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Liu D, Yang K, Chen S. Development and Future Trends of Protective Strategies for Magnesium Alloy Vascular Stents. MATERIALS (BASEL, SWITZERLAND) 2023; 17:68. [PMID: 38203922 PMCID: PMC10779993 DOI: 10.3390/ma17010068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/09/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
Magnesium alloy stents have been extensively studied in the field of biodegradable metal stents due to their exceptional biocompatibility, biodegradability and excellent biomechanical properties. Nevertheless, the specific in vivo service environment causes magnesium alloy stents to degrade rapidly and fail to provide sufficient support for a certain time. Compared to previous reviews, this paper focuses on presenting an overview of the development history, the key issues, mechanistic analysis, traditional protection strategies and new directions and protection strategies for magnesium alloy stents. Alloying, optimizing stent design and preparing coatings have improved the corrosion resistance of magnesium alloy stents. Based on the corrosion mechanism of magnesium alloy stents, as well as their deformation during use and environmental characteristics, we present some novel strategies aimed at reducing the degradation rate of magnesium alloys and enhancing the comprehensive performance of magnesium alloy stents. These strategies include adapting coatings for the deformation of the stents, preparing rapid endothelialization coatings to enhance the service environment of the stents, and constructing coatings with self-healing functions. It is hoped that this review can help readers understand the development of magnesium alloy cardiovascular stents and solve the problems related to magnesium alloy stents in clinical applications at the early implantation stage.
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Affiliation(s)
- Dexiao Liu
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Shenyang 110016, China
| | - Ke Yang
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Shanshan Chen
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
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2
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Wang L, Zhang D, Zhan W, Zeng Z, Yin J, Wang K, Wang H, Song L, Gu Z, Guo C, Zhong Q, Wang W, Rong X, Bei W, Guo J. Chinese medicine Fufang Zhenzhu Tiaozhi capsule ameliorates coronary atherosclerosis in diabetes mellitus-related coronary heart disease minipigs. Biomed Pharmacother 2022; 156:113831. [PMID: 36228370 DOI: 10.1016/j.biopha.2022.113831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Diabetes mellitus-related coronary heart disease (DM-CHD) is the most common cause of death in diabetic patients. Various studies have shown that Chinese medicine Fufang-Zhenzhu-Tiaozhi capsule (FTZ) has therapeutic effects on cardiovascular diseases. More research is required to determine the mechanism of FTZ protection against coronary atherosclerosis. OBJECTIVE To investigate the unique mechanism of FTZ in treatment of DM-CHD minipigs with coronary atherosclerosis. METHODS High-fat/high-sucrose/high-cholesterol diet combined with streptozotocin and coronary balloon injury were used to induce DM-CHD minipig model, which was then randomly divided into: DM-CHD model, DM-CHD treated with FTZ or positive drug (Metformin + Atorvastatin, M+A). After twenty-two weeks, ultrasonography, electrocardiography, and image detection were employed to detect cardiac functions and assess coronary artery stenosis and plaque. Human umbilical vein endothelial cells (HUVECs) were treated high glucose or/and FTZ. Pigs tissues and treated-cells were collected for further testing. RESULTS In DM-CHD minipigs, FTZ treatment significantly reduced disordered glycolipid metabolism similar as M+A administration. FTZ and M+A also alleviated coronary stenosis and myocardial injury. In addition, IκB and NF-κB phosphorylation levels, as well as the protein levels of IL-1β, Bax, cleave-Caspase 3, Bcl-2, and α-SMA were dramatically increased in the DM-CHD coronary artery, whereas CD31 and VE-cadherin expressions were decreased. Similar to M+A, FTZ reversed these protein levels in the DM-CHD coronary artery. Furthermore, FTZ ameliorated the damage and high migration activity of HUVECs induced by high glucose. CONCLUSIONS FTZ improves coronary atherosclerosis through modulating inflammation, alleviating apoptosis, and inhibiting EndMT of coronary artery to protects against DM-CHD.
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Affiliation(s)
- Lexun Wang
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Dongxing Zhang
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Wenjing Zhan
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Zhihuan Zeng
- Department of Cardiology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, Guangdong, China
| | - Jianying Yin
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Ke Wang
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Hong Wang
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Lixia Song
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Zhanhui Gu
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Caijuan Guo
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Qin Zhong
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Weixuan Wang
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Xianglu Rong
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Weijian Bei
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China.
| | - Jiao Guo
- Institute of Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China; Key Unit of Modulating Liver to Treat Hyperlipemia SATCM (State Administration of Traditional Chinese Medicine), SATCM Level 3 Lab of Lipid Metabolism, Guangzhou 510006, China; Guangdong TCM Key Laboratory of Metabolic Diseases, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China.
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Leng J, Zhang J, Li C, Shu C, Wang B, Lin R, Liang Y, Wang K, Shen L, Lam KH, Xie Z, Gong X, Ge J, Song L. Multi-spectral intravascular photoacoustic/ultrasound/optical coherence tomography tri-modality system with a fully-integrated 0.9-mm full field-of-view catheter for plaque vulnerability imaging. BIOMEDICAL OPTICS EXPRESS 2021; 12:1934-1946. [PMID: 33996208 PMCID: PMC8086469 DOI: 10.1364/boe.420724] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 05/15/2023]
Abstract
Myocardial infarctions are most often caused by the so-called vulnerable plaques, usually featured as non-obstructive lesions with a lipid-rich necrotic core, thin-cap fibroatheroma, and large plaque size. The identification and quantification of these characteristics are the keys to evaluate plaque vulnerability. However, single modality intravascular methods, such as intravascular ultrasound, optical coherence tomography and photoacoustic, can hardly achieve all the comprehensive information to satisfy clinical needs. In this paper, for the first time, we developed a novel multi-spectral intravascular tri-modality (MS-IVTM) imaging system, which can perform 360° continuous rotation and pull-backing with a 0.9-mm miniature catheter and achieve simultaneous acquisition of both morphological characteristics and pathological compositions. Intravascular tri-modality imaging demonstrates the ability of our MS-IVTM system to provide macroscopic and microscopic structural information of the vessel wall, with identity and quantification of lipids with multi-wavelength excitation. This study offers clinicians and researchers a novel imaging tool to facilitate the accurate diagnosis of vulnerable atherosclerotic plaques. It also has the potential of clinical translations to help better identify and evaluate high-risk plaques during coronary interventions.
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Affiliation(s)
- Ji Leng
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Equal contribution
| | - Jinke Zhang
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Equal contribution
| | - Chenguang Li
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
- Equal contribution
| | - Chengyou Shu
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Boquan Wang
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Riqiang Lin
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yanmei Liang
- Institute of Modern Optics, Nankai University, Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Tianjin, 300350, China
| | - Keqiang Wang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Li Shen
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kwok-Ho Lam
- Department of Electrical Engineering, Research Institute for Smart Energy, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Zhihua Xie
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiaojing Gong
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liang Song
- Research Center for Biomedical Optics and Molecular Imaging, Shenzhen Key Laboratory for Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Optical Imaging Technology, CAS Key Laboratory of Health Informatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
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Bian D, Zhou X, Liu J, Li W, Shen D, Zheng Y, Gu W, Jiang J, Li M, Chu X, Ma L, Wang X, Zhang Y, Leeflang S, Zhou J. Degradation behaviors and in-vivo biocompatibility of a rare earth- and aluminum-free magnesium-based stent. Acta Biomater 2021; 124:382-397. [PMID: 33508506 DOI: 10.1016/j.actbio.2021.01.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 12/14/2022]
Abstract
Biodegradable stents can provide scaffolding and anti-restenosis benefits in the short term and then gradually disappear over time to free the vessel, among which the Mg-based biodegradable metal stents have been prosperously developed. In the present study, a Mg-8.5Li (wt.%) alloy (RE- and Al-free) with high ductility (> 40%) was processed into mini-tubes, and further fabricated into finished stent through laser cutting and electropolishing. In-vitro degradation test was performed to evaluate the durability of this stent before and after balloon dilation. The influence of plastic deformation and residual stress (derived from the dilation process) on the degradation was checked with the assistance of finite element analysis. In addition, in-vivo degradation behaviors and biocompatibility of the stent were evaluated by performing implantation in iliac artery of minipigs. The balloon dilation process did not lead to deteriorated degradation, and this stent exhibited a decent degradation rate (0.15 mm/y) in vitro, but divergent result (> 0.6 mm/y) was found in vivo. The stent was almost completely degraded in 3 months, revealing an insufficient scaffolding time. Meanwhile, it did not induce possible thrombus, and it was tolerable by surrounding tissues in pigs. Besides, endothelial coverage in 1 month was achieved even under the severe degradation condition. In the end, the feasibility of this stent for treatment of benign vascular stenosis was generally discussed, and perspectives on future improvement of Mg-Li-based stents were proposed.
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Affiliation(s)
- Dong Bian
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Xiaochen Zhou
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Jianing Liu
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Wenting Li
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Danni Shen
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Yufeng Zheng
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China; Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China.
| | - Wenda Gu
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Jingjun Jiang
- Department of Vascular Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Mei Li
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Xiao Chu
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Limin Ma
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Xiaolan Wang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yu Zhang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Sander Leeflang
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands
| | - Jie Zhou
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands
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Menze R, Wittchow E. In vitro and in vivo evaluation of a novel bioresorbable magnesium scaffold with different surface modifications. J Biomed Mater Res B Appl Biomater 2021; 109:1292-1302. [PMID: 33386677 PMCID: PMC8359236 DOI: 10.1002/jbm.b.34790] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/19/2020] [Accepted: 12/19/2020] [Indexed: 12/29/2022]
Abstract
The novel Resoloy® rare earth magnesium alloy was developed for bioresorbable vascular implant application, as an alternative to the WE43 used in Biotronik's Magmaris scaffold, which received CE approval in 2016. Initially, the Magmaris showed very promising preclinical and clinical results, but the formation of an unexpected conversion product and a too fast loss of integrity has proven to be a flaw. The safety and efficacy of Resoloy, which is intended to be bioresorbed without any remnants, has been investigated in an in vitro degradation study and a porcine coronary animal model. Four different groups of scaffolds composed of Resoloy (Res) as the backbone material and additionally equipped with a fluoride passivation layer (Res‐F), a polyester topcoat (Res‐P), or a duplex layer composed of a fluoride passivation layer and a polymeric topcoat (Res‐PF) were compared to a Magmaris scaffold in an in vitro degradation test. Preclinical safety and efficacy of Res‐F and Res‐PF were subsequently evaluated in a coronary porcine model for 12 and 28 days. Scanning electron microscope, quantitative coronary angiography, micro‐computed tomography, histopathology, and histomorphometry analyses were conducted to evaluate preclinical parameters and degradation behavior of the scaffolds. Res‐PF with a duplex layer shows the slowest degradation and the longest supporting force of all test groups. The in vitro data are confirmed by the results of the in vivo study, in which Res‐PF exhibited a longer supporting force than Res‐F, but also caused higher neointima formation. Both studied groups showed excellent biocompatibility. A starter colonization of the strut area with cells during bioresorption was observed. The in vitro degradation test shows that a combination of MgF2 passivation and a PLLA topcoat on a Resoloy magnesium backbone (Res‐PF) leads to a much slower degradation and a longer support time than a Magmaris control group. In a preclinical study, the safety and efficacy of this duplex layer could be demonstrated. The beginning colonization of the degraded strut area by macrophages can be seen as clear indications that the resorption of the intermediate degradation product takes a different course than that of the Magmaris scaffold.
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Affiliation(s)
- Roman Menze
- MeKo Laser Material Processing e.K, Sarstedt, Germany
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In vivo degradation and endothelialization of an iron bioresorbable scaffold. Bioact Mater 2020; 6:1028-1039. [PMID: 33102944 PMCID: PMC7566209 DOI: 10.1016/j.bioactmat.2020.09.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
Detection of in vivo biodegradation is critical for development of next-generation medical devices such as bioresorbable stents or scaffolds (BRSs). In particular, it is urgent to establish a nondestructive approach to examine in vivo degradation of a new-generation coronary stent for interventional treatment based on mammal experiments; otherwise it is not available to semi-quantitatively monitor biodegradation in any clinical trial. Herein, we put forward a semi-quantitative approach to measure degradation of a sirolimus-eluting iron bioresorbable scaffold (IBS) based on optical coherence tomography (OCT) images; this approach was confirmed to be consistent with the present weight-loss measurements, which is, however, a destructive approach. The IBS was fabricated by a metal-polymer composite technique with a polylactide coating on an iron stent. The efficacy as a coronary stent of this new bioresorbable scaffold was compared with that of a permanent metal stent with the name of trade mark Xience, which has been widely used in clinic. The endothelial coverage on IBS was found to be greater than on Xience after implantation in a rabbit model; and our well-designed ultrathin stent exhibited less individual variation. We further examined degradation of the IBSs in both minipig coronary artery and rabbit abdominal aorta models. The present result indicated much faster iron degradation of IBS in the rabbit model than in the porcine model. The semi-quantitative approach to detect biodegradation of IBS and the finding of the species difference might be stimulating for fundamental investigation of biodegradable implants and clinical translation of the next-generation coronary stents. A semi-quantitative OCT method was suggested to evaluate in vivo biodegradation of an iron based coronary stent IBS in a nondestructive manner. The in vivo biodegradation of IBS exhibited dependence on animal species. The endothelial coverage on the biodegradable stent IBS was better than on the commercialized nonbiodegradable stent Xience in rabbits.
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Florin Ferent I, Mester A, Hlinomaz O, Groch L, Rezek M, Sitar J, Semenka J, Novak M, Benedek I. Intracoronary Imaging for Assessment of Vascular Healing and Stent Follow-up in Bioresorbable Vascular Scaffolds. Curr Med Imaging 2020; 16:123-134. [PMID: 32003312 DOI: 10.2174/1573405614666180604093621] [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: 12/15/2016] [Revised: 08/10/2017] [Accepted: 03/19/2018] [Indexed: 11/22/2022]
Abstract
Bioresorbable Vascular Scaffolds (BVS) are polymer-based materials implanted in the coronary arteries in order to treat atherosclerotic lesions, based on the concept that once the lesion has been treated, the material of the implanted stent will undergo a process of gradual resorption that will leave, in several years, the vessel wall smooth, free of any foreign material and with its vasomotion restored. However, after the first enthusiastic reports on the efficacy of BVSs, the recently published trials demonstrated disappointing results regarding long-term patency following BVS implantation, which were mainly attributed to technical deficiencies during the stenting procedure. Intracoronary imaging could play a crucial role for helping the operator to correctly implant a BVS into the coronary artery, as well as providing relevant information in the follow-up period. This review aims to summarize the role of intracoronary imaging in the follow-up of coronary stents, with a particular emphasis on the role of intravascular ultrasound and optical coherence tomography for procedural guidance during stent implantation and also for follow-up of bioabsorbable scaffolds.
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Affiliation(s)
- Ioan Florin Ferent
- Department of Cardiology, Laboratory of Advanced Research in Multimodality Cardiac Imaging, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Andras Mester
- Department of Cardiology, Laboratory of Advanced Research in Multimodality Cardiac Imaging, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
| | - Ota Hlinomaz
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Ladislav Groch
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Michal Rezek
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Jan Sitar
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Jiri Semenka
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Martin Novak
- International Clinical Research Center, St. Anne´s Hospital and Masaryk University, Brno, Czech Republic
| | - Imre Benedek
- Department of Cardiology, Laboratory of Advanced Research in Multimodality Cardiac Imaging, University of Medicine and Pharmacy of Targu Mures, Targu Mures, Romania
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8
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Li Y, Wang L, Chen S, Yu D, Sun W, Xin S. Biodegradable Magnesium Alloy Stents as a Treatment for Vein Graft Restenosis. Yonsei Med J 2019; 60:429-439. [PMID: 31016904 PMCID: PMC6479128 DOI: 10.3349/ymj.2019.60.5.429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To explore the effects of biodegradable magnesium alloy stents (BMAS) on remodeling of vein graft (VG) anastomotic restenosis. MATERIALS AND METHODS To establish a VG restenosis model, seventy two New Zealand rabbits were randomly divided into three groups according to whether a stent was implanted in the graft vein or not. BMASs and 316L stainless steel stents were implanted in BMAS and 316L groups, respectively, while no stent was implanted in the no-treatment control group (NC group). Loss of lumen diameter in the graft vein was measured in all three groups. Upon harvesting VG segments to evaluate intimal proliferation and re-endothelization, the degradation and biological safety of the stents were observed to explore the effects of BMAS on VG remodeling. RESULTS Model establishment and stent implantation were successful. The BMAS reduced lumen loss, compared with the control group (0.05±0.34 mm vs. 0.90±0.39 mm, p=0.001), in the early stage. The neointimal area was smaller in the BMAS group than the 316L group after 4 months (4.96±0.66 mm² vs. 6.80±0.69 mm², p=0.017). Re-endothelialization in the BMAS group was better than that in the 316L group (p=0.001). Within 4 months, the BMAS had degraded, and the magnesium was converted to phosphorus and calcium. The support force of the BMAS began to reduce at 2-3 months after implantation, without significant toxic effects. CONCLUSION BMAS promotes positive remodeling of VG anastomosis and has advantages over the conventional 316L stents in the treatment of venous diseases.
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Affiliation(s)
- Yugang Li
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Lei Wang
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Shanshan Chen
- Institute of Metal Research, Chines Academy of Sciences, Shenyang, China
| | - Dan Yu
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Weifeng Sun
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Shijie Xin
- Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China.
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Nagaraja S, Sullivan SJL, Stafford PR, Lucas AD, Malkin E. Impact of nitinol stent surface processing on in-vivo nickel release and biological response. Acta Biomater 2018; 72:424-433. [PMID: 29597023 DOI: 10.1016/j.actbio.2018.03.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/28/2018] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
Abstract
Although nitinol is widely used in percutaneous cardiovascular interventions, a causal relationship between nickel released from implanted cardiovascular devices and adverse systemic or local biological responses has not been established. The objective of this study was to investigate the relationship between nitinol surface processing, in-vivo nickel release, and biocompatibility. Nitinol stents manufactured using select surface treatments were implanted into the iliac arteries of minipigs for 6 months. Clinical chemistry profile, complete blood count, serum and urine nickel analyses were performed periodically during the implantation period. After explant, stented arteries were either digested and analyzed for local nickel concentration or fixed and sectioned for histopathological analysis of stenosis and inflammation within the artery. The results indicated that markers for liver and kidney function were not different than baseline values throughout 180 days of implantation regardless of surface finish. In addition, white blood cell, red blood cell, and platelet counts were similar to baseline values for all surface finishes. Systemic nickel concentrations in serum and urine were not significantly different between processing groups and comparable to baseline values during 180 days of implantation. However, stents with non-optimized surface finishing had significantly greater nickel levels in the surrounding artery compared to polished stents. These stents had increased stenosis with potential for local inflammation compared to polished stents. These findings demonstrate that proper polishing of nitinol surfaces can reduce in-vivo nickel release locally, which may aid in minimizing adverse inflammatory reactions and restenosis. STATEMENT OF SIGNIFICANCE Nitinol is a commonly used material in cardiovascular medical devices. However, relationships between nitinol surface finishing, in-vivo metal ion release, and adverse biological responses have yet to be established. We addressed this knowledge gap by implanting single and overlapped nitinol stents with different surface finishes to assess systemic impact on minipigs (i.e. serum and urine nickel levels, liver and kidney function, immune and blood count) over the 6 month implantation period. In addition, nickel levels and histopathology in stented arteries were analyzed on explant to determine relationships between surface processing and local adverse tissue reactions. The findings presented here highlight the importance of surface processing on in-vivo nickel release and subsequent impact on local biological response for nitinol implants.
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Affiliation(s)
- Srinidhi Nagaraja
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD 20993, USA.
| | - Stacey J L Sullivan
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD 20993, USA
| | - Philip R Stafford
- U.S. Food and Drug Administration, Winchester Engineering and Analytical Center, Winchester, MA 01890, USA
| | - Anne D Lucas
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD 20993, USA
| | - Elon Malkin
- U.S. Food and Drug Administration, Winchester Engineering and Analytical Center, Winchester, MA 01890, USA
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10
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Zhang J, Li H, Wang W, Huang H, Pei J, Qu H, Yuan G, Li Y. The degradation and transport mechanism of a Mg-Nd-Zn-Zr stent in rabbit common carotid artery: A 20-month study. Acta Biomater 2018; 69:372-384. [PMID: 29369807 DOI: 10.1016/j.actbio.2018.01.018] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/18/2017] [Accepted: 01/15/2018] [Indexed: 12/17/2022]
Abstract
Mg-based stent is a promising candidate of the next generation fully degradable vascular stents. The latest progress includes the CE approval of the Magmaris ® WE43 based drug eluting stent. However, so far, the long term (more than 1 year implantation) in vivo degradation and the physiological effects caused by the degradation products were still unclear. In this study, a 20 month observation was carried out after the bare Mg-Nd-Zn-Zr (abbr. JDBM) stent prototype was implanted into the common carotid artery of New Zealand white rabbit in order to evaluate its safety, efficacy and especially degradation behavior. The degradation of the main second phase Mg12Nd was also studied. Results showed that the bare JDBM stent had good safety and efficacy with a complete re-endothelialization within 28 days. The JDBM stent struts were mostly replaced in situ by degradation products in 4 month. The important finding was that the volume and Ca concentration of the degradation products decreased in the long term, eliminating the clinicians' concern of possible vessel calcification. In addition, the alloying elements Mg and Zn in the stent could be safely metabolized as continuous enrichment in any of the main organs were not detected although Nd and Zr showed an abrupt increase in spleen and liver after 1 month implantation. Collectively, the long term in vivo results showed the rapid re-endothelialization of JDBM stent and the long term safety of the degradation products, indicating its great potential as the backbone of the fully degradable vascular stent. STATEMENT OF SIGNIFICANCE Mg-based stent is a promising candidate of the next generation fully degradable stents, especially after the recent market launch of one of its kind (Magmaris). However the fundamental question about the long term degradation and metabolic mechanism of Mg-based stent and its degradation products remain unanswered. We implanted our patented Mg-Nd-Zn-Zr bare stent into the common carotid artery of rabbits and conducted a 20 months observation. We found that the Ca containing degradation products could be further degraded in vivo. All the alloying elements showed no continuous enrichment in the main organs of rabbits. These findings eliminate the clinicians' concern of possible vessel calcification and element enrichment after the implantation of Mg alloy based stents to some extent.
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Affiliation(s)
- Jian Zhang
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China; Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Haiyan Li
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Wu Wang
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Hua Huang
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jia Pei
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Haiyun Qu
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, China
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming and State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Yongdong Li
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
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11
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Sullivan SJL, Madamba D, Sivan S, Miyashiro K, Dreher ML, Trépanier C, Nagaraja S. The effects of surface processing on in-vivo corrosion of Nitinol stents in a porcine model. Acta Biomater 2017; 62:385-396. [PMID: 28842334 DOI: 10.1016/j.actbio.2017.08.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/17/2017] [Accepted: 08/21/2017] [Indexed: 11/28/2022]
Abstract
A major limitation with current assessments of corrosion in metallic medical devices is the lack of correlation between in-vitro and in-vivo corrosion performance. Therefore, the objective of this study was to elucidate the relationship between pitting corrosion measured by breakdown potentials (Eb) in ASTM F2129 testing and corrosion resistance in-vivo. Four groups of Nitinol stents were manufactured using different processing methods to create unique surface properties. The stents were implanted into iliac arteries of minipigs for six months and explanted for corrosion analysis. Scanning electron microscopy and energy dispersive X-ray spectrometry analyses indicated that stents with a thick complex thermal oxide (420nm) and high corrosion resistance in-vitro (Eb=975±94mV) were free from detectable corrosion in-vivo and exhibited no changes in Ni/Ti ratio when compared to non-implanted controls. This result was also found in mechanically polished stents with a thin native oxide (4nm; Eb=767±226mV). In contrast, stents with a moderately thick thermal oxide (130nm) and low corrosion resistance in-vitro (Eb=111±63mV) possessed corrosion with associated surface microcracks in-vivo. In addition, Ni/Ti ratios in corroded regions were significantly lower compared to non-corroded adjacent areas on explanted stents. When stents were minimally processed (i.e. retained native tube oxide from the drawing process), a thick thermal oxide was present (399nm) with low in-vitro corrosion resistance (Eb=68±29mV) resulting in extensive in-vivo pitting. These findings demonstrate that functional corrosion testing combined with a detailed understanding of the surface characteristics of a Nitinol medical device can provide insight into in-vivo corrosion resistance. STATEMENT OF SIGNIFICANCE Nitinol is a commonly used material in the medical device industry. However, correlations between surface processing of nitinol and in-vivo corrosion has yet to be established. Elucidating the link between in-vivo corrosion and pre-clinical characterization can aid in improved prediction of clinical safety and performance of nitinol devices. We addressed this knowledge gap by fabricating nitinol stents to possess distinct surface properties and evaluating their corrosion susceptibility both in-vitro and after six months of in-vivo exposure. Relationships between stent processing, surface characterization, corrosion bench testing, and outcomes from explanted devices are discussed. These findings highlight the importance of surface characterization in nitinol devices and provide in-vitro pitting corrosion levels that can induce in-vivo corrosion in nitinol stents.
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Affiliation(s)
- Stacey J L Sullivan
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, MD 20993, USA
| | | | - Shiril Sivan
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, MD 20993, USA
| | | | - Maureen L Dreher
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, MD 20993, USA
| | | | - Srinidhi Nagaraja
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Division of Applied Mechanics, Silver Spring, MD 20993, USA.
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12
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Yang H, Wang C, Liu C, Chen H, Wu Y, Han J, Jia Z, Lin W, Zhang D, Li W, Yuan W, Guo H, Li H, Yang G, Kong D, Zhu D, Takashima K, Ruan L, Nie J, Li X, Zheng Y. Evolution of the degradation mechanism of pure zinc stent in the one-year study of rabbit abdominal aorta model. Biomaterials 2017; 145:92-105. [PMID: 28858721 DOI: 10.1016/j.biomaterials.2017.08.022] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/09/2017] [Accepted: 08/14/2017] [Indexed: 01/01/2023]
Abstract
In the present study, pure zinc stents were implanted into the abdominal aorta of rabbits for 12 months. Multiscale analysis including micro-CT, scanning electron microscopy (SEM), scanning transmission electron microscopy (STEM) and histological stainings was performed to reveal the fundamental degradation mechanism of the pure zinc stent and its biocompatibility. The pure zinc stent was able to maintain mechanical integrity for 6 months and degraded 41.75 ± 29.72% of stent volume after 12 months implantation. No severe inflammation, platelet aggregation, thrombosis formation or obvious intimal hyperplasia was observed at all time points after implantation. The degradation of the zinc stent played a beneficial role in the artery remodeling and healing process. The evolution of the degradation mechanism of pure zinc stents with time was revealed as follows: Before endothelialization, dynamic blood flow dominated the degradation of pure zinc stent, creating a uniform corrosion mode; After endothelialization, the degradation of pure zinc stent depended on the diffusion of water molecules, hydrophilic solutes and ions which led to localized corrosion. Zinc phosphate generated in blood flow transformed into zinc oxide and small amounts of calcium phosphate during the conversion of degradation microenvironment. The favorable physiological degradation behavior makes zinc a promising candidate for future stent applications.
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Affiliation(s)
- Hongtao Yang
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Cong Wang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Chaoqiang Liu
- College of Materials Science and Engineering, Chongqing University, Chongqing, 400044, China
| | - Houwen Chen
- College of Materials Science and Engineering, Chongqing University, Chongqing, 400044, China
| | - Yifan Wu
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin, 300071, China
| | - Jintao Han
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Zichang Jia
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Wenjiao Lin
- R&D Center, Lifetech Scientific (Shenzhen) Co Ltd, Shenzhen, 518057, China
| | - Deyuan Zhang
- R&D Center, Lifetech Scientific (Shenzhen) Co Ltd, Shenzhen, 518057, China
| | - Wenting Li
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Wei Yuan
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Hui Guo
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Huafang Li
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Guangxin Yang
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Deling Kong
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin, 300071, China
| | - Donghui Zhu
- Department of Biomedical Engineering, College of Engineering, University of North Texas, Denton, TX 76207, USA
| | - Kazuki Takashima
- Department of Mechanical Engineering and Materials Science, Faculty of Engineering, Kumamoto University, 2-39-1 Kurokami, Kumamoto, 860-8555, Japan
| | - Liqun Ruan
- Department of Mechanical Systems Engineering, Graduate School of Science and Technology, Kumamoto University, Kurokami 2-39-1, Kumamoto-shi, 860-8555, Japan
| | - Jianfeng Nie
- College of Materials Science and Engineering, Chongqing University, Chongqing, 400044, China; Department of Materials Science and Engineering, Monash University, Victoria, 3800, Australia.
| | - Xuan Li
- Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing, 100191, China.
| | - Yufeng Zheng
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing, 100871, China; International Research Organization for Advanced Science and Technology, Kumamoto University, 2-39-1 Kurokami, Chuo-Ku, Kumamoto 860-8555, Japan.
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13
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Shi Y, Zhang L, Chen J, Zhang J, Yuan F, Shen L, Chen C, Pei J, Li Z, Tan J, Yuan G. In vitro and in vivo degradation of rapamycin-eluting Mg-Nd-Zn-Zr alloy stents in porcine coronary arteries. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 80:1-6. [PMID: 28866142 DOI: 10.1016/j.msec.2017.05.124] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/04/2017] [Accepted: 05/13/2017] [Indexed: 10/19/2022]
Abstract
In this work, rapamycin-eluting poly (d, l-lactic acid) coating (PDLLA/RAPA) was prepared on biodegradable Mg-Nd-Zn-Zr alloy (JDBM) for both in vitro and in vivo investigation of the degradation behaviors of the magnesium alloy stent platform. Electrochemical tests and hydrogen evolution test demonstrated significant in vitro protection of the polymeric coating against magnesium degradation both in short and long term. The 3-month in vivo study on the RAPA-eluting JDBM stent implanted into porcine coronary arteries confirmed its favorable safety, and in the meanwhile revealed similar neointima proliferation compared to the second generation DES Firebird 2 with no occurrence of adverse complications. Moreover, Micro-CT examination combined with IVUS and OCT detection indicated a remarkably lower degradation rate and prolonged radial supporting duration of the drug-eluting JDBM stent as compared to the bare, attributable to the protection of the coating in vivo. Hence, rapamycin-eluting JDBM stents exhibit great potential for clinical application.
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Affiliation(s)
- Yongjuan Shi
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Lei Zhang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jiahui Chen
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jian Zhang
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Feng Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Li Shen
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Chenxin Chen
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jia Pei
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Zhonghua Li
- Microport Endovascular (Shanghai) Co., Ltd, Shanghai 201318, China
| | - Jinyun Tan
- Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite, Shanghai Jiao Tong University, Shanghai 200240, China.
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Liu Y, Zheng S, Li N, Guo H, Zheng Y, Peng J. In vivo response of AZ31 alloy as biliary stents: a 6 months evaluation in rabbits. Sci Rep 2017; 7:40184. [PMID: 28084306 PMCID: PMC5234016 DOI: 10.1038/srep40184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022] Open
Abstract
Mg-based metallic materials have been making continuing progress as vascular stents. However, the research of Mg-based materials as non-vascular stents is still at its primary stage. AZ31 stents hereby were implanted into the common bile duct of rabbits for 6 months. The results revealed an existence of 93.82 ± 1.36% and 30.89 ± 2.46% of the original volume after 1 and 3 month, respectively. Whole blood tests indicated an inflammation decreasing to normal level after 3 month implantation. A benign host response was observed via H&E staining. Nonuniform corrosion at the two ends of the stents was observed and considered the results of flow or local inflammation. Moreover, the application of Mg-based materials for different stenting treatment were reviewed and compared. Esophagus was hypothesized most destructive, whilst blood vessel and bile duct considered similar and less destructive. Trachea and nasal cavity were thought to be mildest.
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Affiliation(s)
- Yang Liu
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Shengmin Zheng
- Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China
| | - Nan Li
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Huahu Guo
- Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China
| | - Yufeng Zheng
- Department of Materials Science and Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Jirun Peng
- Department of Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
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Ma J, Zhao N, Betts L, Zhu D. Bio-Adaption between Magnesium Alloy Stent and the Blood Vessel: A Review. JOURNAL OF MATERIALS SCIENCE & TECHNOLOGY 2016; 32:815-826. [PMID: 27698548 PMCID: PMC5044878 DOI: 10.1016/j.jmst.2015.12.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Biodegradable magnesium (Mg) alloy stents are the most promising next generation of bio-absorbable stents. In this article, we summarized the progresses on the in vitro studies, animal testing and clinical trials of biodegradable Mg alloy stents in the past decades. These exciting findings led us to propose the importance of the concept "bio-adaption" between the Mg alloy stent and the local tissue microenvironment after implantation. The healing responses of stented blood vessel can be generally described in three overlapping phases: inflammation, granulation and remodeling. The ideal bio-adaption of the Mg alloy stent, once implanted into the blood vessel, needs to be a reasonable function of the time and the space/dimension. First, a very slow degeneration of mechanical support is expected in the initial four months in order to provide sufficient mechanical support to the injured vessels. Although it is still arguable whether full mechanical support in stented lesions is mandatory during the first four months after implantation, it would certainly be a safety design parameter and a benchmark for regulatory evaluations based on the fact that there is insufficient human in vivo data available, especially the vessel wall mechanical properties during the healing/remodeling phase. Second, once the Mg alloy stent being degraded, the void space will be filled by the regenerated blood vessel tissues. The degradation of the Mg alloy stent should be 100% completed with no residues, and the degradation products (e.g., ions and hydrogen) will be helpful for the tissue reconstruction of the blood vessel. Toward this target, some future research perspectives are also discussed.
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Affiliation(s)
- Jun Ma
- Department of Chemical, Biological and Bioengineering, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
- NSF Engineering Research Center-Revolutionizing Metallic Biomaterials, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Nan Zhao
- Department of Chemical, Biological and Bioengineering, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
- NSF Engineering Research Center-Revolutionizing Metallic Biomaterials, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Lexxus Betts
- Department of Chemical, Biological and Bioengineering, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
- NSF Engineering Research Center-Revolutionizing Metallic Biomaterials, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - Donghui Zhu
- Department of Chemical, Biological and Bioengineering, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
- NSF Engineering Research Center-Revolutionizing Metallic Biomaterials, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
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Feyerabend F, Wendel HP, Mihailova B, Heidrich S, Agha NA, Bismayer U, Willumeit-Römer R. Blood compatibility of magnesium and its alloys. Acta Biomater 2015. [PMID: 26210283 DOI: 10.1016/j.actbio.2015.07.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
RATIONALE Blood compatibility analysis in the field of biomaterials is a highly controversial topic. Especially for degradable materials like magnesium and its alloys no established test methods are available. OBJECTIVE The purpose of this study was to apply advanced test methodology for the analysis of degrading materials to get a mechanistic insight into the corrosion process in contact with human blood and plasma. METHODS AND RESULTS Pure magnesium and two magnesium alloys were analysed in a modified Chandler-Loop setup. Standard clinical parameters were determined, and a thorough analysis of the resulting implant surface chemistry was performed. The contact of the materials to blood evoked an accelerated inflammatory and cell-induced osteoconductive reaction. Corrosion products formed indicate a more realistic, in vivo like situation. CONCLUSIONS The active regulation of corrosion mechanisms of magnesium alloys by different cell types should be more in the focus of research to bridge the gap between in vitro and in vivo observations and to understand the mechanism of action. This in turn could lead to a better acceptance of these materials for implant applications. STATEMENT OF SIGNIFICANCE The presented study deals with the first mechanistic insights during whole human blood contact and its influence on a degrading magnesium-based biomaterial. The combination of clinical parameters and corrosion layer analysis has been performed for the first time. It could be of interest due to the intended use of magnesium-based stents and for orthopaedic applications for clinical applications. An interest for the readers of Acta Biomaterialia may be given, as one of the first clinically approved magnesium-based devices is a wound-closure device, which is in direct contact with blood. Moreover, for orthopaedic applications also blood contact is of high interest. Although this is not the focus of the manuscript, it could help to rise awareness for potential future applications.
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Affiliation(s)
- Frank Feyerabend
- Helmholtz-Zentrum Geesthacht, Institute of Material Research, Department for Material Design and Characterisation, Max-Planck-Str. 1, 21502 Geesthacht, Germany.
| | - Hans-Peter Wendel
- Department of Cardiovascular Surgery, Clinical Research Laboratory, University Hospital Tuebingen, Calwerstr. 7/1, 72076 Tuebingen, Germany
| | - Boriana Mihailova
- University of Hamburg, Department of Earth Sciences, Grindelallee 48, 20146 Hamburg, Germany
| | - Stefanie Heidrich
- University of Hamburg, Department of Earth Sciences, Grindelallee 48, 20146 Hamburg, Germany
| | - Nezha Ahmad Agha
- Helmholtz-Zentrum Geesthacht, Institute of Material Research, Department for Material Design and Characterisation, Max-Planck-Str. 1, 21502 Geesthacht, Germany
| | - Ulrich Bismayer
- University of Hamburg, Department of Earth Sciences, Grindelallee 48, 20146 Hamburg, Germany
| | - Regine Willumeit-Römer
- Helmholtz-Zentrum Geesthacht, Institute of Material Research, Department for Material Design and Characterisation, Max-Planck-Str. 1, 21502 Geesthacht, Germany
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Bowen PK, McNamara CT, Mills OP, Drelich J, Goldman J. FIB-TEM Study of Magnesium Corrosion Products after 14 Days in the Murine Artery. ACS Biomater Sci Eng 2015; 1:919-926. [DOI: 10.1021/acsbiomaterials.5b00044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Patrick K. Bowen
- Department of Materials Science
and Engineering, ‡Applied Chemical and Morphological
Analysis Laboratory, and §Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan 49331, United States
| | - Cameron T. McNamara
- Department of Materials Science
and Engineering, ‡Applied Chemical and Morphological
Analysis Laboratory, and §Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan 49331, United States
| | - Owen P. Mills
- Department of Materials Science
and Engineering, ‡Applied Chemical and Morphological
Analysis Laboratory, and §Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan 49331, United States
| | - Jaroslaw Drelich
- Department of Materials Science
and Engineering, ‡Applied Chemical and Morphological
Analysis Laboratory, and §Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan 49331, United States
| | - Jeremy Goldman
- Department of Materials Science
and Engineering, ‡Applied Chemical and Morphological
Analysis Laboratory, and §Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan 49331, United States
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18
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The basics of intravascular optical coherence tomography. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2015; 11:74-83. [PMID: 26161097 PMCID: PMC4495121 DOI: 10.5114/pwki.2015.52278] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/12/2015] [Accepted: 05/09/2015] [Indexed: 12/23/2022] Open
Abstract
Optical coherence tomography (OCT) has opened new horizons for intravascular coronary imaging. It utilizes near-infrared light to provide a microscopic insight into the pathology of coronary arteries in vivo. Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is an exceptional modality to detect plaques that are prone to rupture (thin fibrous cap atheromas). Moreover, it facilitates distinguishing between plaque rupture and plaque erosion as a cause of acute intracoronary thrombosis. Optical coherence tomography is applied to guide angioplasties of coronary lesions and to assess outcomes of percutaneous coronary interventions broadly. It identifies stent malapposition, dissections, and thrombosis with unprecedented precision. Furthermore, OCT helps to monitor vessel healing after stenting. It evaluates the coverage of stent struts by the neointima and detects in-stent neoatherosclerosis. With so much potential, new studies are warranted to determine OCT's clinical impact. The following review presents the technical background, basics of OCT image interpretation, and practical tips for adequate OCT imaging, and outlines its established and potential clinical application.
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Zhang E, Shen F. A ferulic acid (FA)-eluting system for biodegradable magnesium stent: Cells response of HUVECs. J Biomed Mater Res A 2015; 103:2758-69. [DOI: 10.1002/jbm.a.35410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/02/2014] [Accepted: 01/09/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Erlin Zhang
- Key Lab. for Anisotropy and Texture of Materials, Education Ministry of China; Northeastern University; Shenyang 110819 China
| | - Feng Shen
- Shenzhen Salubris Biomedical Engineering Co., LTD; Shenzhen 518102 China
- School of Materials Sciences and Engineering; Harbin Institute of Technology; Harbin 150001 China
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20
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Wang J, Smith CE, Sankar J, Yun Y, Huang N. Absorbable magnesium-based stent: physiological factors to consider for in vitro degradation assessments. Regen Biomater 2015; 2:59-69. [PMID: 26816631 PMCID: PMC4669031 DOI: 10.1093/rb/rbu015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/30/2014] [Indexed: 12/15/2022] Open
Abstract
Absorbable metals have been widely tested in various in vitro settings using cells to evaluate their possible suitability as an implant material. However, there exists a gap between in vivo and in vitro test results for absorbable materials. A lot of traditional in vitro assessments for permanent materials are no longer applicable to absorbable metallic implants. A key step is to identify and test the relevant microenvironment and parameters in test systems, which should be adapted according to the specific application. New test methods are necessary to reduce the difference between in vivo and in vitro test results and provide more accurate information to better understand absorbable metallic implants. In this investigative review, we strive to summarize the latest test methods for characterizing absorbable magnesium-based stent for bioabsorption/biodegradation behavior in the mimicking vascular environments. Also, this article comprehensively discusses the direction of test standardization for absorbable stents to paint a more accurate picture of the in vivo condition around implants to determine the most important parameters and their dynamic interactions.
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Affiliation(s)
- Juan Wang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China and National Science Foundation Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A & T State University, Greensboro, NC 27411, USA
| | - Christopher E Smith
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China and National Science Foundation Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A & T State University, Greensboro, NC 27411, USA
| | - Jagannathan Sankar
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China and National Science Foundation Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A & T State University, Greensboro, NC 27411, USA
| | - Yeoheung Yun
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China and National Science Foundation Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A & T State University, Greensboro, NC 27411, USA
| | - Nan Huang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China and National Science Foundation Engineering Research Center for Revolutionizing Metallic Biomaterials, North Carolina A & T State University, Greensboro, NC 27411, USA
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21
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Vignali L, Solinas E, Emanuele E. Research and clinical applications of optical coherence tomography in invasive cardiology: a review. Curr Cardiol Rev 2014; 10:369-76. [PMID: 24893934 PMCID: PMC4101202 DOI: 10.2174/1573403x10666140604120753] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 11/22/2022] Open
Abstract
In cardiology, optical coherence tomography (OCT) is an invasive imaging technique based on the principle of light coherence. This system was developed to obtain three-dimensional high resolution images to examine coronary artery normal and/or pathological structure. This technique replaces the ultrasound used by its main alternative procedure, intravascular ultrasound, by a near-infrared light source. Acute coronary syndromes due to atherosclerotic vascular disease are the leading cause of mortality in developed and developing countries. As a consequence, intravascular imaging systems became an important area of research and 1991 marks the first use of OCT in coronary artery observations. Since its first appearance in invasive cardiology, OCT maintains a strong presence in the research environments for the identification of vulnerable plaques, as it is able to overcome difficulties presented by other techniques such as virtual intravascular ultrasound, near-infrared spectroscopy, and histology. Moreover, OCT is increasingly being used in the clinical practice as a guide during coronary interventions and in the assessment of vascular response after coronary stent implantation. This review focuses on the relevance of OCT in research and clinical applications in the field of invasive cardiology and discusses the future directions of the field.
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Affiliation(s)
| | | | - Enzo Emanuele
- Living Research s.a.s., Via Monte Grappa, 13, I-27038, Robbio (PV), Italy.
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22
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Lin W, Zhang G, Cao P, Zhang D, Zheng Y, Wu R, Qin L, Wang G, Wen T. Cytotoxicity and its test methodology for a bioabsorbable nitrided iron stent. J Biomed Mater Res B Appl Biomater 2014; 103:764-76. [DOI: 10.1002/jbm.b.33246] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 04/30/2014] [Accepted: 06/20/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Wenjiao Lin
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Gui Zhang
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Ping Cao
- Shenzhen Testing Center of Medical Devices; Shenzhen 518057 China
| | - Deyuan Zhang
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Yufeng Zheng
- Department of Materials Science and Engineering; College of Engineering, Peking University; Beijing 100871 China
| | - Rangxiu Wu
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Li Qin
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Geqi Wang
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
| | - Taoyuan Wen
- R&D Center; Lifetech Scientific (Shenzhen) Co. Ltd.; Shenzhen 518057 China
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23
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Lipinski MJ, Escarcega RO, Lhermusier T, Waksman R. The effects of novel, bioresorbable scaffolds on coronary vascular pathophysiology. J Cardiovasc Transl Res 2014; 7:413-25. [PMID: 24800874 DOI: 10.1007/s12265-014-9571-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 04/21/2014] [Indexed: 12/01/2022]
Abstract
Percutaneous coronary intervention (PCI) has rapidly evolved over the past 30 years as technology has sought to improve clinical outcomes by addressing pathophysiologic complications arising from the intervention. Stents were designed to resolve the drawbacks of balloon angioplasty by providing radial support to prevent vessel recoil, by sealing coronary dissections, and by preventing abrupt vessel closure. The conceptualization of an ideal drug-eluting fully bioresorbable scaffold (BRS), whether metallic or polymeric, would theoretically address the adverse aspects of permanent metallic stents. In this review of the literature, we will discuss the impact these novel fully BRS platforms have on vascular pathophysiology following PCI.
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Affiliation(s)
- Michael J Lipinski
- MedStar Cardiovascular Research Network, MedStar Heart Institute, MedStar Washington Hospital Center, 110 Irving St., NW, Suite 4B-1, Washington, DC, 20010, USA
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Bowen PK, Drelich A, Drelich J, Goldman J. Rates ofin vivo(arterial) andin vitrobiocorrosion for pure magnesium. J Biomed Mater Res A 2014; 103:341-9. [DOI: 10.1002/jbm.a.35179] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/06/2014] [Accepted: 03/21/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Patrick K. Bowen
- Department of Materials Science and Engineering; Michigan Technological University; Houghton Michigan
| | - Adam Drelich
- Department of Materials Science and Engineering; Michigan Technological University; Houghton Michigan
| | - Jaroslaw Drelich
- Department of Materials Science and Engineering; Michigan Technological University; Houghton Michigan
| | - Jeremy Goldman
- Department of Biomedical Engineering; Michigan Technological University; Houghton Michigan
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25
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Bowen PK, Drelich J, Goldman J. Magnesium in the murine artery: probing the products of corrosion. Acta Biomater 2014; 10:1475-83. [PMID: 24296127 DOI: 10.1016/j.actbio.2013.11.021] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/04/2013] [Accepted: 11/22/2013] [Indexed: 11/18/2022]
Abstract
Many publications are available on the physiological and pseudophysiological corrosion of magnesium and its alloys for bioabsorbable implant application, yet few focus on the characterization of explanted materials. In this work, commercially pure magnesium wires were corroded in the arteries of rats for up to 1 month, removed, and both bulk and surface products characterized. Surface characterization using infrared spectroscopy revealed a duplex structure comprising heavily magnesium-substituted hydroxyapatite that later transformed into an A-type (carbonate-substituted) hydroxyapatite. To explain this transformation, an ion-exchange mechanism is suggested. Elemental mapping of the bulk products of biocorrosion revealed the elemental distribution of Ca, P, Mg and O in the outer and Mg, O and P in the inner layers. Carbon was not observed in any significant quantity from the inner corrosion layer, suggesting that carbonates are not a prevalent product of corrosion. Backscatter electron imaging of cross-sections showed that thinning or absence of the hydroxyapatite in the later stages of degradation is related to local thickening of the inner corrosion layer. Based on these experimental observations, mechanisms describing corrosion in the quasi-steady state and during terminal breakdown of the magnesium specimens are proposed.
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Affiliation(s)
- Patrick K Bowen
- Department of Materials Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| | - Jaroslaw Drelich
- Department of Materials Science and Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| | - Jeremy Goldman
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA
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26
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Zeng J, Ren L, Yuan Y, Wang Y, Zhao J, Zeng R, Yang K, Mei X. Short-term effect of magnesium implantation on the osteomyelitis modeled animals induced by Staphylococcus aureus. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:2405-2416. [PMID: 23793564 DOI: 10.1007/s10856-013-4982-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 06/10/2013] [Indexed: 06/02/2023]
Abstract
Pure magnesium (Mg) granules were implanted into the tibial medullary cavity of osteomyelitis modeled animals after debridement, and the animals without implant were taken as the control group. The antibacterial and osteogenic effects on bone tissue during Mg degradation were evaluated through detecting Mg ions, counting bacteria culture in peripheral blood, histology and iconography. The results showed that there was no significant difference for the concentration of serum Mg between the preoperative and postoperative animals within 5 weeks, maintaining in the normal range, and the number of bacteria in bone tissue of the Mg implant group was significantly lower than that of the control group. Mg implantation showed good biocompatibility no harmful to the liver, spleen, kidney and other organs in the modeled animals. In addition, the formation rate of new bone tissues around the implanted Mg was faster, indicating that the degradation of Mg could also promote the osteogenic process with good biocompatibility.
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Affiliation(s)
- Jinhao Zeng
- Department of Orthopedics, First Affiliated Hospital of Liaoning Medical University, No. 5-2, Renmin Street, Guta District, Jinzhou, 121000, China,
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27
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Cheng J, Zheng Y. In vitrostudy on newly designed biodegradable Fe-X composites (X = W, CNT) prepared by spark plasma sintering. J Biomed Mater Res B Appl Biomater 2013; 101:485-97. [DOI: 10.1002/jbm.b.32783] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 06/20/2012] [Accepted: 07/07/2012] [Indexed: 12/15/2022]
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Karanasos A, Ligthart J, Witberg K, van Soest G, Bruining N, Regar E. Optical Coherence Tomography: Potential Clinical Applications. CURRENT CARDIOVASCULAR IMAGING REPORTS 2012; 5:206-220. [PMID: 22798978 PMCID: PMC3389242 DOI: 10.1007/s12410-012-9140-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Optical coherence tomography (OCT) is a novel intravascular imaging modality using near-infrared light. By OCT it is possible to obtain high-resolution cross-sectional images of the vascular wall structure and assess the acute and long-term effects of percutaneous coronary intervention. For the time being OCT has been mainly used in research providing new insights into the pathophysiology of the atheromatic plaque and of the vascular response to stenting, however, it seems that there is potential for clinical application of OCT in various fields, such as pre-interventional evaluation of coronary arteries, procedural guidance in coronary interventions, and follow-up assessment of vascular healing after stent implantation. This review will focus on the potential and advantages of OCT in the clinical practice of a catheterization laboratory.
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Affiliation(s)
- Antonios Karanasos
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Jurgen Ligthart
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Karen Witberg
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Gijs van Soest
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Nico Bruining
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Evelyn Regar
- Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, BA-585, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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29
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Corrosion studies of modified organosilane coated magnesium–yttrium alloy in different environments. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012. [DOI: 10.1016/j.msec.2012.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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30
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Herrero-Garibi J, Cruz-González I, Parejo-Díaz P, Jang IK. Optical coherence tomography: its value in intravascular diagnosis today. Rev Esp Cardiol 2011; 63:951-62. [PMID: 20738940 DOI: 10.1016/s1885-5857(10)70189-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Optical coherence tomography is a recently developed high-resolution intravascular diagnostic technique. Initially, it was mainly used for characterizing atherosclerotic plaque because it served a number of functions, from identifying plaque with high lipid content to detecting macrophage accumulation, both of which are associated with plaque instability. Currently, there is growing interest in the value of optical coherence tomography in the area of coronary intervention, where the technique offers significant advantages over more widespread intravascular diagnostic techniques such as intravascular ultrasound: its higher resolution means that the vessel lumen diameter can be measured more precisely, periprocedural complications such microdissection of the coronary artery can be detected, stent apposition relative to the vessel wall can be optimized, neointimal hyperplasia can be detected after stent implantation, and neointimal thickness can be measured. It would therefore appear to be a very useful technique for interventional cardiologists. This review article considers the technical details of the technique and its applications, and compares it with other intravascular diagnostic techniques.
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31
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Ben-Dor I, Mahmoudi M, Pichard AD, Satler LF, Waksman R. Optical coherence tomography: a new imaging modality for plaque characterization and stent implantation. J Interv Cardiol 2010; 24:184-92. [PMID: 21198851 DOI: 10.1111/j.1540-8183.2010.00615.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Optical coherence tomography (OCT) is a novel, catheter-based, invasive imaging system based on near-infrared light with high image resolution (15-20 μm). The system allows for unparalleled imaging of the coronary artery lumen, plaque characterization, assessment of coronary stent strut apposition, neointimal coverage, vascular proliferative response, complications such as focal dissection or thrombus formation, and insight into the time course of stent endothelization. This review will describe the currently available developments in OCT technology and its application in both the clinical and research arenas.
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The pre-clinical animal model in the translational research of interventional cardiology. JACC Cardiovasc Interv 2010; 2:373-83. [PMID: 19463458 DOI: 10.1016/j.jcin.2009.03.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 02/19/2009] [Accepted: 03/08/2009] [Indexed: 11/23/2022]
Abstract
Scientific discoveries for improvement of human health must be translated into practical applications. Such discoveries typically begin at "the bench" with basic research, then progress to the clinical level. In particular, in the field of interventional cardiology, percutaneous cardiovascular intervention has rapidly evolved from an experimental procedure to a therapeutic clinical setting. Pre-clinical studies using animal models play a very important role in the evaluation of efficacy and safety of new medical devices before their use in human clinical studies. This review provides an overview of the emerging role, results of pre-clinical studies and development, and evaluation of animal models for percutaneous cardiovascular intervention technologies for patients with symptomatic cardiovascular disease.
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33
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Herrero-Garibi J, Cruz-González I, Parejo-Díaz P, Jang IK. Tomografía de coherencia óptica: situación actual en el diagnóstico intravascular. Rev Esp Cardiol 2010. [DOI: 10.1016/s0300-8932(10)70207-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wang B, Su JL, Karpiouk AB, Sokolov KV, Smalling RW, Emelianov SY. Intravascular Photoacoustic Imaging. IEEE JOURNAL OF QUANTUM ELECTRONICS 2010; 16:588-599. [PMID: 21359138 PMCID: PMC3045110 DOI: 10.1109/jstqe.2009.2037023] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Intravascular photoacoustic (IVPA) imaging is a catheter-based, minimally invasive, imaging modality capable of providing high-resolution optical absorption map of the arterial wall. Integrated with intravascular ultrasound (IVUS) imaging, combined IVPA and IVUS imaging can be used to detect and characterize atherosclerotic plaques building up in the inner lining of an artery. In this paper, we present and discuss various representative applications of combined IVPA/IVUS imaging of atherosclerosis, including assessment of the composition of atherosclerotic plaques, imaging of macrophages within the plaques, and molecular imaging of biomarkers associated with formation and development of plaques. In addition, imaging of coronary artery stents using IVPA and IVUS imaging is demonstrated. Furthermore, the design of an integrated IVUS/IVPA imaging catheter needed for in vivo clinical applications is discussed.
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Affiliation(s)
- Bo Wang
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | - Jimmy L. Su
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | - Andrei B. Karpiouk
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712 USA
| | - Konstantin V. Sokolov
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712 USA, and also with the Department of Imaging Physics, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030 USA
| | - Richard W. Smalling
- Division of Cardiology, University of Texas Health Science Center, Houston, TX 77030 USA, and also with the Memorial Hermann Heart and Vascular Institute, Houston, TX 77024 USA
| | - Stanislav Y. Emelianov
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712 USA
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35
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Di Mario C, Borgia F. Assimilating the current clinical data of fully bioabsorbable stents. EUROINTERVENTION 2009; 5 Suppl F:F103-8. [DOI: 10.4244/eijv5ifa18] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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36
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37
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Su JLS, Wang B, Emelianov SY. Photoacoustic imaging of coronary artery stents. OPTICS EXPRESS 2009; 17:19894-901. [PMID: 19997212 DOI: 10.1364/oe.17.019894] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Coronary stents are the most commonly used treatment in the United States to repair narrowed or weakened arteries. The ability to visualize the stent during the stenting procedure and post-surgery is crucial to correctly place the stent with respect to the vessel stenosis, and to identify its position within the vessel wall. Current imaging modalities suffer from low contrast, resolution and/or unfavorable artifacts that can inhibit correct visualization of the stent in the artery. We demonstrated the effectiveness of a combined intravascular photoacoustic and intravascular ultrasound imaging method for high resolution and sufficient contrast imaging of commercial stents with respect to the vessel wall.
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Affiliation(s)
- Jimmy Li-Shin Su
- Department of Biomedical Engineering, The University of Texas at Austin, 1 University Station C0800, Austin, TX 78712, USA
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