Polyurethane thermoplastic elastomers with inherent radiopacity for biomedical applications

Modification of Polyvinyl Chloride Composites for Radiographic Detection of Polyvinyl Chloride Retained Surgical Items

The ever-present risk of surgical items being retained represents a real medical peril for the patient and potential liability issues for medical staff. Radiofrequency scanning technology is a very good means to substantially reduce such accidents. Radiolucent medical-grade polyvinyl chloride (PVC) used for the production of medical items is filled with radiopaque agents to enable X-ray visibility. The present study proves the suitability of bismuth oxychloride (BiOCl) and documents its advantages over the classical radiopaque agent barium sulfate (BaSO₄). An addition of BiOCl exhibits excellent chemical and physical stability (no leaching, thermo-mechanical properties) and good dispersibility within the PVC matrix. As documented, using half the quantity of BiOCl compared to BaSO₄ will provide a very good result. The conclusions are based on the methods of rotational rheometry, scanning electron microscopy, dynamic mechanical analysis, atomic absorption spectroscopy, and the verification of zero leaching of BiOCl out of a PVC matrix. X-ray images of the studied materials are presented, and an optimal concentration of BiOCl is evaluated.

Radiopaque scaffolds based on electrospun iodixanol/polycaprolactone fibrous composites

Grafts based on biodegradable polymer scaffolds are increasingly used in tissue-engineering applications as they facilitate natural tissue regeneration. However, monitoring the position and integrity of these scaffolds over time is challenging due to radiolucency. In this study, we used an electrospinning method to fabricate biodegradable scaffolds based on polycaprolactone (PCL) and iodixanol, a clinical contrast agent. Scaffolds were implanted subcutaneously into C57BL/6 mice and monitored in vivo using longitudinal X-ray imaging and micro-computed tomography (CT). The addition of iodixanol altered the physicochemical properties of the PCL scaffold; notably, as the iodixanol concentration increased, the fiber diameter decreased. Radiopacity was achieved with corresponding signal enhancement as iodine concentration increased while exhibiting a steady time-dependent decrease of 0.96% per day in vivo. The electrospun scaffolds had similar performance with tissue culture-treated polystyrene in supporting the attachment, viability, and proliferation of human mesenchymal stem cells. Furthermore, implanted PCL-I scaffolds had more intense acute inflammatory infiltrate and thicker layers of maturing fibrous tissue. In conclusion, we developed radiopaque, biodegradable, biocompatible scaffolds whose position and integrity can be monitored noninvasively. The successful development of other imaging enhancers may further expand the use of biodegradable scaffolds in tissue engineering applications.

In Vitro Biocompatibility, Radiopacity, and Physical Property Tests of Nano-Fe₃O₄ Incorporated Poly-l-lactide Bone Screws

The aim of this study was to fabricate biodegradable poly-l-lactic acid (PLLA) bone screws containing iron oxide (Fe₃O₄) nanoparticles, which are radiopaque and 3D-printable. The PLLA composites were fabricated by loading 20%, 30%, and 40% Fe₃O₄ nanoparticles into the PLLA. The physical properties, including elastic modulus, thermal properties, and biocompatibility of the composites were tested. The 20% nano-Fe₃O₄/PLLA composite was used as the material for fabricating the 3D-printed bone screws. The mechanical performance of the nano-Fe₃O₄/PLLA bone screws was evaluated by anti-bending and anti-torque strength tests. The tissue response and radiopacity of the nano-Fe₃O₄/PLLA bone screws were assessed by histologic and CT imaging studies using an animal model. The addition of nano-Fe₃O₄ increased the crystallization of the PLLA composites. Furthermore, the 20% nano-Fe₃O₄/PLLA composite exhibited the highest thermal stability compared to the other Fe₃O₄ proportions. The 3D-printed bone screws using the 20% nano-Fe₃O₄/PLLA composite provided excellent local tissue response. In addition, the radiopacity of the 20% nano-Fe₃O₄/PLLA screw was significantly better compared with the neat PLLA screw.

Effect of cooling induced crystallization upon the properties of segmented thermoplastic polyurethanes

An investigation on the cooling-induced crystallization in three thermoplastic polyurethanes based on MDI, PTMG, and 1.4-BD as chain extender with different hard segment content is reported. Thermal transitions were determined using differential scanning calorimetry (DSC) measurements at different cooling rates, and thermal stability was studied by thermogravimetric analysis. Changes in Raman spectra were useful to correlate the thermal transitions with changes in the morphology of the polymers. The dissimilarity in the composition gave different rheological behavior in the molten state, indicated by the temperature dependence of the viscosity. The mechanical properties and the crystallinity was influenced not only by the cooling rate but also by the hard segment content. Thermoplastic polyurethanes with more hard segment content formed more crystalline hard domains as evidenced by the DSC and atomic force microscopy results.

X-ray visible and doxorubicin-loaded beads based on inherently radiopaque poly(lactic acid)-polyurethane for chemoembolization therapy

The aim of current study was to develop drug-loaded polymeric beads with intrinsic X-ray visibility as embolic agents, targeting for noninvasive intraoperative location and postoperative examination during chemoembolization therapy. To endow polymer with inherent radiopacity, 4,4'-isopropylidinedi-(2,6-diiodophenol) (IBPA) was firstly synthesized and employed as a contrast agent, and then a set of radiopaque iodinated poly(lactic acid)-polyurethanes (I-PLAUs) via chain extender method were synthesized and characterized. These I-PLAU copolymers possessed sufficient radiopacity, in vitro non-cytotoxicity with human adipose-derived stem cells, and in vivo biocompatibility and degradability in rabbit model via intramuscular implantation. Doxorubicin (DOX), as a chemotherapeutic agent, was further incorporated into I-PLAU beads via a double emulsification (W/O/W) method. For drug release, two ratios of DOX-loaded I-PLAU beads exhibited calibrated size (200-550μm), porous internal structure, good X-ray visibility, evenly drug loading as well as tunable drug release. A preliminary test on in vitro tumor cell toxicity demonstrated that the DOX-loaded I-PLAU beads performed efficient anti-tumor effect. This study highlights novel X-ray visible drug-loaded I-PLAU beads used as promising embolic agents for non-invasive in situ X-ray tracking and efficient chemotherapy, which could bring opportunities to the next generation of multifunctional embolic agents.

Theranostic Bioabsorbable Bone Fixation Plate with Drug-Layered Double Hydroxide Nanohybrids

A bioabsorbable polymeric bone plate enabled with both diagnostic and therapeutic functionalities (radiopacity and sustained drug release, respectively) is proposed. To this end, a drug-inorganic nanohybrid (RS-LDH) is examined as a theranostic agent by intercalating an anti-resorptive bone remodeling drug, risedronate (RS) into a layered double hydroxide (LDH) via an ion-exchange reaction. The RS-LDH is prepared as a sheet with a biodegradable polymer, poly(lactic-co-glycolic acid), and is then attached onto the clinically approved bioabsorbable bone plate to produce the theranostic plate. Because of the presence of the metals in the LDH, the theranostic plate results in discernible in vivo X-ray images for up to four weeks after implantation. Concurrently, bone regeneration is also significantly improved compared with the other control groups, likely because of this material's sustained drug-release property. The theranostic plate is also largely biocompatible, similar to the plate already approved for clinical use. It is concluded that the combination of a biodegradable bone plate with RS-LDH nanohybrids can constitute a promising system with theranostic ability in both X-ray diagnosis and expedited bone repair.

Tungsten-loaded SMP foam nanocomposites with inherent radiopacity and tunable thermo-mechanical properties

Shape memory polymer (SMP) foams have been developed for use in neurovascular occlusion applications. These materials are predominantly polyurethanes that are known for their biocompatibility and tunable properties. However, these polymers inherently lack X-ray visibility, which is a significant challenge for their use as implantable materials. Herein, low density, highly porous shape memory polyurethane foams were developed with tungsten nanoparticles dispersed into the foam matrix, at increasing concentrations, to serve as a radiopaque agent. Utilizing X-ray fluoroscopy sufficient visibility of the foams at small geometries was observed. Thermal characterization of the foams indicated altered thermal response and delayed foam actuation with increasing nanoparticle loading (because of restricted network mobility). Mechanical testing indicated decreased toughness and strength for higher loading because of disruption of the SMP matrix. Overall, filler addition imparted x-ray visibility to the SMP foams and allowed for tuned control of the transition temperature and actuation kinetics for the material.

Mono- and triiodophenyl isocyanate as radiopacifying agents for methacrylate-based copolymers; biocompatibility and non-toxicity

New radiopaque acrylic copolymers were prepared via the copolymerization of methyl methacrylate (MMA) and acrylic acid (AA).

Nucleated nanocomposites of TPU–PDMS blends based on spherical nanohydroxyapatite

The present investigation gives a profound insight into the preparation of nucleated nanocomposites of TPU–PDMS blends based on uniquely synthesized PPG-wrapped spherical nanohydroxyapatite (nHap).

Development and Testing of X-Ray Imaging-Enhanced Poly-L-Lactide Bone Screws

Nanosized iron oxide particles exhibit osteogenic and radiopaque properties. Thus, iron oxide (Fe₃O₄) nanoparticles were incorporated into a biodegradable polymer (poly-L-lactic acid, PLLA) to fabricate a composite bone screw. This multifunctional, 3D printable bone screw was detectable on X-ray examination. In this study, mechanical tests including three-point bending and ultimate tensile strength were conducted to evaluate the optimal ratio of iron oxide nanoparticles in the PLLA composite. Both injection molding and 3D printing techniques were used to fabricate the PLLA bone screws with and without the iron oxide nanoparticles. The fabricated screws were implanted into the femoral condyles of New Zealand White rabbits. Bone blocks containing the PLLA screws were resected 2 and 4 weeks after surgery. Histologic examination of the surrounding bone and the radiopacity of the iron-oxide-containing PLLA screws were evaluated. Our results indicated that addition of iron oxide nanoparticles at 30% significantly decreased the ultimate tensile stress properties of the PLLA screws. The screws with 20% iron oxide exhibited strong radiopacity compared to the screws fabricated without the iron oxide nanoparticles. Four weeks after surgery, the average bone volume of the iron oxide PLLA composite screws was significantly greater than that of PLLA screws without iron oxide. These findings suggested that biodegradable and X-ray detectable PLLA bone screws can be produced by incorporation of 20% iron oxide nanoparticles. Furthermore, these screws had significantly greater osteogenic capability than the PLLA screws without iron oxide.

Examination of radio-opacity enhancing additives in shape memory polyurethane foams

Three microparticle additives, tungsten (W), zirconium oxide (ZrO2), and barium sulfate (BaSO4) were selected to enhance the radio-opacity in shape memory polymer (SMP) foam biomaterials. The addition of filler causes no significant alterations of glass transition temperatures, density of the materials increases, pore diameter decreases, and total volume recovery decreases from approximately 70 times in unfilled foams to 20 times (4% W and 10% ZrO2). The addition of W increases time to recovery; ZrO2 causes little variation in time to shape recovery; BaSO4 increases the time to recovery. On a 2.00 mean X-ray density (mean X.D.) scale, a GDC coil standard has a mean X.D. of 0.62; 4% W enhances the mean X.D. to 1.89, 10% ZrO2 to 1.39 and 4% BaSO4 to 0.74. Radio-opacity enhancing additives could be used to produce SMP foams with controlled shape memory kinetics, low density, and enhanced X-ray opacity for medical materials.

Radiopaque poly(ε-caprolactone) as additive for X-ray imaging of temporary implantable medical devices

A family of radiopaque PCL, poly(ε-caprolactone-co-α-triiodobenzoate-ε-caprolactone), has been designed, used and evaluated as macromolecular contrast agent for X-ray imaging of implantable polymeric biomaterials.

Intrinsically radiopaque polyurethanes with chain extender 4,4'-isopropylidenebis [2-(2,6-diiodophenoxy)ethanol] for biomedical applications

Radiopaque polyurethanes are used for medical applications as it allows post-operative assessment of the biomaterial devices using X-ray. Inherently, radiopaque polyurethanes based on polytetramethylene glycol (PTMG), polypropylene glycol, 4,4'-methylenebis(phenyl isocyanate), and a new iodinated chain extender 4,4'-isopropylidenebis[2-(2,6-diiodophenoxy)ethanol] with flexible spacers were synthesized and characterized. The iodinated polyurethanes were clear, optically transparent, and had high molecular weights. The polyurethanes also possessed excellent radiopacity and high thermal stability. The biocompatibility of the most promising iodinated polyurethane was evaluated both in vitro (cytotoxicity evaluation by direct contact and MTT assay, using L929 mouse fibroblast cells) and in vivo (toxicology studies in rabbits and subcutaneous implantation in rats). The material was nontoxic and well tolerated by the animals. Thus, these radiopaque and transparent polyurethanes are expected to have potential for various biomedical applications.

Biodegradable radiopaque iodinated poly(ester urethane)s containing poly(ε-caprolactone) blocks: synthesis, characterization, and biocompatibility

Biodegradable radiopaque iodinated poly(ester-urethane) (I-PU), consisting of poly(ε-caprolactone) (PCL) diol and iodinated bisphenol A (IBPA), has been successfully synthesized via a coupling reaction of PCL-diisocyanate and IBPA with varying compositions. The IBPA with four iodine atoms per molecule was applied as a chain extender to endow the I-PUs with intrinsic X-ray visibility. The chemical structure and molecular weights of I-PUs were characterized by Fourier transform infrared spectroscopy (FT-IR), proton-nuclear magnetic resonance, and gel permeation chromatography (GPC). The effects of IBPA on the physical properties of I-PUs were systematically studied by means of differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and wide-angle X-ray diffraction (WAXD). The DSC results showed that the crystallization of PCL segments in I-PUs was restrained with increasing amount of IBPA, which was also confirmed by WAXD. In the X-radiography analysis, all the synthesized I-PUs exhibited high radiopacity compared with an aluminum wedge of equivalent thickness. Enzymatic degradation tests showed that the incorporation of IBPA prolonged the degradation of I-PUs and distinct mass loss and degradation happened in the third month. Basic cytocompatibility conducted using rat adipose-derived cells proved that all the I-PUs and their biodegradation products were nontoxic. The radiopaque I-PUs is expected to possess a significant advantage over the traditional polymer counterparts in some related biomedical fields.