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Biomechanical Challenges to Polymeric Biodegradable Stents.

Abstract：

:Biodegradable implants have demonstrated clinical success in simple applications (e.g., absorbable sutures) and have shown great potential in many other areas of interventional medicine, such as localized drug delivery, engineered tissue scaffolding, and structural implants. For endovascular stenting and musculoskeletal applications, they can serve as temporary mechanical support that provides a smooth stress-transfer from the degradable implant to the healing tissue. However, for more complex device geometries, in vivo environments, and evolving load-bearing functions, such as required for vascular stents, there are considerable challenges associated with the use of biodegradable materials. A biodegradable stent must restore blood flow and provide support for a predictable appropriate period to facilitate artery healing, and subsequently, fail safely and be absorbed in a controllable manner. Biodegradable polymers are typically weaker than metals currently employed to construct stents, so it is difficult to ensure sufficient strength to keep the artery open and alleviate symptoms acutely while keeping other design parameters within clinically acceptable ranges. These design challenges are serious, given the general lack of understanding of biodegradable polymer behavior and evolution in intimal operating conditions. The modus operandi is mainly empirical and relies heavily on trial-and-error methodologies burdened by difficult, resource-expensive, and time-consuming experiments. We are striving for theoretical advancements systematizing the empirical knowledge into rational frameworks that could be cast into in silico tools for simulation and product development optimization. These challenges are evident when one considers that there are no biodegradable stents on the US market despite more than 30 years of development efforts (and currently only a couple with CE mark). This review summarizes previous efforts at implementing biodegradable stents, discusses the specific challenges involved, and presents recently developed material-modeling frameworks that can benefit this exciting field.

journal_name

Ann Biomed Eng

journal_title

Annals of biomedical engineering

authors

Soares JS,Moore JE Jr

doi

10.1007/s10439-015-1477-2

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

560-79

issue

eissn

0090-6964

issn

1573-9686

pii

10.1007/s10439-015-1477-2

journal_volume

pub_type

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Biomechanical Challenges to Polymeric Biodegradable Stents.