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Ribaudo JG, He K, Madira S, Young ER, Martin C, Lu T, Sacks JM, Li X. Sutureless vascular anastomotic approaches and their potential impacts. Bioact Mater 2024; 38:73-94. [PMID: 38699240 PMCID: PMC11061647 DOI: 10.1016/j.bioactmat.2024.04.003] [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: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Sutureless anastomotic devices present several advantages over traditional suture anastomosis, including expanded global access to microvascular surgery, shorter operation and ischemic times, and reduced costs. However, their adaptation for arterial use remains a challenge. This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation. These approaches include extraluminal couplers, intraluminal devices, and methods assisted by lasers or vacuums, with a particular emphasis on tissue adhesives. We analyze these devices for artery compatibility, material composition, potential for intimal damage, risks of thrombosis and restenosis, and complications arising from their deployment and maintenance. Additionally, we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques. Ideally, a sutureless anastomotic device or technique should eliminate the need for vessel eversion, mitigate thrombosis through either biodegradation or the release of antithrombotic drugs, and be easily deployable for broad use. The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.
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Affiliation(s)
- Joseph G. Ribaudo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Kevin He
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Sarah Madira
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Emma R. Young
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Cameron Martin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Tingying Lu
- Department of Plastic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Justin M. Sacks
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
| | - Xiaowei Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, MO, 63110, USA
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2
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Jang EH, Ryu JY, Kim JH, Lee J, Ryu W, Youn YN. Effect of sequential release of sirolimus and rosuvastatin using silk fibroin microneedle to prevent intimal hyperplasia. Biomed Pharmacother 2023; 168:115702. [PMID: 37837879 DOI: 10.1016/j.biopha.2023.115702] [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: 08/08/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023] Open
Abstract
Intimal hyperplasia (IH) is a major cause of vascular restenosis after bypass surgery, which progresses as a series of processes from the acute to chronic stage in response to endothelial damage during bypass grafting. A strategic localized drug delivery system that reflects the pathophysiology of IH and minimizes systemic side effects is necessary. In this study, the sequential release of sirolimus, a mechanistic target of rapamycin (mTOR) inhibitor, and statin, an HMG-COA inhibitor, was realized as a silk fibroin-based microneedle device in vivo. The released sirolimus in the acute stage reduced neointima (NI) and vascular fibrosis through mTOR inhibition. Furthermore, rosuvastatin, which was continuously released from the acute to chronic stage, reduced vascular stiffness and apoptosis through the inactivation of Yes-associated protein (YAP). The sequential release of sirolimus and rosuvastatin confirmed the synergistic treatment effects on vascular inflammation, VSMC proliferation, and ECM degradation remodeling through the inhibition of transforming growth factor (TGF)-beta/NF-κB pathway. These results demonstrate the therapeutic effect on preventing restenosis with sufficient vascular elasticity and significantly reduced IH in response to endothelial damage. Therefore, this study suggests a promising strategy for treating coronary artery disease through localized drug delivery of customized drug combinations.
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Affiliation(s)
- Eui Hwa Jang
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Ji-Yeon Ryu
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Jung-Hwan Kim
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - JiYong Lee
- School of Mechanical Engineering, Yonsei University, Seoul 03722, South Korea; Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - WonHyoung Ryu
- School of Mechanical Engineering, Yonsei University, Seoul 03722, South Korea
| | - Young-Nam Youn
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea.
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Chen X, Xia Y, Shen S, Wang C, Zan R, Yu H, Yang S, Zheng X, Yang J, Suo T, Gu Y, Zhang X. Research on the Current Application Status of Magnesium Metal Stents in Human Luminal Cavities. J Funct Biomater 2023; 14:462. [PMID: 37754876 PMCID: PMC10532415 DOI: 10.3390/jfb14090462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
The human body comprises various tubular structures that have essential functions in different bodily systems. These structures are responsible for transporting food, liquids, waste, and other substances throughout the body. However, factors such as inflammation, tumors, stones, infections, or the accumulation of substances can lead to the narrowing or blockage of these tubular structures, which can impair the normal function of the corresponding organs or tissues. To address luminal obstructions, stenting is a commonly used treatment. However, to minimize complications associated with the long-term implantation of permanent stents, there is an increasing demand for biodegradable stents (BDS). Magnesium (Mg) metal is an exceptional choice for creating BDS due to its degradability, good mechanical properties, and biocompatibility. Currently, the Magmaris® coronary stents and UNITY-BTM biliary stent have obtained Conformité Européene (CE) certification. Moreover, there are several other types of stents undergoing research and development as well as clinical trials. In this review, we discuss the required degradation cycle and the specific properties (anti-inflammatory effect, antibacterial effect, etc.) of BDS in different lumen areas based on the biocompatibility and degradability of currently available magnesium-based scaffolds. We also offer potential insights into the future development of BDS.
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Affiliation(s)
- Xiang Chen
- School of Medicine, Anhui University of Science and Technology, Huainan 232000, China;
| | - Yan Xia
- School of Stomatology, Anhui Medical College, Hefei 230601, China;
| | - Sheng Shen
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Chunyan Wang
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
- Department of General Surgery, Shanghai Xuhui Central Hospital, Shanghai 200031, China
| | - Rui Zan
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Han Yu
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
| | - Shi Yang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
| | - Xiaohong Zheng
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Jiankang Yang
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Tao Suo
- Department of Biliary Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; (S.S.); (R.Z.); (T.S.)
- Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai 200032, China;
| | - Yaqi Gu
- School of Medicine, Anhui University of Science and Technology, Huainan 232000, China;
- Department of Hepatopancreatobiliary Surgery, Huainan Xinhua Hospital Affiliated to Anhui University of Science and Technology, Huainan 232000, China; (X.Z.); (J.Y.)
| | - Xiaonong Zhang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; (H.Y.); (S.Y.)
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Bioabsorbable, elastomer-coated magnesium alloy coils for treating saccular cerebrovascular aneurysms. Biomaterials 2022; 290:121857. [DOI: 10.1016/j.biomaterials.2022.121857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 11/19/2022]
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Abbasnezhad N, Zirak N, Champmartin S, Shirinbayan M, Bakir F. An Overview of In Vitro Drug Release Methods for Drug-Eluting Stents. Polymers (Basel) 2022; 14:2751. [PMID: 35808798 PMCID: PMC9269075 DOI: 10.3390/polym14132751] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 01/08/2023] Open
Abstract
The drug release profile of drug-eluting stents (DESs) is affected by a number of factors, including the formulation, design, and physicochemical properties of the utilized material. DES has been around for twenty years and despite its widespread clinical use, and efficacy in lowering the rate of target lesion restenosis, it still requires additional development to reduce side effects and provide long-term clinical stability. Unfortunately, for analyzing these implants, there is still no globally accepted in vitro test method. This is owing to the stent's complexity as well as the dynamic arterial compartments of the blood and vascular wall. The former is the source of numerous biological, chemical, and physical mechanisms that are more commonly observed in tissue, lumen, and DES. As a result, universalizing bio-relevant apparatus, suitable for liberation testing of such complex implants is difficult. This article aims to provide a comprehensive review of the methods used for in vitro release testing of DESs. Aspects related to the correlation of the release profiles in the cases of in vitro and in vivo are also addressed.
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Affiliation(s)
- Navideh Abbasnezhad
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Nader Zirak
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Stéphane Champmartin
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
| | - Mohammadali Shirinbayan
- Arts et Métiers Institute of Technology, CNAM, PIMM, HESAM University, F-75013 Paris, France;
| | - Farid Bakir
- Arts et Métiers Institute of Technology, CNAM, LIFSE, HESAM University, F-75013 Paris, France; (N.Z.); (S.C.)
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Chang CJ, Chang CH, Hung TK. A Computational Pitting Corrosion Model of Magnesium Alloys. Front Bioeng Biotechnol 2022; 10:887444. [PMID: 35646850 PMCID: PMC9136027 DOI: 10.3389/fbioe.2022.887444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
Controlling the corrosion rate of implants to maintain mechanical properties during tissue healing is significant in developing magnesium alloy implants. In addition to surface treatment and material properties, the study of geometric alteration and mechanical strength are also vital for implant development. In this study, we developed a three-dimensional model for semi-autonomous computational pitting corrosion. It is based on the Monte Carlo method, modeling magnesium alloy implants toward clinical application. The corrosion probability is based on the number of exposed surfaces to saline and the oxidation characteristics of the elements. The computational results are well compared with the experimental measurement using micro-computed tomography (micro-CT) in 500 h. Subsequently, the computational analysis is extended to 3,000 h of corrosion analysis. The 3D model appears promising to assist the development of biodegradable implants.
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Affiliation(s)
- Chia-Jung Chang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Han Chang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Tin-Kan Hung
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Tin-Kan Hung,
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Wu J, Jin L, Tan JY, Chen XF, Wang QQ, Yuan GY, Chen TX. The effects of a biodegradable Mg-based alloy on the function of VSMCs via immunoregulation of macrophages through Mg-induced responses. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1292. [PMID: 34532429 PMCID: PMC8422083 DOI: 10.21037/atm-21-1375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/24/2021] [Indexed: 12/12/2022]
Abstract
Background Restenosis is one of the worst side effects of percutaneous coronary intervention (PCI) due to neointima formation resulting from the excessive proliferation and migration of vascular smooth muscle cells (VSMCs) and continuous inflammation. Biodegradable Mg-based alloy is a promising candidate material because of its good mechanical properties and biocompatibility, and biodegradation of cardiovascular stents. Although studies have shown reduced neointima formation after Mg-based CVS implantation in vivo, these findings were inconsistent with in vitro studies, demonstrating magnesium-mediated promotion of the proliferation and migration of VSMCs. Given the vital role of activated macrophage-driven inflammation in neointima formation, along with the well-demonstrated crosstalk between macrophages and VSMCs, we investigated the interactions of a biodegradable Mg-Nd-Zn-Zr alloy (denoted JDBM), which is especially important for cardiovascular stents, with VSMCs via macrophages. Methods JDBM extracts and MgCl2 solutions were prepared to study their effect on macrophages. To study the effects of the JDBM extracts and MgCl2 solutions on the function of VSMCs via immunoregulation of macrophages, conditioned media (CM) obtained from macrophages was used to establish a VSMC-macrophage indirect coculture system. Results Our results showed that both JDBM extracts and MgCl2 solutions significantly attenuated the inflammatory response stimulated by lipopolysaccharide (LPS)-activated macrophages and converted macrophages into M2-type cells. In addition, JDBM extracts and MgCl2 solutions significantly decreased the expression of genes related to VSMC phenotypic switching, migration, and proliferation in macrophages. Furthermore, the proliferation, migration, and proinflammatory phenotypic switching of VSMCs were significantly inhibited when the cells were incubated with CMs from macrophages treated with LPS + extracts or LPS + MgCl2 solutions. Conclusions Taken together, our results suggested that the magnesium in the JDBM extract could affect the functions of VSMCs through macrophage-mediated immunoregulation, inhibiting smooth muscle hyperproliferation to suppress restenosis after implantation of a biodegradable Mg-based stent.
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Affiliation(s)
- Jing Wu
- Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Allergy/Immunology Innovation Team, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Rheumatology/Immunology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liang Jin
- Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Rheumatology/Immunology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,College of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China.,School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Yun Tan
- Department of Vascular Surgery, Huashan Hospital of Fudan University, Shanghai, China
| | - Xia-Fang Chen
- Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Neonatology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Guang-Yin Yuan
- School of Biomedical Engineering, Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.,National Engineering Research Center of Light Alloys Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai, China
| | - Tong-Xin Chen
- Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Allergy/Immunology Innovation Team, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Rheumatology/Immunology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Lin LH, Lee HP, Yeh ML. Characterization of a Sandwich PLGA-Gallic Acid-PLGA Coating on Mg Alloy ZK60 for Bioresorbable Coronary Artery Stents. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5538. [PMID: 33291735 PMCID: PMC7730464 DOI: 10.3390/ma13235538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023]
Abstract
Absorbable magnesium stents have become alternatives for treating restenosis owing to their better mechanical properties than those of bioabsorbable polymer stents. However, without modification, magnesium alloys cannot provide the proper degradation rate required to match the vascular reform speed. Gallic acid is a phenolic acid with attractive biological functions, including anti-inflammation, promotion of endothelial cell proliferation, and inhibition of smooth muscle cell growth. Thus, in the present work, a small-molecule eluting coating is designed using a sandwich-like configuration with a gallic acid layer enclosed between poly (d,l-lactide-co-glycolide) layers. This coating was deposited on ZK60 substrate, a magnesium alloy that is used to fabricate bioresorbable coronary artery stents. Electrochemical analysis showed that the corrosion rate of the specimen was ~2000 times lower than that of the bare counterpart. The released gallic acid molecules from sandwich coating inhibit oxidation by capturing free radicals, selectively promote the proliferation of endothelial cells, and inhibit smooth muscle cell growth. In a cell migration assay, sandwich coating delayed wound closure in smooth muscle cells. The sandwich coating not only improved the corrosion resistance but also promoted endothelialization, and it thus has great potential for the development of functional vascular stents that prevent late-stent restenosis.
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Affiliation(s)
- Li-Han Lin
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan;
| | - Hung-Pang Lee
- Biomedical Engineering, Dwight Look College of Engineering, Texas A&M University, College Station, TX 77843, USA;
| | - Ming-Long Yeh
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan;
- Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan
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Sun Y, Wu H, Wang W, Zan R, Peng H, Zhang S, Zhang X. Translational status of biomedical Mg devices in China. Bioact Mater 2019; 4:358-365. [PMID: 31909297 PMCID: PMC6939060 DOI: 10.1016/j.bioactmat.2019.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022] Open
Abstract
Magnesium (Mg) and its alloys as temporary medical implants with biodegradable and properly mechanical properties have been investigated for a long time. There are already three kinds of biodegradable Mg implants which are approved by Conformite Europeene (CE) or Korea Food and Drug Administration (KFDA), but not China Food and Drug Administration (CFDA, now it is National Medical Products Administration, NMPA). As we know, Chinese researchers, surgeons, and entrepreneurs have tried a lot to research and develop biodegradable Mg implants which might become other new approved implants for clinical applications. So in this review, we present the representative Mg implants of three categories, orthopedic implants, surgical implants, and intervention implants and provide an overview of current achievement in China from academic publications and Chinese patents. We would like to provide a systematic way to translate Mg and its alloy implants from experiment designs to clinical products.
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Affiliation(s)
- Yu Sun
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Hongliu Wu
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Wenhui Wang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Rui Zan
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Hongzhou Peng
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Shaoxiang Zhang
- Suzhou Origin Medical Technology Co. Ltd., Suzhou, 215513, China
| | - Xiaonong Zhang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- Suzhou Origin Medical Technology Co. Ltd., Suzhou, 215513, China
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