improved. This work provides a research basis on the theoretical model of polymer braided stents, and improves the feasibility of rapid personalized customization of polymer braided stents.
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Affiliation(s)
- Xue Hu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China
| | - Qingwei Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China
| | - Li Chen
- Modern Education Technology Center, Henan University of Economics and Law, Zhengzhou 450046, China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China
| | - Muqing Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Renhua Sun
- Department of Cardiology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng, 224006, China
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China.
| | - Juekuan Yang
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China.
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, Jiangsu, China.
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Roman AM, Cimpoeșu R, Pricop B, Cazacu MM, Zegan G, Istrate B, Cocean A, Chelariu R, Moscu M, Bădărău G, Cimpoeșu N, Ivănescu MC. Investigations on the Degradation Behavior of Processed FeMnSi-xCu Shape Memory Alloys. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:330. [PMID: 38392703 PMCID: PMC10893035 DOI: 10.3390/nano14040330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
A new functional Fe-30Mn-5Si-xCu (x = 1.5 and 2 wt%) biomaterial was obtained from the levitation induction melting process and evaluated as a biodegradable material. The degradation characteristics were assessed in vitro using immersion tests in simulated body fluid (SBF) at 37 ± 1 °C, evaluating mass loss, pH variation that occurred in the solution, open circuit potential (OCP), linear and cyclic potentiometry (LP and CP), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and nano-FTIR. To obtain plates as samples, the cast materials were thermo-mechanically processed by hot rolling. Dynamic mechanical analysis (DMA) was employed to evaluate the thermal properties of the smart material. Atomic force microscopy (AFM) was used to show the nanometric and microstructural changes during the hot rolling process and DMA solicitations. The type of corrosion identified was generalized corrosion, and over the first 3-5 days, an increase in mass was observed, caused by the compounds formed at the metal-solution interface. The formed compounds were identified mainly as oxides that passed into the immersion liquid. The degradation rate (DR) was obtained as a function of mass loss, sample surface area and immersion duration. The dynamic mechanical behavior and dimensions of the sample were evaluated after 14 days of immersion. The nanocompounds found on the surface after atmospheric corrosion and immersion in SBF were investigated with the Neaspec system using the nano-FTIR technique.
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Affiliation(s)
- Ana-Maria Roman
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Ramona Cimpoeșu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Bogdan Pricop
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Marius Mihai Cazacu
- Physics Department, “Gheorghe Asachi” Technical University of Iasi, 59A Dimitrie Mangeron Blvd, 700050 Iasi, Romania;
| | - Georgeta Zegan
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
| | - Bogdan Istrate
- Faculty of Mechanical Engineering, “Gheorghe Asachi” Technical University of Iasi, 43 Dimitrie Mangeron Blvd, 700050 Iasi, Romania;
| | - Alexandru Cocean
- Atmosphere Optics, Spectroscopy and Laser Laboratory (LOASL), Faculty of Physics, Alexandru Ioan Cuza University, 11 Carol I Blvd, 700506 Iasi, Romania;
- Laboratory of Applied Meteorology and Climatology, A Building, Physics, Research Center with Integrated Techniques for Atmospheric Aerosol Investigation in Romania (RECENT AIR), Alexandru Ioan Cuza University of Iasi, 11 Carol I, 700506 Iasi, Romania
| | - Romeu Chelariu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Mihaela Moscu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
| | - Gheorghe Bădărău
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Nicanor Cimpoeșu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University of Iasi, 41 Dimitrie Mangeron Blvd, 700050 Iasi, Romania; (A.-M.R.); (R.C.); (B.P.); (R.C.); (G.B.)
| | - Mircea Cătălin Ivănescu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania; (M.M.); (M.C.I.)
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6
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Xie A, Hao J, Duan F, Mitchell K, Jin Y, Zhao D. Mechanical analysis of radial performance in biodegradable polymeric vascular stents manufactured using micro-injection molding. J Mech Behav Biomed Mater 2024; 150:106362. [PMID: 38169208 DOI: 10.1016/j.jmbbm.2023.106362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
Micro-injection molding (MiM) is a promising technique for manufacturing biodegradable polymeric vascular stents (BPVSs) at scale, in which a trapezoidal strut cross section is needed to ensure high-quality de-molding. However, there is a lack of research on the influence of the strut cross-sectional shape on its mechanical properties, posing a challenge in determining the key geometries of the strut when using MiM to produce BPVSs. Hence, this work has investigated the relationships between the geometry parameters, including the de-molding angle, and the radial support property of BPVSs using the finite element method. The results reveal that the radial stiffness of BPVSs is significantly affected by the de-molding angle, which can be counteracted by adjusting strut height, bending radius, and strut thickness. Stress distribution analysis underscores the crucial role of the curved portion of the support ring during compression, with the inner side of the curved region experiencing stress concentration. A mathematical model has been established to describe the relationships between the geometry parameters and the radial support property of the BPVSs. Notably, the radius of the neutral layer emerges as a key determinant of radial stiffness. This study is expected to serve as a guideline for the development of BPVSs that can be manufactured using MiM.
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Affiliation(s)
- Ankun Xie
- School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning, 116024, China
| | - Jiangtao Hao
- School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning, 116024, China
| | - Fei Duan
- School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning, 116024, China
| | - Kellen Mitchell
- Department of Mechanical Engineering, University of Nevada Reno, Reno, NV, 89557, USA
| | - Yifei Jin
- Department of Mechanical Engineering, University of Nevada Reno, Reno, NV, 89557, USA.
| | - Danyang Zhao
- School of Mechanical Engineering, Dalian University of Technology, Dalian, Liaoning, 116024, China.
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West-Livingston L, Lim JW, Lee SJ. Translational tissue-engineered vascular grafts: From bench to bedside. Biomaterials 2023; 302:122322. [PMID: 37713761 DOI: 10.1016/j.biomaterials.2023.122322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023]
Abstract
Cardiovascular disease is a primary cause of mortality worldwide, and patients often require bypass surgery that utilizes autologous vessels as conduits. However, the limited availability of suitable vessels and the risk of failure and complications have driven the need for alternative solutions. Tissue-engineered vascular grafts (TEVGs) offer a promising solution to these challenges. TEVGs are artificial vascular grafts made of biomaterials and/or vascular cells that can mimic the structure and function of natural blood vessels. The ideal TEVG should possess biocompatibility, biomechanical mechanical properties, and durability for long-term success in vivo. Achieving these characteristics requires a multi-disciplinary approach involving material science, engineering, biology, and clinical translation. Recent advancements in scaffold fabrication have led to the development of TEVGs with improved functional and biomechanical properties. Innovative techniques such as electrospinning, 3D bioprinting, and multi-part microfluidic channel systems have allowed the creation of intricate and customized tubular scaffolds. Nevertheless, multiple obstacles must be overcome to apply these innovations effectively in clinical practice, including the need for standardized preclinical models and cost-effective and scalable manufacturing methods. This review highlights the fundamental approaches required to successfully fabricate functional vascular grafts and the necessary translational methodologies to advance their use in clinical practice.
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Affiliation(s)
- Lauren West-Livingston
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA; Department of Vascular and Endovascular Surgery, Duke University, Durham, NC, 27712, USA
| | - Jae Woong Lim
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA; Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital, Bucheon-Si, Gyeonggi-do, 420-767, Republic of Korea
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA.
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8
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Li Y, Shi Y, Lu Y, Li X, Zhou J, Zadpoor AA, Wang L. Additive manufacturing of vascular stents. Acta Biomater 2023:S1742-7061(23)00338-0. [PMID: 37331614 DOI: 10.1016/j.actbio.2023.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
With the advancement of additive manufacturing (AM), customized vascular stents can now be fabricated to fit the curvatures and sizes of a narrowed or blocked blood vessel, thereby reducing the possibility of thrombosis and restenosis. More importantly, AM enables the design and fabrication of complex and functional stent unit cells that would otherwise be impossible to realize with conventional manufacturing techniques. Additionally, AM makes fast design iterations possible while also shortening the development time of vascular stents. This has led to the emergence of a new treatment paradigm in which custom and on-demand-fabricated stents will be used for just-in-time treatments. This review is focused on the recent advances in AM vascular stents aimed at meeting the mechanical and biological requirements. First, the biomaterials suitable for AM vascular stents are listed and briefly described. Second, we review the AM technologies that have been so far used to fabricate vascular stents as well as the performances they have achieved. Subsequently, the design criteria for the clinical application of AM vascular stents are discussed considering the currently encountered limitations in materials and AM techniques. Finally, the remaining challenges are highlighted and some future research directions are proposed to realize clinically-viable AM vascular stents. STATEMENT OF SIGNIFICANCE: Vascular stents have been widely used for the treatment of vascular disease. The recent progress in additive manufacturing (AM) has provided unprecedented opportunities for revolutionizing traditional vascular stents. In this manuscript, we review the applications of AM to the design and fabrication of vascular stents. This is an interdisciplinary subject area that has not been previously covered in the published review articles. Our objective is to not only present the state-of-the-art of AM biomaterials and technologies but to also critically assess the limitations and challenges that need to be overcome to speed up the clinical adoption of AM vascular stents with both anatomical superiority and mechanical and biological functionalities that exceed those of the currently available mass-produced devices.
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Affiliation(s)
- Yageng Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yixuan Shi
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yuchen Lu
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Xuan Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jie Zhou
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands.
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology, Delft 2628 CD, The Netherlands.
| | - Luning Wang
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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9
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Cardiovascular Nanotechnology. Nanomedicine (Lond) 2023. [DOI: 10.1007/978-981-16-8984-0_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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10
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Zong J, He Q, Liu Y, Qiu M, Wu J, Hu B. Advances in the development of biodegradable coronary stents: A translational perspective. Mater Today Bio 2022; 16:100368. [PMID: 35937578 PMCID: PMC9352968 DOI: 10.1016/j.mtbio.2022.100368] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/25/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases. Bioresorbable stents can overcome the limitations of non-degradable stents. 3D printing of shape-memory polymeric stents can lead to better clinical outcomes. Advances in Mg-, Fe- and Zn-based stents from a translational perspective. Electronic stents integrated with biosensors can covey stent status in real time. Development in the assessment of stent performance in vivo.
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Affiliation(s)
- Jiabin Zong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Quanwei He
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yuxiao Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Min Qiu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jiehong Wu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Corresponding author.
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Corresponding author.
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11
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Marriott R, Spiridonova TI, Tverdokhlebov SI, Anissimov YG. Using Compartments to Model Drug Delivery from Biodegradable Polymers. J Pharm Sci 2022; 111:3096-3107. [PMID: 35872022 DOI: 10.1016/j.xphs.2022.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
Polymeric drug delivery systems can improve patient compliance, decrease toxicity and prolong therapeutic effects for a wide range of therapeutic treatments, by controlling drug release. Polymer delivery system development can be facilitated by mathematical models. We present here a new compartmental model that will be more familiar to pharmaceutical professionals and equally as effective as common diffusion equation-based models. The compartmental model considers both polymer degradation and drug diffusion to predict drug release. The model is adapted into three different geometries for different polymer delivery scenarios: membranes, fibres and particles. Model parameters are derived in terms of diffusion coefficients. Polymer-drug binding interactions and distributions of fibre/particle diameters are incorporated to the model. The model is validated by comparison to common diffusion equation-based solutions and fitting to experimental data. It is shown how the model for drug release can be incorporated into existing distribution models to predict plasma concentrations of an in vivo administration. A user-friendly Python implementation of the model is available on Github, at https://github.com/spirt-t/compartments_model.
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Affiliation(s)
- R Marriott
- School of Environment and Science, Griffith University, Gold Coast, Queensland, 4222, Australia
| | - T I Spiridonova
- The Weinberg Research Center, National Research Tomsk Polytechnic University, 30 Lenin Avenue, 634050, Russia
| | - S I Tverdokhlebov
- The Weinberg Research Center, National Research Tomsk Polytechnic University, 30 Lenin Avenue, 634050, Russia
| | - Y G Anissimov
- School of Environment and Science, Griffith University, Gold Coast, Queensland, 4222, Australia.
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12
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Wang Y, Li G, Yang L, Luo R, Guo G. Development of Innovative Biomaterials and Devices for the Treatment of Cardiovascular Diseases. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2201971. [PMID: 35654586 DOI: 10.1002/adma.202201971] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/29/2022] [Indexed: 06/15/2023]
Abstract
Cardiovascular diseases have become the leading cause of death worldwide. The increasing burden of cardiovascular diseases has become a major public health problem and how to carry out efficient and reliable treatment of cardiovascular diseases has become an urgent global problem to be solved. Recently, implantable biomaterials and devices, especially minimally invasive interventional ones, such as vascular stents, artificial heart valves, bioprosthetic cardiac occluders, artificial graft cardiac patches, atrial shunts, and injectable hydrogels against heart failure, have become the most effective means in the treatment of cardiovascular diseases. Herein, an overview of the challenges and research frontier of innovative biomaterials and devices for the treatment of cardiovascular diseases is provided, and their future development directions are discussed.
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Affiliation(s)
- Yunbing Wang
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, 29 Wangjiang Road, Chengdu, 610064, China
| | - Gaocan Li
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, 29 Wangjiang Road, Chengdu, 610064, China
| | - Li Yang
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, 29 Wangjiang Road, Chengdu, 610064, China
| | - Rifang Luo
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, 29 Wangjiang Road, Chengdu, 610064, China
| | - Gaoyang Guo
- National Engineering Research Center for Biomaterials and College of Biomedical Engineering, Sichuan University, 29 Wangjiang Road, Chengdu, 610064, China
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13
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Hill A, Ronan W. A kinetic scission model for molecular weight evolution in bioresorbable polymers. POLYM ENG SCI 2022. [DOI: 10.1002/pen.26131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Aoife Hill
- Biomechanics Research Centre, Biomedical Engineering, School of Engineering University of Galway Galway Ireland
| | - William Ronan
- Biomechanics Research Centre, Biomedical Engineering, School of Engineering University of Galway Galway Ireland
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14
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Xia Q, Ye W, Zhang Q, Liu D, Gao S, Fan Z, Liu Q. Structure, properties, and in vitro degradation behavior of biodegradable poly(L‐lactic acid)‐trimethylene carbonate‐glycolide terpolymer. J Appl Polym Sci 2022. [DOI: 10.1002/app.52968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Qi Xia
- Department of Materials Science Fudan University Shanghai China
| | - Wuyou Ye
- Department of Materials Science Fudan University Shanghai China
| | - Qin Zhang
- Department of Materials Science Fudan University Shanghai China
| | - Dongyang Liu
- Department of Materials Science Fudan University Shanghai China
| | - Shida Gao
- Department of Materials Science Fudan University Shanghai China
| | - Zhongyong Fan
- Department of Materials Science Fudan University Shanghai China
| | - Qing Liu
- Beijing Advanced Medical Technologies, Ltd. Inc. Beijing China
- The Institute for Translational Nanomedicine, Shanghai East Hospital, The Institute for Biomedical Engineering and Nano Science Tongji University School of Medicine Shanghai China
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15
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Fabrication and characterization of biodegradable Zn-Cu-Mn alloy micro-tubes and vascular stents: microstructure, texture, mechanical properties and corrosion behavior. Acta Biomater 2022; 151:647-660. [DOI: 10.1016/j.actbio.2022.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
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16
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Fabrication and Processing of Bioabsorbable Hybrid Zn/(Ag + Fe + Mg)-MMC on Developed Ultrasonic Vibration-Assisted Argon Atmosphere Stir Casting Set-up. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022. [DOI: 10.1007/s13369-021-06205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Loffredo S, Gambaro S, Copes F, Paternoster C, Giguère N, Vedani M, Mantovani D. Effect of silver in thermal treatments of Fe-Mn-C degradable metals: Implications for stent processing. Bioact Mater 2022; 12:30-41. [PMID: 35087961 PMCID: PMC8777259 DOI: 10.1016/j.bioactmat.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/15/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022] Open
Abstract
Twinning-induced plasticity (TWIP) steels are considered excellent materials for manufacturing products requiring extremely high mechanical properties for various applications including thin medical devices, such as biodegradable intravascular stents. It is also proven that the addition of Ag can guarantee an appropriate degradation while implanted in human body without affecting its bioactive properties. In order to develop an optimized manufacturing process for thin stents, the effect of Ag on the recrystallization behavior of TWIP steels needs to be elucidated. This is of major importance since manufacturing stents involves several intermediate recrystallization annealing treatments. In this work, the recrystallization mechanism of two Fe-Mn-C steels with and without Ag was thoroughly investigated by microstructural and mechanical analyses. It was observed that Ag promoted a finer microstructure with a different texture evolution, while the recrystallization kinetics resulted unaffected. The presence of Ag also reduced the effectiveness of the recrystallization treatment. This behavior was attributed to the presence of Ag-rich second phase particles, precipitation of carbides and to the preferential development of grains possessing a {111} orientation upon thermal treatment. The prominence of {111} grains can also give rise to premature twinning, explaining the role of Ag in reducing the ductility of TWIP steels already observed in other works. Furthermore, in vitro biological performances were unaffected by Ag. These findings could allow the design of efficient treatments for supporting the transformation of Fe-Mn-C steels alloyed with Ag into commercial products. Recrystallization of a TWIP steel is hampered by the presence of Ag and carbides. Ag promotes preferential formation of {111} grains during thermal treatments. Ag broadens the Schmid factor distribution, leading to a reduction in ductility. Ag does not affect cytotoxicity and hemocompatibility. Annealing treatment above 900 °C is required for the Fe-Mn-C-Ag system.
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18
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Li Y, Wang Y, Shen Z, Miao F, Wang J, Sun Y, Zhu S, Zheng Y, Guan S. A biodegradable magnesium alloy vascular stent structure: Design, optimisation and evaluation. Acta Biomater 2022; 142:402-412. [PMID: 35085798 DOI: 10.1016/j.actbio.2022.01.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/05/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
Abstract
The existing biodegradable magnesium alloy stent (BMgS) structure is prone to problems, such as insufficient support capacity and early fracture at areas of concentrated stress. Herein, a stent structural design, which reduced the cross section of the traditional sin-wave stent by nearly 30% and introduces a regular arc structure in the middle of the support ring. The influence of the dual-parameter design of bending radius (r) and ring length (L) on plastic deformation, expansion and compression resistance performances are discussed. The non-dominated sorting genetic algorithm II (NSGA-II) was used to search for the optimal solution. It was found that the introduction of parameter r effectively improved the plastic deformation and expansion performance, and the reduction of L improved stent compression resistance. Finally, an optimized stent configuration was obtained. In vitro mechanical tests, including balloon inflation, radial strength and flexibility, verified the simulation results. The radial strength for the optimised stent increases by approximately 40% compared with that for the sinusoidal stent. Microarea X-ray diffraction result shows that the circumferential residual stress for the optimised stent decreases by half compared with that for the sinusoidal stent, thus effectively reducing the stress concentration phenomenon. STATEMENT OF SIGNIFICANCE: Despite current progress in BMgS research, the optimal design of the structure is limited. We present a new type of structurally designed stent. The performance of this stent was analysed by a finite element method and experimentally verified. The structural design positively influenced stent performance.
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Affiliation(s)
- Yafei Li
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Yan Wang
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Zhenquan Shen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Fulong Miao
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Jianfeng Wang
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China; Key Laboratory of Advanced Materials Processing & Mold Ministry of Education, Zhengzhou 450002, China
| | - Yufeng Sun
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China; Key Laboratory of Advanced Materials Processing & Mold Ministry of Education, Zhengzhou 450002, China
| | - Shijie Zhu
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China; Key Laboratory of Advanced Materials Processing & Mold Ministry of Education, Zhengzhou 450002, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Shaokang Guan
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Advanced Magnesium Alloys, Zhengzhou 450002, China; Key Laboratory of Advanced Materials Processing & Mold Ministry of Education, Zhengzhou 450002, China.
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19
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Deng D, Tian Y, Liu M, Cheng J, Wu G, Zhang Y, Zhao G, Ni Z. Enhanced mechanical properties of poly(L‐lactide) braided stent with six‐arm poly(L‐lactide‐co‐ε‐caprolactone) coating cross‐linked by hexamethylene diisocyanate. POLYM ADVAN TECHNOL 2022. [DOI: 10.1002/pat.5668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Dongwen Deng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Yuan Tian
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Muqing Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering Nanjing Forestry University Nanjing China
| | - Yi Zhang
- Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing China
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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20
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3D Printing of Polymeric Bioresorbable Stents: A Strategy to Improve Both Cellular Compatibility and Mechanical Properties. Polymers (Basel) 2022; 14:polym14061099. [PMID: 35335430 PMCID: PMC8954590 DOI: 10.3390/polym14061099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
One of the leading causes of death is cardiovascular disease, and the most common cardiovascular disease is coronary artery disease. Percutaneous coronary intervention and vascular stents have emerged as a solution to treat coronary artery disease. Nowadays, several types of vascular stents share the same purpose: to reduce the percentage of restenosis, thrombosis, and neointimal hyperplasia and supply mechanical support to the blood vessels. Despite the numerous efforts to create an ideal stent, there is no coronary stent that simultaneously presents the appropriate cellular compatibility and mechanical properties to avoid stent collapse and failure. One of the emerging approaches to solve these problems is improving the mechanical performance of polymeric bioresorbable stents produced through additive manufacturing. Although there have been numerous studies in this field, normalized control parameters for 3D-printed polymeric vascular stents fabrication are absent. The present paper aims to present an overview of the current types of stents and the main polymeric materials used to fabricate the bioresorbable vascular stents. Furthermore, a detailed description of the printing parameters' influence on the mechanical performance and degradation profile of polymeric bioresorbable stents is presented.
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21
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In Vitro Corrosion Behavior of Zn3Mg0.7Y Biodegradable Alloy in Simulated Body Fluid (SBF). APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Biodegradable metallic materials represent a new class of biocompatible materials for medical applications based on numerous advantages. Among them, those based on zinc have a rate of degradation close to the healing period required by many clinical problems, which makes them more suitable than those based on magnesium or iron. The poor mechanical properties of Zn could be significantly improved by the addition of Mg and Y. In this research, we analyze the electro-chemical and mechanical behavior of a new alloy based on Zn3Mg0.7Y compared with pure Zn and Zn3Mg materials. Microstructure and chemical composition were investigated by electron microscopy and energy dispersive spectroscopy. The electrochemical corrosion was analyzed by linear polarization (LP), cyclic polarization (CP) and electrochemical impedance spectroscopy (EIS). For hardness and scratch resistance, a microhardness tester and a scratch module were used. Findings revealed that the mechanical properties of Zn improved through the addition of Mg and Y. Zn, Zn-Mg and Zn-Mg-Y alloys in this study showed highly active behavior in SBF with uniform corrosion. Zinc metals and their alloys with magnesium and yttrium showed a moderate degradation rate and can be considered as promising biodegradable materials for orthopedic application.
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22
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Zhao G, Liu Q, Tian Y, Liu J, Cheng J, Ni Z. Evaluation of mechanical properties of poly(
L
‐lactic acid) braided stents with axial stiffeners. J Appl Polym Sci 2022. [DOI: 10.1002/app.52242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Qingwei Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Yuan Tian
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jinbo Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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23
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Zhang S, Yuan P, Wang X, Wang T, Zhao L, Cui C. Fabrication and Properties of Zn-3Mg-1Ti Alloy as a Potential Biodegradable Implant Material. MATERIALS 2022; 15:ma15030940. [PMID: 35160886 PMCID: PMC8839224 DOI: 10.3390/ma15030940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/26/2022]
Abstract
A Zn-3Mg-1Ti alloy was fabricated by ultrasonic treatment of Zn-Mg alloy melt using a Ti ultrasonic radiation rod. The microstructure, phase structure, mechanical properties, degradation property, and in vitro cytotoxicity were investigated systematically. The obtained Zn-3Mg-1Ti alloy is composed of the Zn, Mg2Zn11, and TiZn16. Owing to the grain refinement and second phase reinforcement, the mechanical properties of Zn-3Mg-1Ti alloy is improved. In addition, the Zn-3Mg-1Ti alloy exhibits minimal cytotoxicity compared to pure Zn and Zn-1Ti alloy. Electrochemical tests show that the Zn-3Mg-1Ti alloy has an appropriate degradation rate in Hank’s solution.
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24
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Wu X, Chen K, Chai Q, Liu S, Feng C, Xu L, Zhang D. Freestanding vascular scaffolds engineered by direct 3D printing with Gt-Alg-MMT bioinks. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2022; 133:112658. [DOI: 10.1016/j.msec.2022.112658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 12/15/2022]
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25
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Cardiovascular Nanotechnology. Nanomedicine (Lond) 2022. [DOI: 10.1007/978-981-13-9374-7_12-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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26
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The new generation fibers: a review of high performance and specialty fibers. Polym Bull (Berl) 2021. [DOI: 10.1007/s00289-021-03966-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Na JY, Kim D, Kwon AM, Jeon JY, Kim H, Kim CR, Lee HJ, Lee J, Park HK. Artificial intelligence model comparison for risk factor analysis of patent ductus arteriosus in nationwide very low birth weight infants cohort. Sci Rep 2021; 11:22353. [PMID: 34785709 PMCID: PMC8595677 DOI: 10.1038/s41598-021-01640-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
Despite the many comorbidities and high mortality rate in preterm infants with patent ductus arteriosus (PDA), therapeutic strategies vary depending on the clinical setting, and most studies of the related risk factors are based on small sample populations. We aimed to compare the performance of artificial intelligence (AI) analysis with that of conventional analysis to identify risk factors associated with symptomatic PDA (sPDA) in very low birth weight infants. This nationwide cohort study included 8369 very low birth weight (VLBW) infants. The participants were divided into an sPDA group and an asymptomatic PDA or spontaneously close PDA (nPDA) group. The sPDA group was further divided into treated and untreated subgroups. A total of 47 perinatal risk factors were collected and analyzed. Multiple logistic regression was used as a standard analytic tool, and five AI algorithms were used to identify the factors associated with sPDA. Combining a large database of risk factors from nationwide registries and AI techniques achieved higher accuracy and better performance of the PDA prediction tasks, and the ensemble methods showed the best performances.
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Affiliation(s)
- Jae Yoon Na
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Dongkyun Kim
- Department of Electrical and Electronic Engineering, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, 15588, Korea
| | - Amy M Kwon
- Artificial Intelligence Convergence Research Center, Hanyang University ERICA, Ansan, 15588, Korea
| | - Jin Yong Jeon
- Department of Medical and Digital Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Hyuck Kim
- Department of Thoracic and Cardiovascular Surgery, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Chang-Ryul Kim
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Joohyun Lee
- Department of Electrical and Electronic Engineering, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan, 15588, Korea.
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea.
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28
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Chandra G, Pandey A, Tipan N. Longitudinally centered embossed structure in the locking compression plate for biodegradable bone implant plate: a finite element analysis. Comput Methods Biomech Biomed Engin 2021; 25:603-618. [PMID: 34486894 DOI: 10.1080/10255842.2021.1970145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the current revolution of internal fixation implant in orthopaedics, a biodegradable implant is the most awaited and exceptional medical device where biodegradable material has paid more attention to the success of a biodegradable implant than the design of a biodegradable bone implant plate. By far, LCP is the most traditionally used implant plate (using non-biodegradable material) because of its experimental success, but not with qualified biodegradable material (Mg-alloy). This lack of mechanical performance is a major drawback that can be rectified by better structural design. This will help avoid few other problems as well. Therefore, with proper consideration, the LCP has been added to a semicircular filleted longitudinally centered embossed (LCE) structure to enhance overall mechanical performance that can help emphasize mechanical support even after continuous degradation when applied in a physiological environment. For mechanical verification of this advanced design of biodegradable bone implant plate, four-point bending test (4PBT) and axial compression test (ACT) have been performed using FEM on LCELCP, LCP, continuously degraded (CD)-LCELCP, and CD-LCP. LCELCP showed reduced stress of about 22% and 10% in 4PBT and ACT, respectively, compared to LCP. CD-LCELCP is safe during ACT over 6 months of continuous degradation when the degradation rate is assumed to be 4 mm/year. These results also ensured accuracy using mesh convergence and also mesh checked for quality assurance. Overall, LCELCP can be considered as a biodegradable bone implant plate because of its superior performance, if its ultimate validation is carried out through animal/human trials as future work.
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Affiliation(s)
- Girish Chandra
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Ajay Pandey
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Nilesh Tipan
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
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29
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Recent advances and directions in the development of bioresorbable metallic cardiovascular stents: Insights from recent human and in vivo studies. Acta Biomater 2021; 127:1-23. [PMID: 33823325 DOI: 10.1016/j.actbio.2021.03.058] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Abstract
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.
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30
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New Zn3Mg-xY Alloys: Characteristics, Microstructural Evolution and Corrosion Behavior. MATERIALS 2021; 14:ma14102505. [PMID: 34066121 PMCID: PMC8150708 DOI: 10.3390/ma14102505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
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.
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Im SH, Im DH, Park SJ, Chung JJ, Jung Y, Kim SH. Stereocomplex Polylactide for Drug Delivery and Biomedical Applications: A Review. Molecules 2021; 26:2846. [PMID: 34064789 PMCID: PMC8150862 DOI: 10.3390/molecules26102846] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Polylactide (PLA) is among the most common biodegradable polymers, with applications in various fields, such as renewable and biomedical industries. PLA features poly(D-lactic acid) (PDLA) and poly(L-lactic acid) (PLLA) enantiomers, which form stereocomplex crystals through racemic blending. PLA emerged as a promising material owing to its sustainable, eco-friendly, and fully biodegradable properties. Nevertheless, PLA still has a low applicability for drug delivery as a carrier and scaffold. Stereocomplex PLA (sc-PLA) exhibits substantially improved mechanical and physical strength compared to the homopolymer, overcoming these limitations. Recently, numerous studies have reported the use of sc-PLA as a drug carrier through encapsulation of various drugs, proteins, and secondary molecules by various processes including micelle formation, self-assembly, emulsion, and inkjet printing. However, concerns such as low loading capacity, weak stability of hydrophilic contents, and non-sustainable release behavior remain. This review focuses on various strategies to overcome the current challenges of sc-PLA in drug delivery systems and biomedical applications in three critical fields, namely anti-cancer therapy, tissue engineering, and anti-microbial activity. Furthermore, the excellent potential of sc-PLA as a next-generation polymeric material is discussed.
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Affiliation(s)
- Seung Hyuk Im
- NBIT, KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Korea; (S.H.I.); (S.J.P.)
- enoughU Inc., 114 Goryeodae-ro, Seongbuk-gu, Seoul 02856, Korea
| | - Dam Hyeok Im
- Department of Mechanical Engineering, Graduate School, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Korea;
| | - Su Jeong Park
- NBIT, KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Korea; (S.H.I.); (S.J.P.)
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (J.J.C.); (Y.J.)
| | - Justin Jihong Chung
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (J.J.C.); (Y.J.)
| | - Youngmee Jung
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (J.J.C.); (Y.J.)
- School of Electrical and Electronic Engineering, Yonsei-KIST Convergence Research Institute, Yonsei University, Seoul 03722, Korea
| | - Soo Hyun Kim
- NBIT, KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Korea; (S.H.I.); (S.J.P.)
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea; (J.J.C.); (Y.J.)
- Korea Institute of Science and Technology (KIST) Europe, Campus E 7.1, 66123 Saarbrueken, Germany
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Liu Y, Liu P, Song Y, Li S, Shi Y, Quan K, Yu G, Li P, An Q, Zhu W. A heparin-rosuvastatin-loaded P(LLA-CL) nanofiber-covered stent inhibits inflammatory smooth-muscle cell viability to reduce in-stent stenosis and thrombosis. J Nanobiotechnology 2021; 19:123. [PMID: 33926468 PMCID: PMC8086342 DOI: 10.1186/s12951-021-00867-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background An endovascular covered-stent has unique advantages in treating complex intracranial aneurysms; however, in-stent stenosis and late thrombosis have become the main factors affecting the efficacy of covered-stent treatment. Smooth-muscle-cell phenotypic modulation plays an important role in late in-stent stenosis and thrombosis. Here, we determined the efficacy of using covered stents loaded with drugs to inhibit smooth-muscle-cell phenotypic modulation and potentially lower the incidence of long-term complications. Methods Nanofiber-covered stents were prepared using coaxial electrospinning, with the core solution prepared with 15% heparin and 20 µM rosuvastatin solution (400: 100 µL), and the shell solution prepared with 120 mg/mL hexafluoroisopropanol. We established a rabbit carotid-artery aneurysm model, which was treated with covered stents. Angiography and histology were performed to evaluate the therapeutic efficacy and incidence rate of in-stent stenosis and thrombosis. Phenotype, function, and inflammatory factors of smooth-muscle cells were studied to explore the mechanism of rosuvastatin action in smooth-muscle cells. Result Heparin–rosuvastatin-loaded nanofiber scaffold mats inhibited the proliferation of synthetic smooth-muscle cells, and the nanofiber-covered stent effectively treated aneurysms in the absence of notable in-stent stenosis. Additionally, in vitro experiments showed that rosuvastatin inhibited the smooth-muscle-cell phenotypic modulation of platelet-derived growth factor-BB induction and decreased synthetic smooth-muscle-cell viability, as well as secretion of inflammatory cytokines. Conclusion Rosuvastatin inhibited the abnormal proliferation of synthetic smooth-muscle cells, and heparin–rosuvastatin-loaded covered stents reduced the incidence of stenosis and late thrombosis, thereby improving the healing rates of stents used for aneurysm treatment. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12951-021-00867-8.
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Affiliation(s)
- Yingjun Liu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Peixi Liu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Yaying Song
- Department of Neurology, Renji Hospital of Shanghai Jiao Tong University, Shanghai, China.,Neuroscience and Neuroengineering Research Center, Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Sichen Li
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Yuan Shi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Kai Quan
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Guo Yu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Neurosurgical Institute of Fudan University, Shanghai, China.,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China.,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
| | - Peiliang Li
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. .,Neurosurgical Institute of Fudan University, Shanghai, China. .,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China. .,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China.
| | - Qingzhu An
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. .,Neurosurgical Institute of Fudan University, Shanghai, China. .,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China. .,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China.
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. .,Neurosurgical Institute of Fudan University, Shanghai, China. .,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China. .,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China.
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Cockerill I, See CW, Young ML, Wang Y, Zhu D. Designing Better Cardiovascular Stent Materials - A Learning Curve. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2005361. [PMID: 33708033 PMCID: PMC7942182 DOI: 10.1002/adfm.202005361] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 05/07/2023]
Abstract
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.
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Affiliation(s)
- Irsalan Cockerill
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76207, USA
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Carmine Wang See
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Marcus L. Young
- Department of Materials Science and Engineering, University of North Texas, Denton, TX 76207, USA
| | - Yadong Wang
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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Holman H, Kavarana MN, Rajab TK. Smart materials in cardiovascular implants: Shape memory alloys and shape memory polymers. Artif Organs 2020; 45:454-463. [PMID: 33107042 DOI: 10.1111/aor.13851] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/03/2020] [Accepted: 10/19/2020] [Indexed: 12/12/2022]
Abstract
Smart materials have intrinsic properties that change in a controlled fashion in response to external stimuli. Currently, the only smart materials with a significant clinical impact in cardiovascular implant design are shape memory alloys, particularly Nitinol. Recent prodigious progress in material science has resulted in the development of sophisticated shape memory polymers. In this article, we have reviewed the literature and outline the characteristics, advantages, and disadvantages of shape memory alloys and shape memory polymers which are relevant to clinical cardiovascular applications, and describe the potential of these smart materials for applications in coronary stents and transcatheter valves.
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Affiliation(s)
- Heather Holman
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Minoo Naozer Kavarana
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Taufiek Konrad Rajab
- Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA
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The self-organized differentiation from MSCs into SMCs with manipulated micro/Nano two-scale arrays on TiO2 surfaces for biomimetic construction of vascular endothelial substratum. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 116:111179. [DOI: 10.1016/j.msec.2020.111179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 01/26/2023]
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In vivo degradation and endothelialization of an iron bioresorbable scaffold. Bioact Mater 2020; 6:1028-1039. [PMID: 33102944 PMCID: PMC7566209 DOI: 10.1016/j.bioactmat.2020.09.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
Detection of in vivo biodegradation is critical for development of next-generation medical devices such as bioresorbable stents or scaffolds (BRSs). In particular, it is urgent to establish a nondestructive approach to examine in vivo degradation of a new-generation coronary stent for interventional treatment based on mammal experiments; otherwise it is not available to semi-quantitatively monitor biodegradation in any clinical trial. Herein, we put forward a semi-quantitative approach to measure degradation of a sirolimus-eluting iron bioresorbable scaffold (IBS) based on optical coherence tomography (OCT) images; this approach was confirmed to be consistent with the present weight-loss measurements, which is, however, a destructive approach. The IBS was fabricated by a metal-polymer composite technique with a polylactide coating on an iron stent. The efficacy as a coronary stent of this new bioresorbable scaffold was compared with that of a permanent metal stent with the name of trade mark Xience, which has been widely used in clinic. The endothelial coverage on IBS was found to be greater than on Xience after implantation in a rabbit model; and our well-designed ultrathin stent exhibited less individual variation. We further examined degradation of the IBSs in both minipig coronary artery and rabbit abdominal aorta models. The present result indicated much faster iron degradation of IBS in the rabbit model than in the porcine model. The semi-quantitative approach to detect biodegradation of IBS and the finding of the species difference might be stimulating for fundamental investigation of biodegradable implants and clinical translation of the next-generation coronary stents. A semi-quantitative OCT method was suggested to evaluate in vivo biodegradation of an iron based coronary stent IBS in a nondestructive manner. The in vivo biodegradation of IBS exhibited dependence on animal species. The endothelial coverage on the biodegradable stent IBS was better than on the commercialized nonbiodegradable stent Xience in rabbits.
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Zhou C, Feng X, Shi Z, Song C, Cui X, Zhang J, Li T, Toft ES, Ge J, Wang L, Zhang H. Research on elastic recoil and restoration of vessel pulsatility of Zn-Cu biodegradable coronary stents. ACTA ACUST UNITED AC 2020; 65:219-227. [PMID: 31527289 DOI: 10.1515/bmt-2019-0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/24/2019] [Indexed: 11/15/2022]
Abstract
Coronary stents made of zinc (Zn)-0.8 copper (Cu) (in wt%) alloy were developed as biodegradable metal stents (Zn-Cu stents) in this study. The mechanical properties of the Zn-Cu stents and the possible gain effects were characterized by in vitro and in vivo experiments compared with 316L stainless steel stents (316L stents). Young's modulus of the as-extruded Zn-0.8Cu alloy and properties of the stents, including their intrinsic elastic recoil, stent trackability were evaluated compared with 316L stents. In vivo study was also conducted to evaluate restoration of pulsatility of vessel segment implanted stents. Both Zn-Cu stents and 316L stents have good acute lumen gain. By comparison, the advantages of Zn-Cu stents are as follows: (I) Zn-Cu stents have less intrinsic elastic recoil than 316L stents; (II) stent trackability indicates that Zn-Cu stents have a smaller push force when passing through curved blood vessels, which may cause less mechanical stimulation to blood vessels; (III) in vivo study suggests that Zn-Cu stents implantation better facilitates the recovery of vascular pulsatility.
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Affiliation(s)
- Chao Zhou
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, P.R. China
| | - Xiangyi Feng
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou City, Shandong 251100, P.R. China
| | - Zhangzhi Shi
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, P.R. China
| | - Caixia Song
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou City, Shandong 251100, P.R. China
| | - Xiaoshan Cui
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou City, Shandong 251100, P.R. China
| | - Junwei Zhang
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic and Development Zone, Dezhou City, Shandong 251100, P.R. China
| | - Ting Li
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, P.R. China
| | - Egon Steen Toft
- Vice President for Medical and Health Sciences, Medical and Health Sciences Office, College of Medicine, Qatar University, Doha, Qatar
| | - Junbo Ge
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, P.R. China
| | - Luning Wang
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, P.R. China
| | - Haijun Zhang
- Department of Interventional and Vascular Surgery, The Tenth People's Hospital of Shanghai, Tongji University, Shanghai 200072, P.R. China.,Branden Industrial Park, Qihe Economic and Development Zone, Dezhou City, Shandong 251100, P.R. China.,Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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38
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Yu X, Li D, Liu Y, Ding P, He X, Zhao Y, Chen M, Liu D. In vitro and in vivo studies on the degradation and biosafety of Mg-Zn-Ca-Y alloy hemostatic clip with the carotid artery of SD rat model. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 115:111093. [PMID: 32600697 DOI: 10.1016/j.msec.2020.111093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/25/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
An Mg-Zn-Ca-Y alloy operative clip was developed to overcome the drawbacks of the Ti clips such as ion dissolution inflammation, interference imaging diagnosis, and the potential harm that permanent retention brings to the patient. The structure optimization design of the hemostatic clip was carried out by the finite element numerical simulation method to realize the matching between the structure design and the material properties. Hot extrusion and wire cutting process was used to prepare the Mg-Zn-Ca-Y alloy operative clip. Corrosion degradation behavior of Mg-Zn-Ca-Y alloy in vitro was investigated using electrochemical noise (EN) and immersion test in Simulated body fluid (SBF). The carotid artery of SD rats was clipped using the Mg-Zn-Ca-Y operative clip to evaluate occlusion safety and the complete corrosion degradation behavior and biocompatibility of Mg-Zn-Ca-Y alloy clip in vivo were investigated using micro-computed tomography, histological analysis, and blood biochemical indicators. It was found that the newly designed Mg-Zn-Ca-Y clip can successfully ligate the carotid artery, and no blood leakage occurred after surgery. After eight months, the Mg-Zn-Ca-Y clip degraded utterly. Histological analysis and various blood biochemical parameters in SD rat serum samples collected at different time periods showed no tissue inflammation around the clips.
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Affiliation(s)
- Xiao Yu
- School of Materials Science and Engineering, Tianjin University of Technology, Tianjin 300384, China
| | - Dongyang Li
- Tianjin Medical University General Hospital, Department of General Surgery, Tianjin 300070, China
| | - Yuanchao Liu
- Tianjin Medical University General Hospital, Department of General Surgery, Tianjin 300070, China
| | - Pengfei Ding
- School of Materials Science and Engineering, Tianjin University of Technology, Tianjin 300384, China
| | - Xianghui He
- Tianjin Medical University General Hospital, Department of General Surgery, Tianjin 300070, China
| | - Yue Zhao
- School of Mechanical, Materials & Mechatronic Engineering, University of Wollongong, NSW2522, Australia
| | - Minfang Chen
- Tianjin Key Laboratory for Photoelectric Materials and Devices, Tianjin 300384, China
| | - Debao Liu
- National Demonstration Center for Experimental Function Materials Education, Tianjin University of Technology, Tianjin 300384, China.
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Bian D, Qin L, Lin W, Shen D, Qi H, Shi X, Zhang G, Liu H, Yang H, Wang J, Zhang D, Zheng Y. Magnetic resonance (MR) safety and compatibility of a novel iron bioresorbable scaffold. Bioact Mater 2020; 5:260-274. [PMID: 32128465 PMCID: PMC7044471 DOI: 10.1016/j.bioactmat.2020.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 11/29/2022] Open
Abstract
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).
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Affiliation(s)
- Dong Bian
- Biotyx Medical (Shenzhen) Co.,Ltd, Shenzhen, 518110, Guangdong, China
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Li Qin
- Biotyx Medical (Shenzhen) Co.,Ltd, Shenzhen, 518110, Guangdong, China
| | - Wenjiao Lin
- Biotyx Medical (Shenzhen) Co.,Ltd, Shenzhen, 518110, Guangdong, China
| | - Danni Shen
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Haiping Qi
- Biotyx Medical (Shenzhen) Co.,Ltd, Shenzhen, 518110, Guangdong, China
| | - Xiaoli Shi
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China
| | - Gui Zhang
- Shenzhen Advanced Medical Services Co., Ltd, Shenzhen, 518000, Guangdong, China
| | - Hongwei Liu
- Shen Zhen Testing Center of Medical Devices, Shenzhen, 518057, Guangdong, China
| | - Han Yang
- Shen Zhen Testing Center of Medical Devices, Shenzhen, 518057, Guangdong, China
| | - Jin Wang
- Key Lab. of Advanced Technology for Materials of Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, 610031, Sichuan, China
| | - Deyuan Zhang
- Biotyx Medical (Shenzhen) Co.,Ltd, Shenzhen, 518110, Guangdong, China
| | - Yufeng Zheng
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
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The Functional Properties of Mg-Zn-X Biodegradable Magnesium Alloys. MATERIALS 2020; 13:ma13030544. [PMID: 31979227 PMCID: PMC7040658 DOI: 10.3390/ma13030544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 11/17/2022]
Abstract
The implantation of metallic devices in orthopaedic surgical procedures and coronary angioplasty is associated with the risk of various adverse events: (i) mechanical (premature failure), (ii) chemo-mechanical (corrosion and corrosion-fatigue degradation) and (iii) biomedical (chronic local inflammatory reactions, tissue necrosis, etc.). In this regard, the development of biodegradable implants/stents, which provide the necessary mechanical support for the healing period of the bone or the vessel wall and then are completely resorbed, has bright prospects. Magnesium alloys are the most suitable candidates for that purpose due to their superior mechanical performance, bioresorbability and biocompatibility. This article presents the results of the comparative research on several wrought biodegradable alloys, assessing their potential for biomedical applications. The Mg-Zn-X alloys with different chemical compositions and microstructures were produced using severe plastic deformation techniques. Functional properties pivotal for biomedical applications-mechanical strength, in vitro corrosion resistance and cytotoxic activity-were included in the focus of the study. Excellent mechanical performance and low cytotoxic effects are documented for all alloys with a notable exception for one of two Mg-Zn-Zr alloys. The in vitro corrosion resistance is, however, below expectations due to critical impurities, and this property has yet to be drastically improved through the cleaner materials fabrication processing before they can be considered for biomedical applications.
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Bil M, Kijeńska-Gawrońska E, Głodkowska-Mrówka E, Manda-Handzlik A, Mrówka P. Design and in vitro evaluation of electrospun shape memory polyurethanes for self-fitting tissue engineering grafts and drug delivery systems. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110675. [PMID: 32204102 DOI: 10.1016/j.msec.2020.110675] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 12/11/2022]
Abstract
Integration of multiple features including shape memory, biodegradation, and sustained drug delivery in a single material offers the opportunity to significantly improve the abilities of implantable devices for cardiovascular system regeneration. Two types of shape memory polyurethanes (SMPUs): PU-PLGA and PU-PLLA/PEG differing in soft segments composition that comprising blends of various biodegradable polyols, i.e. D,l-lactide-co-glycolide diol (o-PLGA), poly(e-caprolactone) diols (o-PCL) with various molecular weights, poly-l-lactide diol (o-PLLA), polyethylene glycol (o-PEG) were synthesized and further utilized to electrospun nanofibrous - rapamycin (Rap) delivery system. Structure characterization by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DCS) and hydrophilicity measurements were performed to gain more insights on the influence of the particular units of the softs segments on the transition temperature (Ttrans), shape recovery, degradation profile, and drug release kinetics. In vitro study in PBS solution revealed that incorporation of o-PLGA segments to SMPUs is favorable over o-PEG as increased shape memory performance was observed. Moreover, presence of PLGA in PU-PLGA gave more predictable degradation profile in comparison to PU-PLLA/PEG system. Human Cardiac Fibroblasts (HCF) viability tests in vitro confirmed that the amount of Rap released from evaluated PU-PLLA/PEG/Rap and PU-PLGA/Rap drug delivery systems was sufficient to inhibit cells growth on the surface of the tested materials.
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Affiliation(s)
- Monika Bil
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska Street, 02-507 Warsaw, Poland.
| | - Ewa Kijeńska-Gawrońska
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, 141 Woloska Street, 02-507 Warsaw, Poland
| | - Eliza Głodkowska-Mrówka
- Department of Experimental Hematology, Department of Laboratory Medicine, Institute of Hematology and Transfusion Medicine, 5 Indiry Gandhi Str, 02-776 Warsaw, Poland
| | - Aneta Manda-Handzlik
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, 63A Żwirki i Wigury Street, 02-091 Warsaw, Poland
| | - Piotr Mrówka
- Department of Biophysics and Human Physiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland
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Bink N, Mohan VB, Fakirov S. Recent advances in plastic stents: a comprehensive review. INT J POLYM MATER PO 2019. [DOI: 10.1080/00914037.2019.1685519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Nienke Bink
- Plastics Centre of Excellence, Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
- Centre for Advanced Composite Materials, Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
- Department of Mechanics of Solids, Surfaces and Systems, Faculty of Engineering Technology, The University of Twente, Enschede, The Netherlands
| | - Velram Balaji Mohan
- Plastics Centre of Excellence, Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
- Centre for Advanced Composite Materials, Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - Stoyko Fakirov
- Plastics Centre of Excellence, Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
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Chen C, Chen J, Wu W, Shi Y, Jin L, Petrini L, Shen L, Yuan G, Ding W, Ge J, Edelman ER, Migliavacca F. In vivo and in vitro evaluation of a biodegradable magnesium vascular stent designed by shape optimization strategy. Biomaterials 2019; 221:119414. [PMID: 31419654 PMCID: PMC6732791 DOI: 10.1016/j.biomaterials.2019.119414] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/30/2019] [Accepted: 08/03/2019] [Indexed: 01/25/2023]
Abstract
The performance of biodegradable magnesium alloy stents (BMgS) requires special attention to non-uniform residual stress distribution and stress concentration, which can accelerate localized degradation after implantation. We now report on a novel concept in stent shape optimization using a finite element method (FEM) toolkit. A Mg-Nd-Zn-Zr alloy with uniform degradation behavior served as the basis of our BMgS. Comprehensive in vitro evaluations drove stent optimization, based on observed crimping and balloon inflation performance, measurement of radial strength, and stress condition validation via microarea-XRD. Moreover, a Rapamycin-eluting polymer coating was sprayed on the prototypical BMgS to improve the corrosion resistance and release anti-hyperplasia drugs. In vivo evaluation of the optimized coated BMgS was conducted in the iliac artery of New Zealand white rabbit with quantitative coronary angiography (QCA), optical coherence tomography (OCT) and micro-CT observation at 1, 3, 5-month follow-ups. Neither thrombus or early restenosis was observed, and the coated BMgS supported the vessel effectively prior to degradation and allowed for arterial healing thereafter. The proposed shape optimization framework based on FEM provides an novel concept in stent design and in-depth understanding of how deformation history affects the biomechanical performance of BMgS. Computational analysis tools can indeed promote the development of biodegradable magnesium stents.
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Affiliation(s)
- Chenxin Chen
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China; Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milan, 20133, Italy
| | - Jiahui Chen
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Wei Wu
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milan, 20133, Italy; Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249-0669, USA
| | - Yongjuan Shi
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Liang Jin
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Lorenza Petrini
- Department of Civil and Environmental Engineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milan, 20133, Italy
| | - Li Shen
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China.
| | - Wenjiang Ding
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Junbo Ge
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Elazer R Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milan, 20133, Italy.
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Hoare D, Bussooa A, Neale S, Mirzai N, Mercer J. The Future of Cardiovascular Stents: Bioresorbable and Integrated Biosensor Technology. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2019; 6:1900856. [PMID: 31637160 PMCID: PMC6794628 DOI: 10.1002/advs.201900856] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/26/2019] [Indexed: 05/15/2023]
Abstract
Cardiovascular disease is the greatest cause of death worldwide. Atherosclerosis is the underlying pathology responsible for two thirds of these deaths. It is the age-dependent process of "furring of the arteries." In many scenarios the disease is caused by poor diet, high blood pressure, and genetic risk factors, and is exacerbated by obesity, diabetes, and sedentary lifestyle. Current pharmacological anti-atherosclerotic modalities still fail to control the disease and improvements in clinical interventions are urgently required. Blocked atherosclerotic arteries are routinely treated in hospitals with an expandable metal stent. However, stented vessels are often silently re-blocked by developing "in-stent restenosis," a wound response, in which the vessel's lumen renarrows by excess proliferation of vascular smooth muscle cells, termed hyperplasia. Herein, the current stent technology and the future of biosensing devices to overcome in-stent restenosis are reviewed. Second, with advances in nanofabrication, new sensing methods and how researchers are investigating ways to integrate biosensors within stents are highlighted. The future of implantable medical devices in the context of the emerging "Internet of Things" and how this will significantly influence future biosensor technology for future generations are also discussed.
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Affiliation(s)
- Daniel Hoare
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
| | - Anubhav Bussooa
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
| | - Steven Neale
- James Watt South BuildingSchool of EngineeringUniversity of GlasgowG12 8QQGlasgowScotland
| | - Nosrat Mirzai
- Bioelectronics UnitCollege of Medical, Veterinary & Life Sciences (MVLS)University of GlasgowG12 8QQGlasgowScotland
| | - John Mercer
- BHF Cardiovascular Research CentreUniversity of GlasgowG12 8TAGlasgowScotland
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Li C, Mao J, Li Q, Wang F, Jiao Y, Zhang Z, Guidoin R, Wang L. Long-term anticoagulation and selective cells adhesion surface via combination of covalent grafting and layer by layer assembly. Biomed Mater 2019; 14:065012. [DOI: 10.1088/1748-605x/ab452b] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zhou C, Li HF, Yin YX, Shi ZZ, Li T, Feng XY, Zhang JW, Song CX, Cui XS, Xu KL, Zhao YW, Hou WB, Lu ST, Liu G, Li MQ, Ma JY, Toft E, Volinsky AA, Wan M, Yao XJ, Wang CB, Yao K, Xu SK, Lu H, Chang SF, Ge JB, Wang LN, Zhang HJ. Long-term in vivo study of biodegradable Zn-Cu stent: A 2-year implantation evaluation in porcine coronary artery. Acta Biomater 2019; 97:657-670. [PMID: 31401346 DOI: 10.1016/j.actbio.2019.08.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/11/2019] [Accepted: 08/06/2019] [Indexed: 01/11/2023]
Abstract
In the present study, a novel biodegradable Zn-0.8Cu coronary artery stent was fabricated and implanted into porcine coronary arteries for up to 24 months. Micro-CT analysis showed that the implanted stent was able to maintain structural integrity after 6 months, while its disintegration occurred after 9 months of implantation. After 24 months of implantation, approximately 28 ± 13 vol% of the stent remained. Optical coherence tomography and histological analysis showed that the endothelialization process could be completed within the first month after implantation, and no inflammation responses or thrombosis formation was observed within 24 months. Cross-section analysis indicated that the subsequent degradation products had been removed in the abluminal direction, guaranteeing that the strut could be replaced by normal tissue without the risk of contaminating the circulatory system, causing neither thrombosis nor inflammation response. The present work demonstrates that the Zn-0.8Cu stent has provided sufficient structural supporting and exhibited an appropriate degradation rate during 24 months of implantation without degradation product accumulation, thrombosis, or inflammation response. The results indicate that the Zn-0.8Cu coronary artery stent is promising for further clinical applications. STATEMENT OF SIGNIFICANCE: Although Zn and its alloys have been considered to be potential candidates of biodegradable metals for vascular stent use, by far, no Zn-based stent with appropriate medical device performance has been reported because of the low mechanical properties of zinc. The present work presents promising results of a Zn-Cu biodegradable vascular stent in porcine coronary arteries. The Zn-Cu stent fabricated in this work demonstrated adequate medical device performance both in vitro and in vivo and degraded at a proper rate without safety problems induced. Furthermore, large animal models have more cardiovascular similarities as humans. Results of this study may provide further information of the Zn-based stents for translational medicine research.
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Affiliation(s)
- Chao Zhou
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China; Department of Interventional and Vascular Surgery, The Tenth People's Hospital of Shanghai, Tongji University, Shanghai 200072, PR China; National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Hua-Fang Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China
| | - Yu-Xia Yin
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China; National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Zhang-Zhi Shi
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China
| | - Ting Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China
| | - Xiang-Yi Feng
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Jun-Wei Zhang
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Cai-Xia Song
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Xiao-Shan Cui
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Kai-Li Xu
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Yan-Wei Zhao
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Wen-Bo Hou
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Shou-Tao Lu
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Guang Liu
- National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China
| | - Mao-Quan Li
- Department of Interventional and Vascular Surgery, The Tenth People's Hospital of Shanghai, Tongji University, Shanghai 200072, PR China
| | - Jian-Ying Ma
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China
| | - Egon Toft
- Biomedical Research Center, College of Medicine, Qatar University, Shareh Jamiaa, Post Box 2716, Doha, Qatar
| | - Alex A Volinsky
- Department of Mechanical Engineering, University of South Florida, Tampa, FL 33620, USA
| | - Min Wan
- Shandong Quality Inspection Center for Medical Devices, No. 15166 Century Avenue, Jinan H-T Industrial Development Zone, Shandong 250101, PR China
| | - Xiu-Jun Yao
- Shandong Quality Inspection Center for Medical Devices, No. 15166 Century Avenue, Jinan H-T Industrial Development Zone, Shandong 250101, PR China
| | - Chang-Bin Wang
- Shandong Quality Inspection Center for Medical Devices, No. 15166 Century Avenue, Jinan H-T Industrial Development Zone, Shandong 250101, PR China
| | - Kang Yao
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China
| | - Shi-Kun Xu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China
| | - Hao Lu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China
| | - Shu-Fu Chang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China
| | - Jun-Bo Ge
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032 PR China.
| | - Lu-Ning Wang
- Beijing Advanced Innovation Center for Materials Genome Engineering, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083, PR China.
| | - Hai-Jun Zhang
- Department of Interventional and Vascular Surgery, The Tenth People's Hospital of Shanghai, Tongji University, Shanghai 200072, PR China; National United Engineering Laboratory for Biomedical Material Modification, Branden Industrial Park, Qihe Economic & Development Zone, Dezhou City, Shandong 251100, PR China; Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Niels Jernes Vej 10, Aalborg Ø 9220, Denmark.
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Hernández-Escobar D, Champagne S, Yilmazer H, Dikici B, Boehlert CJ, Hermawan H. Current status and perspectives of zinc-based absorbable alloys for biomedical applications. Acta Biomater 2019; 97:1-22. [PMID: 31351253 DOI: 10.1016/j.actbio.2019.07.034] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/01/2019] [Accepted: 07/19/2019] [Indexed: 12/22/2022]
Abstract
Absorbable metals have the potential to serve as the next generation of temporary medical implant devices by safely dissolving in the human body upon vascular tissue healing and bone regeneration. Their implementation in the market could greatly reduce the need of costly and risky additional surgeries for either implant replacement or removal, often required in current permanent implants. Despite the extensive research done over the last two decades on magnesium (Mg) and iron (Fe) based alloys, they have not generally shown a satisfactory combination of mechanical properties, biocompatibility and controlled degradation rate in the physiological environment. Consequently, zinc (Zn) based alloys were introduced in the last few years as alternative materials to overcome the limitations of Fe and Mg-based alloys. The blend of different alloying elements and processing conditions have led to a wide variety of Zn-based alloys having tunable mechanical properties and corrosion rates. This review provides the most recent progress in the development of absorbable Zn-based alloys for biomedical implant applications, primarily for cardiovascular and orthopedic devices. Their biocompatibility, processability and metallurgical aspects, as well as their mechanical behavior and corrosion properties are presented and discussed, including their opportunities, limitations and future research directions. STATEMENT OF SIGNIFICANCE: Temporary orthopedic bioimplants have become increasingly popular as they offer an alternative to prevent complications, like infections or secondary surgeries, often related to the implantation of permanent devices. Iron and magnesium alloys were extensively studied as candidates for absorbable medical applications, but they generally failed to provide a desirable mechanical performance and corrosion characteristics in the physiological environment. Zinc was introduced in the last decade as a potential implant material after showing outstanding biocompatibility and biodegradability. This review summarizes the research advances to date and provides a thorough discussion of the future challenges of absorbable zinc alloys to satisfy the demanding clinical benchmarks for absorbable medical applications. Their biocompatibility, mechanical, and corrosion aspects, both in vitro and in vivo, are comprehensively reviewed and assessed accordingly.
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Echeverry-Rendon M, Allain JP, Robledo SM, Echeverria F, Harmsen MC. Coatings for biodegradable magnesium-based supports for therapy of vascular disease: A general view. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:150-163. [DOI: 10.1016/j.msec.2019.04.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 01/22/2023]
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Ammann KR, Li M, Hossainy S, Slepian MJ. The Influence of Polymer Processing Methods on Polymer Film Physical Properties and Vascular Cell Responsiveness. ACS APPLIED BIO MATERIALS 2019; 2:3234-3244. [PMID: 32944709 PMCID: PMC7494131 DOI: 10.1021/acsabm.9b00175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Implantable vascular devices typically interface with blood and vascular tissues. Physical properties of device materials and coatings, independent of chemical composition, can significantly influence cell responses and implant success. Here, we analyzed the effect of various polymer processing regimes, using a single implant polymer - poly(ε-caprolactone) (PCL), on vascular endothelial cell (EC), smooth muscle cell (SMC), and platelet response. PCL films were formed by varying three parameters: 1) formation method - solvent casting, melt pressing or spin coating; 2) molecular weight - 50 or 100 kDa; and 3) solvent type - dichloromethane (DCM) or tetrahydrofuran (THF). We quantified the relationship of polymer processing choice to surface roughness, wettability, and bulk stiffness; and to EC adhesion, SMC adhesion, and platelet activity state (PAS). Multiple regression analysis identified which processing method signficantly impacted (F-ratio>p-value; p<0.1) polymer physical properties and vascular cell interaction. Film formation method affected PCL roughness (Rq), wettability (°), and stiffness (MPa) with spin coating resulting in the most wettable (81.8±0.7°), and stiffest (1.12±0.07 MPa; p<0.001) polymer film; however, solvent cast films were the roughest (281±66nm). Molecular weight influenced wettability, with the highest wettability on 50 kDa films (79.7±0.7°; p<0.001) and DCM solvent films (83.0±1.0°; p<0.01). The multiple regression model confidently predicted (F-ratio=9.88; p=0.005) wettability from molecular weight (p=0.002) and film formation method (p=0.03); stiffness (F-ratio=4.21; p=0.05) also fit well tofilm formation method (p=0.02). Film formation method impacted SMC adhesion and platelet activity state, but not EC adhesion, with melt press PCL promoting the highest SMC adhesion (18000±1536 SMCs; p<0.05) and PAS (5.0±0.7 %PAS). The regression model confidently fit SMC adhesion (F-ratio=3.15; p=0.09) and PAS (F-ratio=5.30; p=0.05) to polymer processing choices, specifically film formation method (p<0.03). However, only SMC adhesion had a model that fit well (F-ratio=4.13; p=0.05) to the physical properties directly, specifically roughness and wettability (p<0.04).
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Affiliation(s)
- Kaitlyn R. Ammann
- Department of Biomedical Engineering, College of Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Maxwell Li
- Department of Biomedical Engineering, College of Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Syed Hossainy
- Department of Bioengineering, College of Engineering, The University of California Berkeley, Berkeley, CA, 94720
| | - Marvin J. Slepian
- Department of Biomedical Engineering, College of Engineering, The University of Arizona, Tucson, AZ 85721, United States
- Department of Medicine, College of Medicine, The University of Arizona, Tucson, AZ 85721, United States
- Sarver Heart Center, The University of Arizona, Tucson, AZ 85721, United States
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