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Gao YN, Yang HT, Qiu ZF, Qi F, Lu QH, Zheng JF, Xi ZW, Wang X, Li L, Zhang G, Zhang DY, Lu YD, Qi HP, Qiu H, Gao RL, Zheng YF. Long-term efficacy, safety and biocompatibility of a novel sirolimus eluting iron bioresorbable scaffold in a porcine model. Bioact Mater 2024; 39:135-146. [PMID: 38783928 PMCID: PMC11112549 DOI: 10.1016/j.bioactmat.2024.05.027] [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: 03/23/2024] [Revised: 04/19/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Iron is considered as an attractive alternative material for bioresorbable scaffolds (BRS). The sirolimus eluting iron bioresorbable scaffold (IBS), developed by Biotyx Medical (Shenzhen, China), is the only iron-based BRS with an ultrathin-wall design. The study aims to investigate the long-term efficacy, safety, biocompatibility, and lumen changes during the biodegradation process of the IBS in a porcine model. A total of 90 IBSs and 70 cobalt-chromium everolimus eluting stents (EES) were randomly implanted into nonatherosclerotic coronary artery of healthy mini swine. The multimodality assessments including coronary angiography, optical coherence tomography, micro-computed tomography, magnetic resonance imaging, real-time polymerase chain reaction (PCR), and histopathological evaluations, were performed at different time points. There was no statistical difference in area stenosis between IBS group and EES group at 6 months, 1year, 2 years and 5 years. Although the scaffolded vessels narrowed at 9 months, expansive remodeling with increased mean lumen area was found at 3 and 5 years. The IBS struts remained intact at 6 months, and the corrosion was detectable at 9 months. At 5 years, the iron struts were completely degraded and absorbed in situ, without in-scaffold restenosis or thrombosis, lumen collapse, aneurysm formation, and chronic inflammation. No local or systemic toxicity and abnormal histopathologic manifestation were found in all experiments. Results from real-time PCR indicated that no sign of iron overload was reported in scaffolded segments. Therefore, the IBS shows comparable efficacy, safety, and biocompatibility with EES, and late lumen enlargement is considered as a unique feature in the IBS-implanted vessels.
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Affiliation(s)
- Ya-Nan Gao
- Department of Cardio-Metabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-Tao Yang
- School of Engineering Medicine, Beihang University, Beijing, China
| | - Zi-Feng Qiu
- Peking University Health Science Center, Beijing, China
| | - Feng Qi
- Department of Cardiology, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China
| | - Qian-Hong Lu
- Department of Cardiology, Coronary Artery Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Feng Zheng
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Zi-Wei Xi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Xin Wang
- Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gui Zhang
- R&D Center, Biotyx Medical (Shenzhen) Co. Ltd., Shenzhen, China
| | - De-Yuan Zhang
- R&D Center, Biotyx Medical (Shenzhen) Co. Ltd., Shenzhen, China
| | - Yu-Die Lu
- R&D Center, Biotyx Medical (Shenzhen) Co. Ltd., Shenzhen, China
| | - Hai-Ping Qi
- R&D Center, Biotyx Medical (Shenzhen) Co. Ltd., Shenzhen, China
| | - Hong Qiu
- Department of Cardio-Metabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Run-Lin Gao
- Department of Cardiology, Coronary Artery Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-Feng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, China
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Ai Y, Gu ZX, Wang P, Tang YY, Chen XG, Lv HP, Li PF, Jiang Q, Xiong RG, Zhang JJ, Zhang HY. Biodegradable Ferroelectric Molecular Plastic Crystal HOCH 2(CF 2) 7CH 2OH Structurally Inspired by Polyvinylidene Fluoride. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2405981. [PMID: 38970528 DOI: 10.1002/adma.202405981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/22/2024] [Indexed: 07/08/2024]
Abstract
Ferroelectric materials, traditionally comprising inorganic ceramics and polymers, are commonly used in medical implantable devices. However, their nondegradable nature often necessitates secondary surgeries for removal. In contrast, ferroelectric molecular crystals have the advantages of easy solution processing, lightweight, and good biocompatibility, which are promising candidates for transient (short-term) implantable devices. Despite these benefits, the discovered biodegradable ferroelectric materials remain limited due to the absence of efficient design strategies. Here, inspired by the polar structure of polyvinylidene fluoride (PVDF), a ferroelectric molecular crystal 1H,1H,9H,9H-perfluoro-1,9-nonanediol (PFND), which undergoes a cubic-to-monoclinic ferroelectric plastic phase transition at 339 K, is discovered. This transition is facilitated by a 2D hydrogen bond network formed through O-H···O interactions among the oriented PFND molecules, which is crucial for the manifestation of ferroelectric properties. In this sense, by reducing the number of -CF2- groups from ≈5 000 in PVDF to seven in PFND, it is demonstrated that this ferroelectric compound only needs simple solution processing while maintaining excellent biosafety, biocompatibility, and biodegradability. This work illuminates the path toward the development of new biodegradable ferroelectric molecular crystals, offering promising avenues for biomedical applications.
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Affiliation(s)
- Yong Ai
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Zhu-Xiao Gu
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, P. R. China
| | - Peng Wang
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, P. R. China
- Jiangsu Key Laboratory for Biomaterials and Devices, State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 211189, P. R. China
| | - Yuan-Yuan Tang
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Xiao-Gang Chen
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Hui-Peng Lv
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Peng-Fei Li
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Qing Jiang
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, P. R. China
| | - Ren-Gen Xiong
- Ordered Matter Science Research Center, Nanchang University, Nanchang, 330031, P. R. China
| | - Jun-Jie Zhang
- Key Laboratory of Quantum Materials and Devices of Ministry of Education, School of Physics, Southeast University, Nanjing, 211189, P. R. China
| | - Han-Yue Zhang
- Jiangsu Key Laboratory for Biomaterials and Devices, State Key Laboratory of Digital Medical Engineering, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 211189, P. R. China
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Kirimi MT, Hoare D, Holsgrove M, Czyzewski J, Mirzai N, Mercer JR, Neale SL. Detection of Blood Clots Using a Whole Stent as an Active Implantable Biosensor. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304748. [PMID: 38342628 DOI: 10.1002/advs.202304748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/28/2023] [Indexed: 02/13/2024]
Abstract
Many cardiovascular problems stem from blockages that form within the vasculature and often treatment includes fitting a stent through percutaneous coronary intervention. This offers a minimally invasive therapy but re-occlusion through restenosis or thrombosis formation often occurs post-deployment. Research is ongoing into the creation of smart stents that can detect the occurrence of further problems. In this study, it is shown that selectively metalizing a non-conductive stent can create a set of electrodes that are capable of detecting a build-up of material around the stent. The associated increase in electrical impedance across the electrodes is measured, testing the stent with blood clot to mimic thrombosis. It is shown that the device is capable of sensing different amounts of occlusion. The stent can reproducibly sense the presence of clot showing a 16% +/-3% increase in impedance which is sufficient to reliably detect the clot when surrounded by explanted aorta (one sample t-test, p = 0.009, n = 9). It is demonstrated that this approach can be extended beyond the 3D printed prototypes by showing that it can be applied to a commercially available stent and it is believed that it can be further utilized by other types of medical implants.
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Affiliation(s)
- Mahmut Talha Kirimi
- Centre for Medical and Industrial Ultrasonics, James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Daniel Hoare
- Institute of Cardiovascular and Medical Sciences/British Heart Foundation, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Michael Holsgrove
- BioElectronics Unit, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Jakup Czyzewski
- BioElectronics Unit, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Nosrat Mirzai
- BioElectronics Unit, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - John R Mercer
- Institute of Cardiovascular and Medical Sciences/British Heart Foundation, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Steve L Neale
- Centre for Medical and Industrial Ultrasonics, James Watt School of Engineering, University of Glasgow, Glasgow, G12 8QQ, UK
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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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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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Khatami M, Doniavi A, Abazari AM, Fotouhi M. Enhancing flexibility and strength-to-weight ratio of polymeric stents: A new variable-thickness design approach. J Mech Behav Biomed Mater 2024; 150:106262. [PMID: 38029464 DOI: 10.1016/j.jmbbm.2023.106262] [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: 09/11/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
This paper presents a new design strategy to improve the flexibility and strength-to-weight ratio of polymeric stents. The proposed design introduces a variable-thickness (VT) stent that outperforms conventional polymeric stents with constant thickness (CT). While polymeric stents offer benefits like flexibility and bioabsorption, their mechanical strength is lower compared to metal stents. To address this limitation, thicker polymer stents are used, compromising flexibility and clinical performance. Leveraging advancements in 3D printing, a new design approach is introduced in this study and is manufactured by the Liquid Crystal Display (LCD) 3D printing method and PLA resin. The mechanical performance of CT and VT stents is compared using the Finite Element Method (FEM), validated by experimental tests. Results demonstrate that the VT stent offers significant improvements compared to a CT stent in bending stiffness (over 20%), reduced plastic strain distribution of expansion (over 26%), and increased radial strength (over 10%). This research showcases the potential of the VT stent design to enhance clinical outcomes and patient care.
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Affiliation(s)
- Mohamad Khatami
- Department of Mechanical Engineering, Faculty of Engineering, Urmia University, Urmia, Iran.
| | - Ali Doniavi
- Department of Mechanical Engineering, Faculty of Engineering, Urmia University, Urmia, Iran.
| | - Amir Musa Abazari
- Department of Mechanical Engineering, Faculty of Engineering, Urmia University, Urmia, Iran.
| | - Mohammad Fotouhi
- Department of Materials, Mechanics, Management & Design (3MD), Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, the Netherlands.
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Hossan MR, Barot V, Harriet S, Peters L, Matsayko AC, Bauer A, Hossain K. Engineering Analysis of Non-Braided Polycaprolactone Bioresorbable Flow Diverters for Aneurysms. J Biomech Eng 2023; 145:111006. [PMID: 37470476 PMCID: PMC10578075 DOI: 10.1115/1.4063001] [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: 01/30/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/21/2023]
Abstract
This paper reports a nonbraided, bioresorbable polycaprolactone (PCL) flow diverter (FD) for the endovascular treatment of aneurysms. Bioresorbable FDs can reduce the risk associated with the permanent metallic FDs as they are resorbed by the body after curing of aneurysms. PCL FDs were designed and fabricated using an in-house hybrid electromelt spinning-fused deposition fabrication unit. Flow diverter's properties, surface qualities, and mechanical characteristics of PCL FDs of 50%, 60%, and 70% porosities were studied using scanning electron microscope (SEM), atomic force microscopy (AFM), and high precision universal testing machine (UTM). The deployability through a clinically relevant catheter was demonstrated in a PDMS aneurysm model. The angiographic visibility of the developed PCL FDs was evaluated using BaSO4 and Bi2O3 coatings of various concentration. The average strut thicknesses were 74.12 ± 6.63 μm, 63.07 ± 1.26 μm, and 56.82 ± 2.09 μm for PCL FDs with 50%, 60%, and 70% porosities, respectively. They average pore areas for the 50%, 60% and 70% porosities FDs were 0.055 ± 0.0056 mm2, 0. 0605 ± 0.0065 mm2, and 0.0712 ± 0.012 mm2, respectively. The surface quality was great with an RMS roughness value of 14.45 nm. The tensile, radial strength, and flexibility were found to be satisfactory and comparable to the nonbraided coronary stents. The developed PCL FDs were highly flexible and demonstrated to be deployable through conventional delivery system as low as 4 Fr catheters in a PDMS aneurysm model. The visibility under X-ray increases with the increasing concentration of coating materials BaSO4 and Bi2O3. The visibility intensity was slightly higher with Bi2O3 coating of PCL FDs. The overall results of the engineering analysis of the developed nonbraided PCL FDs are promising.
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Affiliation(s)
- Mohammad Robiul Hossan
- School of Engineering, Center for Interdisciplinary Biomedical Education and Research (CIBER), University of Central Oklahoma, Edmond, OK 73034
| | - Vishal Barot
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034
| | - Seth Harriet
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034
| | - Lauren Peters
- School of Engineering, University of Central Oklahoma, Edmond, OK 73034
| | | | - Andrew Bauer
- Department of Neurosurgery, University of Oklahoma - Health Science Center, Oklahoma City, OK 73104
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Tabares Ocampo J, Marín Valencia V, Robledo SM, Upegui Zapata YA, Restrepo Múnera LM, Echeverría F, Echeverry-Rendón M. Biological response of degradation products of PEO-modified magnesium on vascular tissue cells, hemocompatibility and its influence on the inflammatory response. BIOMATERIALS ADVANCES 2023; 154:213645. [PMID: 37806213 DOI: 10.1016/j.bioadv.2023.213645] [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: 05/31/2023] [Revised: 09/06/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
Cardiovascular stenting is the most widely used therapy to treat coronary artery disease caused by partial or total obstruction of the artery due to atherosclerotic plaque formation, with potentially fatal effects. There are different types of stents: bare metal stents, drug-eluting stents, bioabsorbable stents and dual therapy stents. However, they can lead to long-term complications, such as in-stent restenosis and late thrombosis. To reduce these adverse effects, research has focused on biodegradable metallic stents, since they retain the mechanical properties necessary to contain the injured artery while it is being repaired and, once their function has been fulfilled, the stent degrades without altering the system or compromising the patient's health. In this work we have evaluated the biological response of the degradation products of a bare Mg based biomaterial surface-modified by the plasma electrolytic oxidation (PEO) method on vascular tissue cells, hemocompatibility and inflammatory response. The results obtained are compatible with a biosafe material for future use as a cardiovascular implant, but it is necessary to continue with in vivo and mechanical properties tests to ensure and guarantee its use. SIGNIFICANCE STATEMENT: The development of fully bioresorbable stents is a promising alternative for the management of coronary artery disease without causing long-term problems at the implantation site. In this work, the hematological and immunological biocompatibility of bare Mg modified superficially by plasma electrolytic oxidation (PEO-Mg) was evaluated by in vitro and ex vivo assays. PEO-Mg was found to be compatible with blood and immune components surrounding the implantation site with no signs of toxicity to endothelial cells, macrophages, and arterial tissue. In addition, degradation products of PEO-Mg are eliminated by phagocytosis. However, an in-depth study of the physical and mechanical properties and in vivo biocompatibility must be carried out for its future use as a biomedical implant.
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Affiliation(s)
| | - Valentina Marín Valencia
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia, Medellín, Colombia
| | - Sara M Robledo
- PECET-Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia
| | | | - Luz Marina Restrepo Múnera
- Grupo Investigación Ingeniería de Tejidos terapias celulares GITTC, Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Félix Echeverría
- Centro de Investigación, Innovación y Desarrollo de Materiales CIDEMAT, Facultad de Ingeniería, Universidad de Antioquia, Medellín, Colombia
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9
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Zhang Y, Lee G, Li S, Hu Z, Zhao K, Rogers JA. Advances in Bioresorbable Materials and Electronics. Chem Rev 2023; 123:11722-11773. [PMID: 37729090 DOI: 10.1021/acs.chemrev.3c00408] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Transient electronic systems represent an emerging class of technology that is defined by an ability to fully or partially dissolve, disintegrate, or otherwise disappear at controlled rates or triggered times through engineered chemical or physical processes after a required period of operation. This review highlights recent advances in materials chemistry that serve as the foundations for a subclass of transient electronics, bioresorbable electronics, that is characterized by an ability to resorb (or, equivalently, to absorb) in a biological environment. The primary use cases are in systems designed to insert into the human body, to provide sensing and/or therapeutic functions for timeframes aligned with natural biological processes. Mechanisms of bioresorption then harmlessly eliminate the devices, and their associated load on and risk to the patient, without the need of secondary removal surgeries. The core content focuses on the chemistry of the enabling electronic materials, spanning organic and inorganic compounds to hybrids and composites, along with their mechanisms of chemical reaction in biological environments. Following discussions highlight the use of these materials in bioresorbable electronic components, sensors, power supplies, and in integrated diagnostic and therapeutic systems formed using specialized methods for fabrication and assembly. A concluding section summarizes opportunities for future research.
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Affiliation(s)
- Yamin Zhang
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, Illinois 60208, United States
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
| | - Geumbee Lee
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, Illinois 60208, United States
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
| | - Shuo Li
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, Illinois 60208, United States
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
| | - Ziying Hu
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, Illinois 60208, United States
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
| | - Kaiyu Zhao
- Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois 60208, United States
| | - John A Rogers
- Center for Bio-Integrated Electronics, Northwestern University, Evanston, Illinois 60208, United States
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois 60208, United States
- Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois 60208, United States
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, United States
- Department of Mechanical Engineering, Biomedical Engineering, Chemistry, Electrical Engineering and Computer Science, Northwestern University, Evanston, Illinois 60208, United States
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10
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Wang Q, Huang S, Miao J, Chen Z, Li H, Zhao L, Yuan J. Impact of inverse unequal height strut structure on the functional performance of an additively manufactured cardiovascular stent. J Mech Behav Biomed Mater 2023; 146:106058. [PMID: 37549521 DOI: 10.1016/j.jmbbm.2023.106058] [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: 06/02/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
Recently, additive manufacturing (AM) has been investigated as an innovative method to manufacture stents due to its capability in producing complex and customized structures. In this paper, the cardiovascular stents of M-type and N-type with inverse unequal height strut structure and N-type with equal height strut structure were designed and manufactured by Selective Laser Melting (SLM). Following surface polishing, balloon expansion, plane compression and three-point bending experiments were carried out to evaluate the mechanical performance of the stent. The stents designed with inverse unequal height strut structure showed higher radial support performance and lower radial recoil when compared to the stents with uniform design. This study proved the feasibility of SLM in rapid manufacturing of cardiovascular stents that can be used for performance evaluation in design stage.
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Affiliation(s)
- Qilong Wang
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Suxia Huang
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, 056038, China; School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jingtao Miao
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Zhiang Chen
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Hezong Li
- School of Mechanical and Equipment Engineering, Hebei University of Engineering, Handan, 056038, China; Key Laboratory of Intelligent Industrial Equipment Technology of Hebei Province, Handan, 056038, China.
| | - Liguo Zhao
- School of Energy and Power Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210016, China.
| | - Jiangyong Yuan
- Affiliated Hospital of Hebei Engineering University, Handan, 056001, China
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11
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Srivastava A, Kumari N, Agarwal M, Bhati P, Bhatnagar N. Fabrication and characterization of bioresorbable radiopaque PLLA/PCL/Mg alloy composite tubes for cardiovascular stent application. INT J POLYM MATER PO 2023. [DOI: 10.1080/00914037.2023.2182783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- Alok Srivastava
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Nisha Kumari
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Mohit Agarwal
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Pooja Bhati
- Department of Mechanical and Automation Engineering, Indira Gandhi Delhi Technical University for Women, New Delhi, India
| | - Naresh Bhatnagar
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
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12
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de Oliveira MF, da Silva LCE, Catori DM, Lorevice MV, Galvão KEA, Millás ALG, de Oliveira MG. Photocurable Nitric Oxide-Releasing Copolyester for the 3D Printing of Bioresorbable Vascular Stents. Macromol Biosci 2023; 23:e2200448. [PMID: 36519642 DOI: 10.1002/mabi.202200448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/30/2022] [Indexed: 12/23/2022]
Abstract
The design of bioresorbable vascular stents (BVS) capable of releasing nitric oxide (NO) at the implant site may enable BVS to mimic the antiplatelet, antiproliferative, and pro-endothelial actions of NO, overcoming complications of BVS such as late thrombosis and restenosis. In this study, the fabrication of BVS composed of methacrylated poly(dodecanediol citrate-co-dodecanediol S-nitroso-mercaptosuccinate) (mP(DC-co-DMSNO)), a novel elastomeric, bioabsorbable, and photocurable copolyester, containing covalently bound S-nitrosothiol groups in the carbon backbone of the polymer, is reported. The mP(DC-co-DMSNO) stents are manufactured via photoinduced 3D printing and allow deployment via a self-expansion process from a balloon catheter. After deployment, hydration of the stents triggers the release of NO, which is maintained during the slow hydrolysis of the polymer. Real-time NO release measurements show that by varying the copolyester composition and the strut geometry of the mP(DC-co-DMSNO) stents, it is possible to modulate their NO release rate in the range of 30-52 pmol min-1 cm-2 . Preliminary biological assays in cell culture show that endothelial cells adhere to the surface of the stents and that NO release favors their endothelization. Thus, mP(DC-co-DMSNO) may emerge as a new platform for the fabrication of advanced BVS.
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Affiliation(s)
- Matheus F de Oliveira
- Institute of Chemistry, University of Campinas, UNICAMP, Rua Josué de Castro, s/n, CP 6154, Campinas, SP, 13083-970, Brazil
| | - Laura C E da Silva
- Institute of Chemistry, University of Campinas, UNICAMP, Rua Josué de Castro, s/n, CP 6154, Campinas, SP, 13083-970, Brazil
| | - Daniele M Catori
- Institute of Chemistry, University of Campinas, UNICAMP, Rua Josué de Castro, s/n, CP 6154, Campinas, SP, 13083-970, Brazil
| | - Marcos V Lorevice
- Institute of Chemistry, University of Campinas, UNICAMP, Rua Josué de Castro, s/n, CP 6154, Campinas, SP, 13083-970, Brazil
| | - Karen E A Galvão
- 3D Biotechnology Solutions, 3DBS, Rua da Abolição, 1880, Campinas, SP, 13041-445, Brazil
| | - Ana L G Millás
- 3D Biotechnology Solutions, 3DBS, Rua da Abolição, 1880, Campinas, SP, 13041-445, Brazil
| | - Marcelo G de Oliveira
- Institute of Chemistry, University of Campinas, UNICAMP, Rua Josué de Castro, s/n, CP 6154, Campinas, SP, 13083-970, Brazil
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13
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Hu X, Li J, Yang J, Cheng J, Zhang Y, Lang J, Liu J, Zhao G, Ni Z. Focus on the crucial deformation region to adjust the comprehensive performance of poly (L-lactic acid) stent. Int J Biol Macromol 2023; 230:123417. [PMID: 36709814 DOI: 10.1016/j.ijbiomac.2023.123417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 01/28/2023]
Abstract
The fully biodegradable polymer stent is considered as the fourth-generation vascular implant with good biocompatibility and long-term therapeutic potential. It has attracted much attention because it overcomes the disadvantage of the permanently implanted metal stent. However, compared with the metal stent, its mechanical properties are slightly inferior, which is an urgent problem. Based on previous studies, fully biodegradable polymer stents are prone to experience cracks and damage in large deformation region during the crimping and expansion process. The large deformation region is mainly located at the ring bend of the stent. We supposed that these damages are the leading causes of weakening the mechanical performance of polymer stents and are mainly affected by the crucial deformation region. For this purpose, this work studies the relationship between different crucial deformation regions and the mechanical performance of the polymer stent. Firstly, the volume of the crucial deformation region is improved by increasing the ring width. Although the radial strength of the stent is enhanced with the increase in ring width, the radial stiffness also increases, and correspondingly, the flexibility of the stent decreases. To obtain acceptable comprehensive mechanical performance, two types of slotting design in critical deformation region were proposed. The proposed slotted stent with a bulge has sufficient radial strength and low radial stiffness, having a good radial support capacity and flexibility. In other words, the proposed stent has improved the radial support without sacrificing flexibility. Overall, different crucial deformation regions cause different degrees of damage to the stent during crimping and expansion, which affects the mechanical properties of the stent. Reasonable structural design of the crucial deformation region is the key to adjust the comprehensive performance of the stent.
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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, China
| | - Junjie Li
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Juekuan Yang
- 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
| | - Yi Zhang
- Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210044, China
| | - Ji Lang
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing 211189, China
| | - Jinbo Liu
- 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.
| | - Zhonghua Ni
- 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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14
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Lucchetti A, Emonts C, Idrissi A, Gries T, Vaughan TJ. An experimental investigation of the mechanical performance of PLLA wire-braided stents. J Mech Behav Biomed Mater 2023; 138:105568. [PMID: 36459705 DOI: 10.1016/j.jmbbm.2022.105568] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/20/2022]
Abstract
Much of our current understanding of the performance of self-expanding wire-braided stents is based on mechanical testing of Nitinol-based or polymeric non-bioresorbable (e.g. PET, PP etc.) devices. The small amount of data present for bioresorbable devices characterizes stents with big nominal diameters (D>6mm), with a distinct lack of data describing the mechanical performance of small-diameter wire-braided bioresorbable devices (D≤5mm). This study presents a systematic investigation of the mechanical performance of wire-braided bioresorbable Poly-L-Lactic Acid (PLLA) stents having different braiding angles (α=45° , α=30°, and α=20°), wire diameters (d=100μm, and d=150μm), wire count (n=24 and n=48), braiding patterns (1:1-1, 2:2-1 and 1:1-2) and stent diameters (D=5mm, D=4mm, and D=2.5mm). Mechanical characterisation was carried out by evaluating the radial, longitudinal and bending response of the devices. Our results showed that smaller braid angles, larger wire diameters, higher number of wires and smaller stent diameter led to an increase in the stent mechanical properties across each of the three mechanical tests performed. It was found that geometrical features of a polymeric braided stent could be adapted to achieve a similar performance to the one of a metallic device. In particular, substantial increases in stent mechanical properties were found for a low braiding angle and when the braiding pattern followed a one-over-one-under configuration with two wires in parallel (1:1-2). Finally, it was shown that a mathematical model proposed in literature for metal braided stents can provide reasonable predictions also of polymeric stent performance but just in circumstances where wire friction does not have a dominant role. This study presents a wide range of experimental data that can provide an important reference for further development of wire-braided bioresorbable devices.
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Affiliation(s)
| | - Caroline Emonts
- Institut für Textiltechnik of RWTH Aachen University, Germany
| | - Akram Idrissi
- Institut für Textiltechnik of RWTH Aachen University, Germany
| | - Thomas Gries
- Institut für Textiltechnik of RWTH Aachen University, Germany
| | - Ted J Vaughan
- Biomechanics Research Centre (BioMEC), School of Engineering, College of Science and Engineering, University of Galway, Ireland.
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15
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Seguchi M, Aytekin A, Lenz T, Nicol P, Alvarez-Covarrubias HA, Xhepa E, Klosterman GR, Beele A, Sabic E, Utsch L, Alyaqoob A, Joner M. Challenges of the newer generation of resorbable magnesium scaffolds: Lessons from failure mechanisms of the past generation. J Cardiol 2023; 81:179-188. [PMID: 36122642 DOI: 10.1016/j.jjcc.2022.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
Bioresorbable scaffolds (BRS) were developed to overcome the obstacles of metallic stents, mostly related to sustained presence of metallic foreign body in the coronary vessel. Following earlier success of single-arm BRS studies, randomized controlled trials of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA, USA) showed poor long-term clinical outcomes, particularly in terms of scaffold thrombosis. BRS made from magnesium alloy provide a promising alternative in terms of radial force, strut thickness and, potentially lower thrombogenicity. A recent clinical study demonstrated that magnesium-based BRS seems to be promising with regards to the risk of scaffold thrombosis. In this review, our aim is to describe the issues that prevented Absorb BVS from achieving favorable outcomes, provide current status of existing BRS technologies and the challenges that newer generation BRSs need to overcome, and the results of clinical studies for commercially available magnesium-based BRS, which remain the only BRS actively studied in clinical practice.
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Affiliation(s)
- Masaru Seguchi
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany.
| | - Alp Aytekin
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Tobias Lenz
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Philipp Nicol
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Hector A Alvarez-Covarrubias
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany; Hospital de Cardiología, Centro Médico Nacional Siglo XXI, IMMS, Ciudad de México, México
| | - Erion Xhepa
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Grace R Klosterman
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Alicia Beele
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Emina Sabic
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Léa Utsch
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Aseel Alyaqoob
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany; Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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16
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Peng W, Chen Y, Fan H, Chen S, Wang H, Song X. A Novel PLLA/MgF 2 Coating on Mg Alloy by Ultrasonic Atomization Spraying for Controlling Degradation and Improving Biocompatibility. MATERIALS (BASEL, SWITZERLAND) 2023; 16:682. [PMID: 36676415 PMCID: PMC9864383 DOI: 10.3390/ma16020682] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Problems of rapid degradation and poor biocompatibility (endothelialization and hemocompatibility) limit magnesium (Mg) alloy's further applications in vascular stents. To solve these problems, a novel composite coating was designed on Mg alloy via a two-step method. First, a Mg alloy sample was immersed in hydrofluoric acid. Then, a poly-l-lactic acid (PLLA) coating was made by ultrasonic atomization spraying with 5 and 10 layers (referred to as PLLA(5)-HF-Mg and PLLA(10)-HF-Mg). Characterizations were analyzed from the microstructure, element distribution, and wettability. The degradation behavior was tested with an electrochemical test and immersion test. Endothelialization was investigated using human umbilical vein endothelial cells (HUVECs). Hemocompatibility was examined with a platelet adhesion test. The results showed that the PLLA coating could not only cover the surface, but also could permeate through and cover the holes on the MgF2 layer, mechanically locked with the substrate. Thus, the composite coating had higher corrosion resistance. The PLLA/MgF2 coating, especially on PLLA(10)-HF-Mg, enhanced HUVECs' viability and growth. While incubated with platelets, the PLLA/MgF2 coating, especially on PLLA(10)-HF-Mg, had the lowest platelet adhesion number and activity. Taken together, the novel PLLA/MgF2 coating controls Mg alloy's degradation by spraying different layers of PLLA, resulting in better endothelialization and hemocompatibility, providing a promising candidate for cardiovascular stents.
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Affiliation(s)
- Wenpeng Peng
- Cardiovascular Center, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Department of Clinical Medicine, Harbin Medical University, Harbin 150000, China
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yizhe Chen
- Hubei Key Laboratory of Advanced Technology for Automotive Components, Wuhan University of Technology, Wuhan 430070, China
| | - Hongde Fan
- Hubei Key Laboratory of Advanced Technology for Automotive Components, Wuhan University of Technology, Wuhan 430070, China
| | - Shanshan Chen
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Hui Wang
- Hubei Key Laboratory of Advanced Technology for Automotive Components, Wuhan University of Technology, Wuhan 430070, China
| | - Xiang Song
- Cardiovascular Center, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Department of Clinical Medicine, Harbin Medical University, Harbin 150000, China
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17
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Lin Z, Chen H, Xu J, Wang J, Wang H, Huang S, Xu S. A Review of the Release Profiles and Efficacies of Chemotherapy Drug-Loaded Electrospun Membranes. Polymers (Basel) 2023; 15:polym15020251. [PMID: 36679132 PMCID: PMC9865042 DOI: 10.3390/polym15020251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
Electrospun fibrous membranes loaded with chemotherapy drugs have been broadly studied, many of which have had promising data demonstrating therapeutic effects on cancer cell inhibition, tumor size reduction, the life extension of tumor-bearing animals, and more. Nevertheless, their drug release profiles are difficult to predict since their degradation pattern varies with crystalline polymers. In addition, there is room for improving their release performances, optimizing the release patterns, and achieving better therapeutic outcomes. In this review, the key factors affecting electrospun membrane drug release profiles have been systematically reviewed. Case studies of the release profiles of typical chemotherapy drugs are carried out to determine the preferred polymer choices and techniques to achieve the expected prolonged or enhanced release profiles. The therapeutic effects of these electrospun, chemo-drug-loaded membranes are also discussed. This review aims to assist in the design of future drug-loaded electrospun materials to achieve preferred release profiles with enhanced therapeutic efficacies.
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Affiliation(s)
- Zhenyu Lin
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
| | - Hao Chen
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Jiawei Xu
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Jie Wang
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Huijing Wang
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Shifen Huang
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Shanshan Xu
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
- Correspondence: ; Tel.: +86-755-26531165
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18
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Bioresorbable vascular metallic scaffolds: Current status and research trends. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2022. [DOI: 10.1016/j.cobme.2022.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Development of 3D printable bioresorbable drug eluting coronary stents: An experimental and computational investigation. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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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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21
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Development of Biodegradable Polymeric Stents for the Treatment of Cardiovascular Diseases. Biomolecules 2022; 12:biom12091245. [PMID: 36139086 PMCID: PMC9496387 DOI: 10.3390/biom12091245] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular disease has become the leading cause of death. A vascular stent is an effective means for the treatment of cardiovascular diseases. In recent years, biodegradable polymeric vascular stents have been widely investigated by researchers because of its degradability and clinical application potential for cardiovascular disease treatment. Compared to non-biodegradable stents, these stents are designed to degrade after vascular healing, leaving regenerated healthy arteries. This article reviews and summarizes the recent advanced methods for fabricating biodegradable polymeric stents, including injection molding, weaving, 3D printing, and laser cutting. Besides, the functional modification of biodegradable polymeric stents is also introduced, including visualization, anti-thrombus, endothelialization, and anti-inflammation. In the end, the challenges and future perspectives of biodegradable polymeric stents were discussed.
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22
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Paunović N, Marbach J, Bao Y, Berger V, Klein K, Schleich S, Coulter FB, Kleger N, Studart AR, Franzen D, Luo Z, Leroux J. Digital Light 3D Printed Bioresorbable and NIR-Responsive Devices with Photothermal and Shape-Memory Functions. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2200907. [PMID: 35896948 PMCID: PMC9507367 DOI: 10.1002/advs.202200907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/23/2022] [Indexed: 06/15/2023]
Abstract
Digital light processing (DLP) 3D printing is a promising technique for the rapid manufacturing of customized medical devices with high precision. To be successfully translated to a clinical setting, challenges in the development of suitable photopolymerizable materials have yet to be overcome. Besides biocompatibility, it is often desirable for the printed devices to be biodegradable, elastic, and with a therapeutic function. Here, a multifunctional DLP printed material system based on the composite of gold nanorods and polyester copolymer is reported. The material demonstrates robust near-infrared (NIR) responsiveness, allowing rapid and stable photothermal effect leading to the time-dependent cell death. NIR light-triggerable shape transformation is demonstrated, resulting in a facilitated insertion and expansion of DLP printed stent ex vivo. The proposed strategy opens a promising avenue for the design of multifunctional therapeutic devices based on nanoparticle-polymer composites.
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Affiliation(s)
- Nevena Paunović
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
| | - Jessica Marbach
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
| | - Yinyin Bao
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
| | - Valentine Berger
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
| | - Karina Klein
- Musculoskeletal Research UnitVetsuisse FacultyUniversity of ZurichZurich8057Switzerland
| | - Sarah Schleich
- Musculoskeletal Research UnitVetsuisse FacultyUniversity of ZurichZurich8057Switzerland
| | | | - Nicole Kleger
- Complex MaterialsDepartment of MaterialsETH ZurichZurich8093Switzerland
| | - André R. Studart
- Complex MaterialsDepartment of MaterialsETH ZurichZurich8093Switzerland
| | - Daniel Franzen
- Department of PulmonologyUniversity Hospital ZurichZurich8006Switzerland
| | - Zhi Luo
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical EngineeringSouthern University of Science and TechnologyShenzhen518055P. R. China
| | - Jean‐Christophe Leroux
- Institute of Pharmaceutical SciencesDepartment of Chemistry and Applied BiosciencesETH ZurichZurich8093Switzerland
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23
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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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24
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Nugud A, Alghfeli L, Elmasry M, El-Serafi I, El-Serafi AT. Biomaterials as a Vital Frontier for Stem Cell-Based Tissue Regeneration. Front Cell Dev Biol 2022; 10:713934. [PMID: 35399531 PMCID: PMC8987776 DOI: 10.3389/fcell.2022.713934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 03/11/2022] [Indexed: 01/01/2023] Open
Abstract
Biomaterials and tissue regeneration represent two fields of intense research and rapid advancement. Their combination allowed the utilization of the different characteristics of biomaterials to enhance the expansion of stem cells or their differentiation into various lineages. Furthermore, the use of biomaterials in tissue regeneration would help in the creation of larger tissue constructs that can allow for significant clinical application. Several studies investigated the role of one or more biomaterial on stem cell characteristics or their differentiation potential into a certain target. In order to achieve real advancement in the field of stem cell-based tissue regeneration, a careful analysis of the currently published information is critically needed. This review describes the fundamental description of biomaterials as well as their classification according to their source, bioactivity and different biological effects. The effect of different biomaterials on stem cell expansion and differentiation into the primarily studied lineages was further discussed. In conclusion, biomaterials should be considered as an essential component of stem cell differentiation strategies. An intense investigation is still required. Establishing a consortium of stem cell biologists and biomaterial developers would help in a systematic development of this field.
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Affiliation(s)
- Ahmed Nugud
- Pediatric Department, Aljalila Children Hospital, Dubai, United Arab Emirates
| | - Latifa Alghfeli
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Moustafa Elmasry
- Department of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden
- Department of Hand Surgery and Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden
| | - Ibrahim El-Serafi
- Department of Hand Surgery and Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden
- Basic Medical Sciences Department, College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Ahmed T. El-Serafi
- Department of Biomedical and Clinical Sciences (BKV), Linköping University, Linköping, Sweden
- Department of Hand Surgery and Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden
- *Correspondence: Ahmed T. El-Serafi,
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Two-Step Geometry Design Method, Numerical Simulations and Experimental Studies of Bioresorbable Stents. MATERIALS 2022; 15:ma15072385. [PMID: 35407718 PMCID: PMC8999420 DOI: 10.3390/ma15072385] [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: 02/16/2022] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022]
Abstract
The stent-implantation process during angioplasty procedures usually involves clamping the stent onto a catheter to a size that allows delivery to the place inside the artery. Finding the right geometrical form of the stent to ensure good functionality in the open form and to enable the clamping process is one of the key elements in the stent-design process. In the first part of the work, an original two-step procedure for stent-geometry design was proposed. This was due to the necessary selection of a geometry that would provide adequate support to the blood-vessel wall without causing damage to the vessel. Numerical simulations of the crimping and deployment processes were performed to verify the method. At the end of this stage, the optimal stent was selected for further testing. In addition, numerical simulations of selected experimental tests (catheter-crimping process, compression process) were used to verify the obtained geometrical forms. The results of experimental tests on stents produced by the microinjection method are presented. The digital image correlation (DIC) method was used to compare the results of numerical simulation and experimental tests. The two-step modeling approach was found to help select the appropriate geometry of the expanded stent, which is an extremely important step in the design of the crimping process. In the part of the paper where the results obtained by numerical simulation were compared with those gained by experiment and using the DIC method, a good compatibility of the displacement results can be observed. For both longitudinal and transverse (pinch) stent compression, the results practically coincide. The paper presents also the application of the DIC method which significantly expands the research possibilities, allowing for a detailed inspection of the deformation state and, above all, verification of local dangerous areas. This approach significantly increases the possibility of assessing the quality of the stents.
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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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Zhao G, Liu J, Liu M, Tian Y, Cheng J, Liu W, Ni Z. Influence of parameters on mechanical properties of poly (L-lactic acid) helical stents. J Biomed Mater Res B Appl Biomater 2022; 110:1705-1712. [PMID: 35157351 DOI: 10.1002/jbm.b.35031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/08/2021] [Accepted: 01/29/2022] [Indexed: 12/17/2022]
Abstract
With better biocompatibility, bioresorbable poly (L-lactic acid) (PLLA) helical stents are expected to replace the commonly used metallic stents. However, due to the great difference between the material properties of PLLA and those of metals, the current research results on mechanical properties of stents will not be applicative. In this article, the effects of i on the radial compression performance and bending stiffness of PLLA helical stents were systematically studied, and the effect of temperature on the radial compression performance of the helical stent was investigated. The findings obtained indicate that the reduction of initial pitch angle and initial diameter can enhance the radial compression performance. The reduction of initial pitch angle and the increase of initial diameter can weaken the bending stiffness of the helical stent. Moreover, the increase of temperature will reduce the radial stiffness and peak compression force of the helical stent. A favorable agreement between the theoretical and experimental results of radial compression properties was found in stents with the initial pitch angle between 14° and 21° and all initial diameters. This work can provide suggestions for the use of the theoretical formula in structure design of the helical stent.
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Affiliation(s)
- Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing, China
| | - Jiaming Liu
- 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
| | - Yuan Tian
- 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
| | - Wentao Liu
- 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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Hoddy B, Ahmed N, Al-Lamee K, Bullett N, Curzen N, Bressloff NW. Investigating the Equivalent Plastic Strain in a Variable Ring Length and Strut Width Thin-Strut Bioresorbable Scaffold. Cardiovasc Eng Technol 2022; 13:899-914. [PMID: 35819580 PMCID: PMC9750924 DOI: 10.1007/s13239-022-00625-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/18/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE The ArterioSorb[Formula: see text] bioresorbable scaffold (BRS) developed by Arterius Ltd is about to enter first in man clinical trials. Previous generations of BRS have been vulnerable to brittle fracture, when expanded via balloon inflation in-vivo, which can be extremely detrimental to patient outcome. Therefore, this study explores the effect of variable ring length and strut width (as facilitated by the ArterioSorb[Formula: see text] design) on fracture resistance via analysis of the distribution of equivalent plastic strain in the scaffold struts post expansion. Scaffold performance is also assessed with respect to side branch access, radial strength, final deployed diameter and percentage recoil. METHODS Finite element analysis was conducted of the crimping, expansion and radial crushing of five scaffold designs comprising different variations in ring length and strut width. The Abaqus/Explicit (DS SIMULIA) solution method was used for all simulations. Direct comparison between in-silico predictions and in-vitro measurements of the performance of the open cell variant of the ArterioSorb[Formula: see text] were made. Paths across the width of the crown apex and around the scaffold rings were defined along which the plastic strain distribution was analysed. RESULTS The in-silico results demonstrated good predictions of final shape for the baseline scaffold design. Percentage recoil and radial strength were predicted to be, respectively, 2.8 and 1.7 times higher than the experimentally measured values, predominantly due to the limitations of the anisotropic elasto-plastic material property model used for the scaffold. Average maximum values of equivalent plastic strain were up to 2.4 times higher in the wide strut designs relative to the narrow strut scaffolds. As well as the concomitant risk of strut fracture, the wide strut designs also exhibited twisting and splaying behaviour at the crowns located on the scaffold end rings. Not only are these phenomena detrimental to the radial strength and risk of strut fracture but they also increase the likelihood of damage to the vessel wall. However, the baseline scaffold design was observed to tolerate significant over expansion without inducing excessive plastic strains, a result which is particularly encouraging, due to post-dilatation being commonplace in clinical practice. CONCLUSION Therefore, the narrow strut designs investigated herein, are likely to offer optimal performance and potentially better patient outcomes. Further work should address the material modelling of next generation polymeric BRS to more accurately capture their mechanical behaviour. Observation of the in-vitro testing indicates that the ArterioSorb[Formula: see text] BRS can tolerate greater levels of over expansion than anticipated.
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Affiliation(s)
- Ben Hoddy
- grid.5491.90000 0004 1936 9297Computational Engineering and Design Research Group, University of Southampton, Southampton, UK
| | - Naveed Ahmed
- grid.498018.c0000 0004 0581 8370Arterius Ltd, Leeds, UK
| | | | - Nial Bullett
- grid.498018.c0000 0004 0581 8370Arterius Ltd, Leeds, UK
| | - Nick Curzen
- grid.430506.40000 0004 0465 4079Coronary Research Group, Southampton University Hospitals NHS Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297Faculty of Medicine, University of Southampton, Southampton, UK
| | - Neil W. Bressloff
- grid.5491.90000 0004 1936 9297Computational Engineering and Design Research Group, University of Southampton, Southampton, UK
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29
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Current status and outlook of biodegradable metals in neuroscience and their potential applications as cerebral vascular stent materials. Bioact Mater 2021; 11:140-153. [PMID: 34938919 PMCID: PMC8665265 DOI: 10.1016/j.bioactmat.2021.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/01/2021] [Accepted: 09/18/2021] [Indexed: 12/12/2022] Open
Abstract
Over the past two decades, biodegradable metals (BMs) have emerged as promising materials to fabricate temporary biomedical devices, with the purpose of avoiding potential side effects of permanent implants. In this review, we first surveyed the current status of BMs in neuroscience, and briefly summarized the representative stents for treating vascular stenosis. Then, inspired by the convincing clinical evidence on the in vivo safety of Mg alloys as cardiovascular stents, we analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for treating ischemic stroke. For these novel applications, some key factors should also be considered in designing BM brain stents, including the anatomic features of the cerebral vasculature, hemodynamic influences, neuro-cytocompatibility and selection of alloying elements. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents. The current status of the application of biodegradable metals (BM) in neuroscience was presented. We analyzed the possibility of producing biodegradable cerebrovascular Mg alloy stents for ischemic stroke treatment. Key factors in designing BM brain stents were discussed. This work may provide insights into the future design and fabrication of BM neurological devices, especially for brain stents.
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30
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Toong DWY, Ng JCK, Cui F, Leo HL, Zhong L, Lian SS, Venkatraman S, Tan LP, Huang YY, Ang HY. Nanoparticles-reinforced poly-l-lactic acid composite materials as bioresorbable scaffold candidates for coronary stents: Insights from mechanical and finite element analysis. J Mech Behav Biomed Mater 2021; 125:104977. [PMID: 34814078 DOI: 10.1016/j.jmbbm.2021.104977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 12/22/2022]
Abstract
Current generation of bioresorbable coronary scaffolds (BRS) posed thrombogenicity and deployment issues owing to its thick struts and overall profile. To this end, we hypothesize that the use of nanocomposite materials is able to provide improved material properties and sufficient radial strength for the intended application even at reduced strut thickness. The nanocomposite formulations of tantalum dioxide (Ta2O5), L-lactide functionalized (LA)-Ta2O5, hydroxyapatite (HA) and LA-HA with poly-l-lactic acid (PLLA) were evaluated in this study. Results showed that tensile modulus and strength were enhanced with non-functionalized nanofillers up until 15 wt% loading, whereas ductility was compromised. On the other hand, functionalized nanofillers/PLLA exhibited improved nanofiller dispersion which resulted higher tensile modulus, strength, and ductility. Selected nanocomposite formulations were evaluated using finite element analysis (FEA) of a stent with varying strut thickness (80, 100 and 150 μm). FEA data has shown that nanocomposite BRS with thinner struts (80-100 μm) made with 15 wt% LA-Ta2O5/PLLA and 10 wt% LA-HA/PLLA have increased radial strength, stiffness and reduced recoil compared to PLLA BRS at 150 μm. The reduced strut thickness can potentially mitigate issues such as scaffold thrombosis and promote re-endothelialisation of the vessel.
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Affiliation(s)
- Daniel Wee Yee Toong
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, 639798, Singapore
| | - Jaryl Chen Koon Ng
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, 117583, Singapore
| | - Fangsen Cui
- Institute of High Performance Computing, A*STAR, 1 Fusionopolis way, 138632, Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, 117583, Singapore
| | - Liang Zhong
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - Shaoliang Shawn Lian
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, 117583, Singapore
| | - Subbu Venkatraman
- Department of Material Science Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore
| | - Lay Poh Tan
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, 639798, Singapore
| | - Ying Ying Huang
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, 639798, Singapore.
| | - Hui Ying Ang
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, 117583, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore.
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31
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Tidwell K, Harriet S, Barot V, Bauer A, Vaughan MB, Hossan MR. Design and Analysis of a Biodegradable Polycaprolactone Flow Diverting Stent for Brain Aneurysms. Bioengineering (Basel) 2021; 8:bioengineering8110183. [PMID: 34821749 PMCID: PMC8614946 DOI: 10.3390/bioengineering8110183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/31/2021] [Accepted: 11/09/2021] [Indexed: 11/21/2022] Open
Abstract
The flow diverting stent (FDS) has become a promising endovascular device for the treatment of aneurysms. This research presents a novel biodegradable and non-braided Polycaprolactone (PCL) FDS. The PCL FDS was designed and developed using an in-house fabrication unit and coated on two ends with BaSO4 for angiographic visibility. The mechanical flexibility and quality of FDS surfaces were examined with the UniVert testing machine, scanning electron microscope (SEM), and 3D profilometer. Human umbilical vein endothelial cell (HUVEC) adhesion, proliferation, and cell morphology studies on PCL FDS were performed. The cytotoxicity and NO production by HUVECs with PCL FDS were also conducted. The longitudinal tensile, radial, and bending flexibility were found to be 1.20 ± 0.19 N/mm, 0.56 ± 0.11 N/mm, and 0.34 ± 0.03 N/mm, respectively. The FDS was returned to the original shape and diameter after repeated compression and bending without compromising mechanical integrity. Results also showed that the proliferation and adhesion of HUVECs on the FDS surface increased over time compared to control without FDS. Lactate dehydrogenase (LDH) release and NO production showed that PCL FDS were non-toxic and satisfactory. Cell morphology studies showed that HUVECs were elongated to cover the FD surface and developed an endothelial monolayer. This study is a step forward toward the development and clinical use of biodegradable flow diverting stents for endovascular treatment of the aneurysm.
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Affiliation(s)
- Kaitlyn Tidwell
- Department of Engineering and Physics, University of Central Oklahoma, Edmond, OK 73034, USA; (K.T.); (S.H.); (V.B.)
| | - Seth Harriet
- Department of Engineering and Physics, University of Central Oklahoma, Edmond, OK 73034, USA; (K.T.); (S.H.); (V.B.)
| | - Vishal Barot
- Department of Engineering and Physics, University of Central Oklahoma, Edmond, OK 73034, USA; (K.T.); (S.H.); (V.B.)
| | - Andrew Bauer
- Department of Neurosurgery, University of Oklahoma-Health Science Center, Oklahoma City, OK 73104, USA;
| | - Melville B. Vaughan
- Department of Biology, University of Central Oklahoma, Edmond, OK 73034, USA;
- Center of Interdisciplinary Biomedical Education and Research, University of Central Oklahoma, Edmond, OK 73034, USA
| | - Mohammad R. Hossan
- Department of Engineering and Physics, University of Central Oklahoma, Edmond, OK 73034, USA; (K.T.); (S.H.); (V.B.)
- Center of Interdisciplinary Biomedical Education and Research, University of Central Oklahoma, Edmond, OK 73034, USA
- Correspondence: ; Tel.: +1-405-975-5295
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Ryu H, Seo M, Rogers JA. Bioresorbable Metals for Biomedical Applications: From Mechanical Components to Electronic Devices. Adv Healthc Mater 2021; 10:e2002236. [PMID: 33586341 DOI: 10.1002/adhm.202002236] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/29/2021] [Indexed: 01/16/2023]
Abstract
Bioresorbable metals and metal alloys are of growing interest for myriad uses in temporary biomedical implants. Examples range from structural elements as stents, screws, and scaffolds to electronic components as sensors, electrical stimulators, and programmable fluidics. The associated physical forms span mechanically machined bulk parts to lithographically patterned conductive traces, across a diversity of metals and alloys based on magnesium, zinc, iron, tungsten, and others. The result is a rich set of opportunities in healthcare materials science and engineering. This review article summarizes recent advances in this area, starting with an historical perspective followed by a discussion of materials options, considerations in biocompatibility, and device applications. Highlights are in system level bioresorbable electronic platforms that support functions as diagnostics and therapeutics in the context of specific, temporary clinical needs. A concluding section highlights challenges and emerging research directions.
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Affiliation(s)
- Hanjun Ryu
- Center for Bio‐Integrated Electronics Querrey Simpson Institute for Bioelectronics Northwestern University Evanston IL 60208 USA
| | - Min‐Ho Seo
- School of Biomedical Convergence Engineering College of Information & Biomedical Engineering Pusan National University 49 Busandaehak‐ro Yangsan‐si Gyeongsangnam‐do 50612 Republic of Korea
| | - John A. Rogers
- Center for Bio‐Integrated Electronics Querrey Simpson Institute for Bioelectronics Northwestern University Evanston IL 60208 USA
- Department of Mechanical Engineering Northwestern University Evanston IL 60208 USA
- Department of Civil and Environmental Engineering Northwestern University Evanston IL 60208 USA
- Department of Materials Science and Engineering Northwestern University Evanston IL 60208 USA
- Department of Biomedical Engineering Northwestern University Evanston IL 60208 USA
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33
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Kirillova A, Yeazel TR, Asheghali D, Petersen SR, Dort S, Gall K, Becker ML. Fabrication of Biomedical Scaffolds Using Biodegradable Polymers. Chem Rev 2021; 121:11238-11304. [PMID: 33856196 DOI: 10.1021/acs.chemrev.0c01200] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Degradable polymers are used widely in tissue engineering and regenerative medicine. Maturing capabilities in additive manufacturing coupled with advances in orthogonal chemical functionalization methodologies have enabled a rapid evolution of defect-specific form factors and strategies for designing and creating bioactive scaffolds. However, these defect-specific scaffolds, especially when utilizing degradable polymers as the base material, present processing challenges that are distinct and unique from other classes of materials. The goal of this review is to provide a guide for the fabrication of biodegradable polymer-based scaffolds that includes the complete pathway starting from selecting materials, choosing the correct fabrication method, and considering the requirements for tissue specific applications of the scaffold.
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Affiliation(s)
- Alina Kirillova
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States
| | - Taylor R Yeazel
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States
| | - Darya Asheghali
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Shannon R Petersen
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Sophia Dort
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Ken Gall
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States
| | - Matthew L Becker
- Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States.,Department of Chemistry, Duke University, Durham, North Carolina 27708, United States.,Departments of Biomedical Engineering and Orthopaedic Surgery, Duke University, Durham, North Carolina 27708, United States
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34
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Wu X, Wu S, Kawashima H, Hara H, Ono M, Gao C, Wang R, Lunardi M, Sharif F, Wijns W, Serruys PW, Onuma Y. Current perspectives on bioresorbable scaffolds in coronary intervention and other fields. Expert Rev Med Devices 2021; 18:351-365. [PMID: 33739213 DOI: 10.1080/17434440.2021.1904894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The first-generation bioresorbable scaffolds (BRSs) had a large strut profile to compensate for the insufficient radial strength of bioresorbable polymer materials, resulting in higher scaffold thrombosis rates than conventional drug-eluting stents. To improve the clinical safety and efficacy, the new generation BRSs have been improved by optimal structure design, post-processing of bioresorbable polymer materials, or altering bioresorbable metallic alloys.Areas covered: This review summarizes the lessons learned from the first-generation BRS, updates the clinical outcomes of trials evaluating ABSORB bioresorbable vascular scaffold at long-term and bioresorbable metallic alloy-based devices, and examines recent outcomes of BRS treated in STEMI patients. This review also provides an overview of the current clinical data of seven BRSs manufactured in Asia, and of the BRSs extended application in other clinical arenas.Expert opinion: Drawbacks of the first-generation BRSs need to be addressed by the next generation of these stents with novel materials and technologies. Clinical research, including randomized controlled trials, are required to further evaluate BRSs application in coronary artery disease. The encouraging results of BRSs innovation applied in the peripheral arteries and gastrointestinal tracts support other potential clinical applications of BRS technology.
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Affiliation(s)
- Xinlei Wu
- Institute of Cardiovascular Development and Translational Medicine, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Sijing Wu
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland.,Department of Cardiology, Beijing Anzhen Hospital, Beijing, China
| | - Hideyuki Kawashima
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Hironori Hara
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Masafumi Ono
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Chao Gao
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland.,Department of Cardiology, Xijing Hospital, Xi'an, China
| | - Rutao Wang
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland.,Department of Cardiology, Xijing Hospital, Xi'an, China
| | - Mattia Lunardi
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Faisal Sharif
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - William Wijns
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland.,National Heart & Lung Institute, Imperial College London, London, UK
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland
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Wei H, Yan S, Menary G. Modelling Stretch Blow Moulding of Poly (l-lactic acid) for the Manufacture of Bioresorbable Vascular Scaffold. Polymers (Basel) 2021; 13:polym13060967. [PMID: 33809921 PMCID: PMC8004264 DOI: 10.3390/polym13060967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 11/25/2022] Open
Abstract
Stretch blow moulding (SBM) has been employed to manufacture bioresorbable vascular scaffold (BVS) from poly (l-lactic acid) (PLLA), whilst an experience-based method is used to develop the suitable processing conditions by trial-and-error. FEA modelling can be used to predict the forming process by the scientific understanding on the mechanical behaviour of PLLA materials above the glass transition temperature (Tg). The applicability of a constitutive model, the ‘glass-rubber’ (GR) model with material parameters from biaxial stretch was examined on PLLA sheets replicating the biaxial strain history of PLLA tubes during stretch blow moulding. The different stress–strain relationship of tubes and sheets under equivalent deformation suggested the need of re-calibration of the GR model for tubes. A FEA model was developed for PLLA tubes under different operation conditions, incorporating a virtual cap and rod to capture the suppression of axial stretch. The reliability of the FEA modelling on tube blowing was validated by comparing the shape evolution, strain history and stress–strain relationship from modelling to the results from the free stretch blow test.
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Affiliation(s)
- Huidong Wei
- College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK;
| | - Shiyong Yan
- School of Mechanical and Aerospace Engineering, Queen’s University Belfast, Belfast BT9 5AH, UK;
| | - Gary Menary
- School of Mechanical and Aerospace Engineering, Queen’s University Belfast, Belfast BT9 5AH, UK;
- Correspondence:
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36
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Demola P, Meucci F, Stolcova M, Mario CD, Mattesini A. The DESolve ® novolimus bioresorbable scaffold. Future Cardiol 2021; 17:945-951. [PMID: 33507091 DOI: 10.2217/fca-2020-0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A longtime aspiration of interventional cardiologists remains to improve the long-term impact of stent permanence in coronaries to restore original vessel patency and physiological endothelium response. Bioresorbable vascular scaffolds were considered revolutionary in coronary devices, but several trials were disappointing; thus, the challenge in this field remains. DESolve is a novolimus-eluting poly-L lactide-based polymer scaffold that dissolves through a bio-reabsorption mechanism, vanishing completely in 2 years. Its ability to supply the necessary radial strength to support the vessel for the critical early months after delivery is an important feature showing a unique self-correction property, which reduces incomplete stent apposition. Overexpansion has a good, safe margin with DESolve. This review aims to provide an overview of this controversial topic.
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Affiliation(s)
- Pierluigi Demola
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Francesco Meucci
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Miroslava Stolcova
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Carlo Di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Alessio Mattesini
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
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Singh J, Pandey PM, Kaur T, Singh N. A comparative analysis of solvent cast 3D printed carbonyl iron powder reinforced polycaprolactone polymeric stents for intravascular applications. J Biomed Mater Res B Appl Biomater 2021; 109:1344-1359. [PMID: 33410262 DOI: 10.1002/jbm.b.34795] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022]
Abstract
In the present research, the effectiveness of developed methodology based on solvent cast 3D printing technique was investigated by printing the different geometries of the stents. The carbonyl iron powder (CIP) reinforced polycaprolactone (CIPC) was used to print three pre-existing stent designs such as ABBOTT BVS1.1, PALMAZ-SCHATZ, and ART18Z. The physicochemical behavior was analyzed by X-ray diffraction and scanning electron microscopy. The radial compression test, three-point bending test and stent deployment test were carried out to analyze the mechanical behavior. The degradation behavior of the stents was investigated in static as well as dynamic environment. To investigate the hemocompatible and cytocompatible behaviors of the stents, platelet adhesion test, hemolysis test, protein adsorption, in vitro cell viability test, and live/dead cell viability assay were performed. The results revealed that stents had the adequate mechanical properties to perform the necessary functions in the human coronary. The degradation studies showed slower degradation rate in the dynamic environment in comparison to static environment. in vitro biological analysis indicated that the stents represented excellent resistance to thrombosis, hemocompatible functions as well as cytocompatible nature. The results concluded that PALMAZ-SCHATZ stent represented better mechanical properties, cell viability, blood compatibility, and degradation behavior.
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Affiliation(s)
- Jasvinder Singh
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Pulak Mohan Pandey
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Tejinder Kaur
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Neetu Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
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38
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Lin S, Dong P, Zhou C, Dallan LAP, Zimin VN, Pereira GTR, Lee J, Gharaibeh Y, Wilson DL, Bezerra HG, Gu L. Degradation modeling of poly-l-lactide acid (PLLA) bioresorbable vascular scaffold within a coronary artery. NANOTECHNOLOGY REVIEWS 2020; 9:1217-1226. [PMID: 34012762 PMCID: PMC8130847 DOI: 10.1515/ntrev-2020-0093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In this work, a strain-based degradation model was implemented and validated to better understand the dynamic interactions between the bioresorbable vascular scaffold (BVS) and the artery during the degradation process. Integrating the strain-modulated degradation equation into commercial finite element codes allows a better control and visualization of local mechanical parameters. Both strut thinning and discontinuity of the stent struts within an artery were captured and visualized. The predicted results in terms of mass loss and fracture locations were validated by the documented experimental observations. In addition, results suggested that the heterogeneous degradation of the stent depends on its strain distribution following deployment. Degradation is faster at the locations with higher strains and resulted in the strut thinning and discontinuity, which contributes to the continuous mass loss, and the reduced contact force between the BVS and artery. A nonlinear relationship between the maximum principal strain of the stent and the fracture time was obtained, which could be transformed to predict the degradation process of the BVS in different mechanical environments. The developed computational model provided more insights into the degradation process, which could complement the discrete experimental data for improving the design and clinical management of the BVS.
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Affiliation(s)
- Shengmao Lin
- School of Civil Engineering and Architecture, Xiamen University of Technology, Xiamen, Fujian, 361024, China
| | - Pengfei Dong
- Department of Biomedical and Chemical Engineering, Florida Institute of Technology, Melbourne, FL 32901, United States of America
| | - Changchun Zhou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, China
| | - Luis Augusto P Dallan
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Vladislav N Zimin
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Gabriel T R Pereira
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States of America
| | - Juhwan Lee
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Yazan Gharaibeh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - David L Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, United States of America
| | - Hiram G Bezerra
- Interventional Cardiology Center, Heart and Vascular Institute, University of South Florida, Tampa, FL 33606, United States of America
| | - Linxia Gu
- Department of Biomedical and Chemical Engineering, Florida Institute of Technology, Melbourne, FL 32901, United States of America
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39
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40
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Yeazel TR, Becker ML. Advancing Toward 3D Printing of Bioresorbable Shape Memory Polymer Stents. Biomacromolecules 2020; 21:3957-3965. [PMID: 32924443 DOI: 10.1021/acs.biomac.0c01082] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stents have evolved significantly since their introduction to the medical field in the early 1980s, becoming widely used in percutaneous coronary interventions and following nephrological procedures. However, the current commercially available stents do not degrade and remain in the body forever, leading to problems like restenosis in cardiovascular applications or requiring removal procedures in ureteral applications. Efforts to replace metal with resorbable materials have largely been halted after the commercial failure of and safety concerns elicited by Abbott's Absorb stent in 2017. Industry continues to use common polymers such as poly(l-lactide) (PLLA) and polycaprolactone (PCL) for biomedical products, but due to the weak mechanical properties of these bioresorbable materials in comparison to metals, these devices have struggled to accomplish the goals set, increasing risk of thrombosis. 3D printing stents using bioresorbable and shape memory materials could provide a method of patient-personalized production, remove the need for balloon expansion, and limit stent migration, thus bringing a new age of stent technology. The investigation of a range of 3D-printable and bioresorbable shape-memory polymers can provide solutions to the shortcomings of previously explored bioresorbable stents and revitalize the medical device industry efforts into advancing stent technology.
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Affiliation(s)
- Taylor R Yeazel
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States
| | - Matthew L Becker
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina 27708, United States.,Departments of Chemistry, Biomedical Engineering, Orthopaedic Surgery, Duke University, Durham, North Carolina 27708, United States
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41
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Majewska P, Oledzka E, Sobczak M. Overview of the latest developments in the field of drug-eluting stent technology. Biomater Sci 2020; 8:544-551. [PMID: 31701961 DOI: 10.1039/c9bm00468h] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Angioplasty with stent implantation is considered to be the basic treatment method of stenosis of blood vessels. The process of stent implantation changed through the years, from stents made only from metals, produced from polymers, to biodegradable ones and those which elute drugs. The purpose of this review is to outline the development of this medical procedure and present the advantages and disadvantages of each type of stent.
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Affiliation(s)
- Paula Majewska
- Department of Biomaterials Chemistry, Chair of Analytical Chemistry and Biomaterials, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, 1 Banacha St., Warsaw 02-097, Poland.
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42
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Hua R, Tian Y, Cheng J, Wu G, Jiang W, Ni Z, Zhao G. The effect of intrinsic characteristics on mechanical properties of poly(l-lactic acid) bioresorbable vascular stents. Med Eng Phys 2020; 81:118-124. [PMID: 32482508 DOI: 10.1016/j.medengphy.2020.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/23/2020] [Accepted: 04/05/2020] [Indexed: 12/31/2022]
Abstract
Poly(L-lactic acid) (PLLA) is currently the bioresorbable polymer of choice for vascular stents with its superior biocompatibility and mechanical properties. However, it is still difficult to enhance the radial supporting capacity of PLLA stents without increasing the strut thickness. In this study, the performance of laser-cut thin-strut stents from two groups of PLLA tubes are investigated. We considered two groups of PLLA tubes. Group 1 indicates the longitudinally stretched from original 150-μm-thick tubes, and Group 2 indicates the directly thinned from original 150-μm-thick tubes. Three stages of mechanical tests were conducted in this study, which are defined as tensile tests of dog-bone specimens, radial loading tests of tubes and radial loading tests of stents. The results suggest that Group 2 has higher radial supporting capacity than Group 1 with the same wall thickness. This work serves as a basis for manufacturing thin-strut stents with sufficient radial supporting capacity.
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Affiliation(s)
- Rixin Hua
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing, 211189, China
| | - Yuan Tian
- 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
| | - Wei Jiang
- State Key Laboratory of Pollution Control and Resources Reuse, School of the Environment, Nanjing University, Nanjing, 210023, 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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43
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Toong DWY, Toh HW, Ng JCK, Wong PEH, Leo HL, Venkatraman S, Tan LP, Ang HY, Huang Y. Bioresorbable Polymeric Scaffold in Cardiovascular Applications. Int J Mol Sci 2020; 21:E3444. [PMID: 32414114 PMCID: PMC7279389 DOI: 10.3390/ijms21103444] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 12/12/2022] Open
Abstract
Advances in material science and innovative medical technologies have allowed the development of less invasive interventional procedures for deploying implant devices, including scaffolds for cardiac tissue engineering. Biodegradable materials (e.g., resorbable polymers) are employed in devices that are only needed for a transient period. In the case of coronary stents, the device is only required for 6-8 months before positive remodelling takes place. Hence, biodegradable polymeric stents have been considered to promote this positive remodelling and eliminate the issue of permanent caging of the vessel. In tissue engineering, the role of the scaffold is to support favourable cell-scaffold interaction to stimulate formation of functional tissue. The ideal outcome is for the cells to produce their own extracellular matrix over time and eventually replace the implanted scaffold or tissue engineered construct. Synthetic biodegradable polymers are the favoured candidates as scaffolds, because their degradation rates can be manipulated over a broad time scale, and they may be functionalised easily. This review presents an overview of coronary heart disease, the limitations of current interventions and how biomaterials can be used to potentially circumvent these shortcomings in bioresorbable stents, vascular grafts and cardiac patches. The material specifications, type of polymers used, current progress and future challenges for each application will be discussed in this manuscript.
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Affiliation(s)
- Daniel Wee Yee Toong
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
| | - Han Wei Toh
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Jaryl Chen Koon Ng
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Philip En Hou Wong
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Subramanian Venkatraman
- Materials Science and Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117575, Singapore;
| | - Lay Poh Tan
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
| | - Hui Ying Ang
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Yingying Huang
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
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Li X, Zhang W, Lin W, Qiu H, Qi Y, Ma X, Qi H, He Y, Zhang H, Qian J, Zhang G, Gao R, Zhang D, Ding J. Long-Term Efficacy of Biodegradable Metal-Polymer Composite Stents After the First and the Second Implantations into Porcine Coronary Arteries. ACS APPLIED MATERIALS & INTERFACES 2020; 12:15703-15715. [PMID: 32159942 DOI: 10.1021/acsami.0c00971] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A biodegradable coronary stent is expected to eliminate the adverse events of an otherwise eternally implanting material after vessel remodeling. Both biocorrodible metals and biodegradable polymers have been tried as the matrix of the new-generation stent. Herein, we utilized a metal-polymer composite material to combine the advantages of the high mechanical strength of metals and the adjustable degradation rate of polymers to prepare the biodegradable stent. After coating polylactide (PLA) on the surface of iron, the degradation of iron was accelerated significantly owing to the decrease of local pH resulting from the hydrolysis of PLA, etc. We implanted the metal-polymer composite stent (MPS) into the porcine artery and examined its degradation in vivo, with the corresponding metal-based stent (MBS) as a control. Microcomputed tomography (micro-CT), coronary angiography (CA), and optical coherence tomography (OCT) were performed to observe the stents and vessels during the animal experiments. The MPS exhibited faster degradation than MBS, and the inflammatory response of MPS was acceptable 12 months after implantation. Additionally, we implanted another MPS after 1-year implantation of the first MPS to investigate the result of the MPS in the second implantation. The feasibility of the biodegradable MPS in second implantation in mammals was also confirmed.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Wanqian Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen 518057, China
- R&D Center, Biotyx Medical (Shenzhen) Co., Ltd., Shenzhen 518109, China
| | - Wenjiao Lin
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen 518057, China
- R&D Center, Biotyx Medical (Shenzhen) Co., Ltd., Shenzhen 518109, China
| | - Hong Qiu
- Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yongli Qi
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Xun Ma
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Haiping Qi
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen 518057, China
- R&D Center, Biotyx Medical (Shenzhen) Co., Ltd., Shenzhen 518109, China
| | - Yao He
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Hongjie Zhang
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
| | - Jie Qian
- Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Gui Zhang
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen 518057, China
- R&D Center, Biotyx Medical (Shenzhen) Co., Ltd., Shenzhen 518109, China
| | - Runlin Gao
- Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Deyuan Zhang
- R&D Center, Lifetech Scientific (Shenzhen) Co., Ltd., Shenzhen 518057, China
- R&D Center, Biotyx Medical (Shenzhen) Co., Ltd., Shenzhen 518109, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai 200438, China
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Zheng JF, Qiu H, Tian Y, Hu XY, Luo T, Wu C, Tian Y, Tang Y, Song LF, Li L, Xu L, Xu B, Gao RL. Preclinical Evaluation of a Novel Sirolimus-Eluting Iron Bioresorbable Coronary Scaffold in Porcine Coronary Artery at 6 Months. JACC Cardiovasc Interv 2020; 12:245-255. [PMID: 30732729 DOI: 10.1016/j.jcin.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/30/2018] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the operability, 6-month efficacy, and safety of the novel sirolimus-eluting iron bioresorbable coronary scaffold (IBS) system compared with a cobalt-chromium everolimus-eluting stent (EES) (XIENCE Prime stent) in porcine coronary arteries. BACKGROUND Bioresorbable scaffolds have been considered the fourth revolution in percutaneous coronary intervention. However, the first-generation bioresorbable scaffold showed suboptimal results. METHODS Forty-eight IBS and 48 EES were randomly implanted into nonatherosclerotic swine. The operability, efficacy, and safety of the IBS and EES were evaluated using coronary angiography, optical coherence tomography, micro-computed tomography, scanning electron microscopy, and histopathologic evaluation at 7, 14, 28, 90, and 180 days after implantation. RESULTS The operability of the ultrathin IBS (∼70 μm) was comparable with that of the EES, except for its visibility. There was no statistically significant difference in area stenosis between the IBS and EES from 28 to 180 days. The IBS maintained its integrity up to 90 days without corrosion, while corrosion was observed in a few struts in 2 of 10 IBS at 180 days. The percentage of endothelialization of IBS was higher than that of XIENCE Prime stents within 14 days after implantation. The fibrin score was higher in the IBS group at 28 days but comparable with the EES group at 90 and 180 days. No scaffold or stent thrombosis was seen in either group. No abnormal histopathologic changes in scaffolded or stented vessel segments and 5 main remote organs were observed in either group. CONCLUSIONS Preclinical results suggest that the novel IBS has comparable operability, mid-term efficacy, and safety with the EES, and its corrosion profile in porcine coronary arteries is reasonable, which could support initial clinical study of the IBS.
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Affiliation(s)
- Jian-Feng Zheng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Qiu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
| | - Yuan Tian
- Urumqi Friendship Hospital, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xiao-Ying Hu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Tong Luo
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Tian
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Tang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Lai-Feng Song
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Li
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Liang Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Run-Lin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
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46
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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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47
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Jeżewski MP, Kubisa MJ, Eyileten C, De Rosa S, Christ G, Lesiak M, Indolfi C, Toma A, Siller-Matula JM, Postuła M. Bioresorbable Vascular Scaffolds-Dead End or Still a Rough Diamond? J Clin Med 2019; 8:E2167. [PMID: 31817876 PMCID: PMC6947479 DOI: 10.3390/jcm8122167] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
Percutaneous coronary interventions with stent-based restorations of vessel patency have become the gold standard in the treatment of acute coronary states. Bioresorbable vascular scaffolds (BVS) have been designed to combine the efficiency of drug-eluting stents (DES) at the time of implantation and the advantages of a lack of foreign body afterwards. Complete resolution of the scaffold was intended to enable the restoration of vasomotor function and reduce the risk of device thrombosis. While early reports demonstrated superiority of BVS over DES, larger-scale application and longer observation exposed major concerns about their use, including lower radial strength and higher risk of thrombosis resulting in higher rate of major adverse cardiac events. Further focus on procedural details and research on the second generation of BVS with novel properties did not allow to unequivocally challenge position of DES. Nevertheless, BVS still have a chance to present superiority in distinctive indications. This review presents an outlook on the available first and second generation BVS and a summary of results of clinical trials on their use. It discusses explanations for unfavorable outcomes, proposed enhancement techniques and a potential niche for the use of BVS.
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Affiliation(s)
- Mateusz P. Jeżewski
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Michał J. Kubisa
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Ceren Eyileten
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Salvatore De Rosa
- Department of Medical and Surgical Sciences, Division of Cardiology, “Magna Graecia” University, 88100 Catanzaro, Italy; (S.D.R.); (C.I.)
| | - Günter Christ
- Department of Cardiology, 5th Medical Department with Cardiology, Kaiser Franz Josef Hospital, 31100 Vienna, Austria;
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, 1061701 Poznań, Poland;
| | - Ciro Indolfi
- Department of Medical and Surgical Sciences, Division of Cardiology, “Magna Graecia” University, 88100 Catanzaro, Italy; (S.D.R.); (C.I.)
| | - Aurel Toma
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 231090 Vienna, Austria;
| | - Jolanta M. Siller-Matula
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 231090 Vienna, Austria;
| | - Marek Postuła
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
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48
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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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49
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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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50
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Nishi H, Ishii A, Ono I, Abekura Y, Ikeda H, Arai D, Yamao Y, Okawa M, Kikuchi T, Nakakura A, Miyamoto S. Biodegradable Flow Diverter for the Treatment of Intracranial Aneurysms: A Pilot Study Using a Rabbit Aneurysm Model. J Am Heart Assoc 2019; 8:e014074. [PMID: 31583935 PMCID: PMC6818033 DOI: 10.1161/jaha.119.014074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Herein, we report an in vivo study of a biodegradable flow diverter (BDFD) for aneurysm occlusion. Conceptually, BDFDs induce a temporal flow‐diverting effect and provide a vascular scaffold for neointimal formation at the neck of the aneurysm until occlusion. This offers several potential advantages, including a reduced risk of remote ischemic complications and more treatment options in case of device failure to occlude the aneurysm. Methods and Results A BDFD consisting of 48 poly‐l‐lactic acid wires with radiopaque markers at both ends was prepared. An in vitro degradation test of the BDFD was performed. Thirty‐six BDFDs were implanted in a rabbit aneurysm model. Digital angiography, optical coherence tomography, histopathology, and scanning electron microscopy were performed after 1, 3, and 6 months, and 1 year. The in vitro degradation test showed that the BDFD was almost degraded in 1.5 years. In the in vivo experiment, aneurysm occlusion rates were 0% at 1 month, 20% at 3 months, 50% at 6 months, and 33% at 1 year. Optical coherence tomography showed that luminal area stenosis was the highest at 3 months (16%) and decreased afterward. Immunohistochemical analysis showed that more than half of the luminal surface area was covered by endothelial cells at 1 month. Device fragmentation was not observed in any lesions. Conclusions This first in vivo study of a BDFD shows the feasibility of using BDFDs for treating aneurysms; however, a longer follow‐up is required for comprehensive evaluation of the biological and mechanical behavior peculiar to biodegradable devices.
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Affiliation(s)
- Hidehisa Nishi
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Akira Ishii
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Isao Ono
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yu Abekura
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Hiroyuki Ikeda
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan.,Department of Neurosurgery Fukui Red Cross Hospital Fukui Japan
| | - Daisuke Arai
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan.,Department of Neurosurgery Shizuoka General Hospital Shizuoka Japan
| | - Yukihiro Yamao
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masakazu Okawa
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
| | - Akiyoshi Nakakura
- Department of Biomedical Statistics and Bioinformatics Kyoto University Graduate School of Medicine Kyoto Japan
| | - Susumu Miyamoto
- Department of Neurosurgery Kyoto University Graduate School of Medicine Kyoto Japan
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