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Glushchenko L, Hubbard B, Sedush N, Shchepochkin V, Krupnin A, Sharafeev A. Novel Self-expanding Shape-Memory Bioresorbable Peripheral Stent Displays Efficient Delivery, Accelerated Resorption, and Low Luminal Loss in a Porcine Model. J Endovasc Ther 2023; 30:140-147. [PMID: 35142226 PMCID: PMC9896407 DOI: 10.1177/15266028221077001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE AND DESIGN The search for improved stenting technologies to treat peripheral artery disease is trending toward biodegradable self-expanding shape-memory stents that, as of now, still suffer from the acute trade-off between deliverability and luminal stability: Higher deliverability leads to lower lumen stability, vessel recoil, and stent breakage. This study was aimed at the development and testing of a self-expanding bioresorbable poly(l,l-lactide-co-ε-caprolactone) stent that was designed to produce confident self-expansion after efficient crimping, as well as quick bioresorption, and sufficient radial force. MATERIALS AND METHODS Bench tests were employed to measure shape-memory properties, radial force, and hydrolytic degradation of the stent. The porcine model was employed to study deliverability, lumen stability, biocompatibility, and stent integrity. A total of 32 stents were implanted in the iliac arteries of 16 pigs with 15 to 180 day follow-up periods. The stented vessels were studied by angiography and histological evaluation. RESULTS Recovery of the diameter of the stent due to shape-memory effect was equal to 90.6% after 6Fr crimping and storage in refrigeration for 1 week. Radial force measured after storage was equal to 0.7 N/mm. Technical success of implantation in pigs (after the delivery implemented by pusher) was 94%. At 180 days, no implanted stents were found to be fragmented: All of the devices remained at the site of implantation with no stent migration and all stents retained their luminal support. Only moderate inflammation and neoepithelialization were detected by histological assessment at 60, 90, 120, and 180 days. Lumen loss at 180 days was less than 25% of the vessel diameter. CONCLUSIONS The stent with the mechanical and chemical properties described in this study may present the optimal solution of the trade-off between deliverability and luminal stability that is necessary for designing the next generation stent for endovascular therapy of peripheral arterial disease.
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Affiliation(s)
- Leonid Glushchenko
- Resotech Medical Solutions Corp,
Delaware, USA,Leonid Glushchenko, Resotech Medical
Solutions Corp, 51 Little Falls Drive, the City of Wilmington, County of New
Castle, Delaware, 19808, USA.
| | - Brad Hubbard
- Pathway Preclinical Services,
Minneapolis, MN, USA
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Lu J, Hu X, Yuan T, Cao J, Zhao Y, Xiong C, Li K, Ye X, Xu T, Zhao J. 3D-Printed Poly (P-Dioxanone) Stent for Endovascular Application: In Vitro Evaluations. Polymers (Basel) 2022; 14:polym14091755. [PMID: 35566924 PMCID: PMC9103802 DOI: 10.3390/polym14091755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
Rapid formation of innovative, inexpensive, personalized, and quickly reproducible artery bioresorbable stents (BRSs) is significantly important for treating dangerous and sometimes deadly cerebrovascular disorders. It is greatly challenging to give BRSs excellent mechanical properties, biocompatibility, and bioabsorbability. The current BRSs, which are mostly fabricated from poly-l-lactide (PLLA), are usually applied to coronary revascularization but may not be suitable for cerebrovascular revascularization. Here, novel 3D-printed BRSs for cerebrovascular disease enabling anti-stenosis and gradually disappearing after vessel endothelialization are designed and fabricated by combining biocompatible poly (p-dioxanone) (PPDO) and 3D printing technology for the first time. We can control the strut thickness and vessel coverage of BRSs by adjusting the printing parameters to make the size of BRSs suitable for small-diameter vascular use. We added bis-(2,6-diisopropylphenyl) carbodiimide (commercial name: stabaxol®-1) to PPDO to improve its hydrolytic stability without affecting its mechanical properties and biocompatibility. In vitro cell experiments confirmed that endothelial cells can be conveniently seeded and attached to the BRSs and subsequently demonstrated good proliferation ability. Owing to the excellent mechanical properties of the monofilaments fabricated by the PPDO, the 3D-printed BRSs with PPDO monofilaments support desirable flexibility, therefore offering a novel BRS application in the vascular disorders field.
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Affiliation(s)
- Junlin Lu
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
| | - Xulin Hu
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu 610081, China; (X.H.); (K.L.)
| | - Tianyu Yuan
- State Key Laboratory for Turbulence and Complex Systems, Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China;
| | - Jianfei Cao
- School of Materials and Environmental Engineering, Chengdu Technology University, Chengdu 610041, China;
| | - Yuanli Zhao
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
| | - Chengdong Xiong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences, Chengdu 610041, China;
| | - Kainan Li
- Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu 610081, China; (X.H.); (K.L.)
| | - Xun Ye
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
| | - Tao Xu
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Bio-Intelligent Manufacturing and Living Matter Bioprinting Center, Research Institute of Tsinghua University in Shenzhen, Tsinghua University, Shenzhen 518057, China
- East China Institute of Digital Medical Engineering, Shangrao 334000, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
| | - Jizong Zhao
- Beijing Tiantan Hospital, Department of Neurosurgery, Capital Medical University, Beijing 100070, China; (J.L.); (Y.Z.)
- Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience, Beijing 100070, China
- Correspondence: (X.Y.); (T.X.); (J.Z.)
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Deng D, Tian Y, Liu M, Cheng J, Wu G, Zhang Y, Zhao G, Ni Z. Enhanced mechanical properties of poly(L‐lactide) braided stent with six‐arm poly(L‐lactide‐co‐ε‐caprolactone) coating cross‐linked by hexamethylene diisocyanate. POLYM ADVAN TECHNOL 2022. [DOI: 10.1002/pat.5668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Dongwen Deng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Yuan Tian
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Muqing Liu
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Jie Cheng
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Gensheng Wu
- School of Mechanical and Electronic Engineering Nanjing Forestry University Nanjing China
| | - Yi Zhang
- Center of Interventional Radiology & Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing China
| | - Gutian Zhao
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
| | - Zhonghua Ni
- School of Mechanical Engineering, Jiangsu Key Laboratory for Design and Manufacture of Micro‐Nano Biomedical Instruments Southeast University Nanjing China
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Sun J, Sun K, Bai K, Chen S, Zhao F, Wang F, Hong N, Hu H. Oversized composite braided biodegradable stents with post-dilatation for pediatric applications: mid-term results of a porcine study. Biomater Sci 2020; 8:5183-5195. [PMID: 32840505 DOI: 10.1039/d0bm00567c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Our aim was to apply a composite braided biodegradable stent (CBBS) made from poly p-dioxanone (PPDO) and polycaprolactone (PCL) as an alternative to metallic stents for the treatment of pediatric endovascular disease. CBBS properties after adjunctive post-dilatation were assessed using radial force testing. CBBS degradation was assessed using in vitro measurements. Self-expandable CBBSs (8 × 20 mm) were implanted in abdominal aortas with an oversizing ratio of 1.1-1.4 (group A, n = 12) and in common iliac arteries with an oversizing ratio >1.4 (group B, n = 12). Self-expandable metal WALLSTENTs (8 × 21 mm) were implanted in common iliac arteries with an oversizing ratio >1.4 and served as controls (group C, n = 12). Artery evaluations including angiography and histological examinations were performed at 1, 4, 6 and 12 months after stent implantation. Eight millimeter CBBSs delivered in 8Fr sheaths with adjunctive post-dilatation had properties similar to those of metallic benchmark stents and were degraded in 12 months, with mild to moderate inflammation-induced neointimal hyperplasia and vessel restenosis. Post-dilatation and oversizing are suggested when using CBBSs for polymeric strut tissue embedding and optimal wall apposition, but an overextended ratio should be avoided because of the induction of less-desirable neointimal hyperplasia. Mid-term outcomes of CBBSs with adjunctive post-dilatation were better than those of WALLSTENTs in a swine endovascular disease model.
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Affiliation(s)
- Jing Sun
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Fu Y, An Q, Cheng Y, Yang Y, Wang L, Zhang H, Ge Y, Li D, Zhang Y. A Textile Pile Debridement Material Consisting of Polyester Fibers for in Vitro Removal of Biofilm. Polymers (Basel) 2020; 12:polym12061360. [PMID: 32560399 PMCID: PMC7362169 DOI: 10.3390/polym12061360] [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: 05/05/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022] Open
Abstract
Biofilms formed on skin wound lead to inflammation and a delay of healing. In the present work, a novel textile pile debridement material was prepared and treated by plasma. Samples before and after plasma treatment were characterized by a series of methods, including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and water uptake capacity. Besides, mechanical, coagulation, and in vitro biofilm removal performances of the textile pile debridement material were evaluated, with a medical gauze as a control. The results demonstrate that the plasma treatment produced corrosions and oxygen-containing polar groups on the fiber surface, offering an enhanced water uptake capacity of the textile pile debridement material. In addition, compressive tests certify the mechanical performances of the textile pile debridement material in both dry and wet conditions. The results from a kinetic clotting time test suggest a favorable ability to promote blood coagulation. Furthermore, the results of an MTT cell viability assay, SEM, and confocal laser scanning microscopy (CLSM) illustrate that the textile pile debridement material demonstrates a more superior in vitro biofilm removal performance than medical gauze. All of these characterizations suggest that the textile pile debridement material can offer a feasible application for clinical wound debridement.
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Affiliation(s)
- Yijun Fu
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Qi An
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
| | - Yue Cheng
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
| | - Yumin Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education and Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226019, China;
| | - Lu Wang
- Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai 201620, China;
| | - Haifeng Zhang
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Yan Ge
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Dawei Li
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- Correspondence: (D.L.); (Y.Z.); Tel.: +86-513-8501-2837 (D.L.); +86-513-8501-2871 (Y.Z.)
| | - Yu Zhang
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
- Correspondence: (D.L.); (Y.Z.); Tel.: +86-513-8501-2837 (D.L.); +86-513-8501-2871 (Y.Z.)
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Qiu T, Jiang W, Yan P, Jiao L, Wang X. Development of 3D-Printed Sulfated Chitosan Modified Bioresorbable Stents for Coronary Artery Disease. Front Bioeng Biotechnol 2020; 8:462. [PMID: 32509747 PMCID: PMC7248363 DOI: 10.3389/fbioe.2020.00462] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/21/2020] [Indexed: 01/09/2023] Open
Abstract
Bioresorbable polymeric stents have attracted great interest for coronary artery disease because they can provide mechanical support first and then disappear within a desired time period. The conventional manufacturing process is laser cutting, and generally they are fabricated from tubular prototypes produced by injection molding or melt extrusion. The aim of this study is to fabricate and characterize a novel bioresorbable polymeric stent for treatment of coronary artery disease. Polycaprolactone (PCL) is investigated as suitable material for biomedical stents. A rotary 3D printing method is developed to fabricate the polymeric stents. Surface modification of polymeric stent is performed by immobilization of 2-N, 6-O-sulfated chitosan (26SCS). Physical and chemical characterization results showed that the surface microstructure of 3D-pinted PCL stents can be influenced by 26SCS modification, but no significant difference was observed for their mechanical behavior. Biocompatibility assessment results indicated that PCL and S-PCL stents possess good compatibility with blood and cells, and 26SCS modification can enhance cell proliferation. These results suggest that 3D printed PCL stent can be a potential candidate for coronary artery disease by modification of sulfated chitosan (CS).
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Affiliation(s)
- Tianyang Qiu
- Key Laboratory of Fundamental Science for Advanced Machining, Beijing Institute of Technology, Beijing, China
| | - Wei Jiang
- School of Mechanical Engineering, Beijing Institute of Technology, Beijing, China
| | - Pei Yan
- Key Laboratory of Fundamental Science for Advanced Machining, Beijing Institute of Technology, Beijing, China
| | - Li Jiao
- Key Laboratory of Fundamental Science for Advanced Machining, Beijing Institute of Technology, Beijing, China
| | - Xibin Wang
- Key Laboratory of Fundamental Science for Advanced Machining, Beijing Institute of Technology, Beijing, China
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Zhao F, Liu L, Yang Y, Wang F, Wang L. The Crimping and Expanding Performance of Self-Expanding Polymeric Bioresorbable Stents: Experimental and Computational Investigation. MATERIALS (BASEL, SWITZERLAND) 2018; 11:E2184. [PMID: 30400381 PMCID: PMC6266750 DOI: 10.3390/ma11112184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022]
Abstract
Abstract: Polymeric bioresorbable stents (PBRSs) are considered the most promising devices to treat cardiovascular diseases. However, the mechanical weakness still hampers their application. In general, PBRSs are crimped into small sheathes and re-expanded to support narrowed vessels during angioplasty. Accordingly, one of the most significant requirements of PBRSs is to maintain mechanical efficacy after implantation. Although a little research has focused on commercial balloon-expanding PBRSs, a near-total lack has appeared on self-expanding PBRSs and their deformation mechanisms. In this work, self-expanding, composite polymeric bioresorbable stents (cPBRSs) incorporating poly(p-dioxanone) (PPDO) and polycaprolactone (PCL) yarns were produced and evaluated for their in vitro crimping and expanding potential. Furthermore, the polymer time-reliable viscoelastic effects of the structural and mechanical behavior of the cPBRSs were analyzed using computational simulations. Our results showed that the crimping process inevitably decreased the mechanical resistance of the cPBRSs, but that this could be offset by balloon dilatation. Moreover, deformation mechanisms at the yarn level were discussed, and yarns bonded in the crossings showed more viscous behavior; this property might help cPBRSs to maintain their structural integrity during implantation.
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Affiliation(s)
- Fan Zhao
- College of Textiles, Donghua University, Shanghai 201620, China.
- Key laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Songjiang District, Shanghai 201620, China.
| | - Laijun Liu
- College of Textiles, Donghua University, Shanghai 201620, China.
- Key laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Songjiang District, Shanghai 201620, China.
| | - Yang Yang
- College of Textiles, Donghua University, Shanghai 201620, China.
| | - Fujun Wang
- College of Textiles, Donghua University, Shanghai 201620, China.
- Key laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Songjiang District, Shanghai 201620, China.
| | - Lu Wang
- College of Textiles, Donghua University, Shanghai 201620, China.
- Key laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Songjiang District, Shanghai 201620, China.
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