Integration of 3D printing and additive manufacturing in the interventional pulmonologist's toolbox

Status of Polymer Fused Deposition Modeling (FDM)-Based Three-Dimensional Printing (3DP) in the Pharmaceutical Industry

Additive manufacturing (AM) or 3D printing (3DP) is arguably a versatile and more efficient way for the production of solid dosage forms such as tablets. Of the various 3DP technologies currently available, fused deposition modeling (FDM) includes unique characteristics that offer a range of options in the production of various types of tablets. For example, amorphous solid dispersions (ASDs), enteric-coated tablets or poly pills can be produced using an appropriate drug/polymer combination during FDM 3DP. The technology offers the possibility of evolving personalized medicines into cost-effective production schemes at pharmacies and hospital dispensaries. In this review, we highlight key FDM features that may be exploited for the production of tablets and improvement of therapy, with emphasis on gastrointestinal delivery. We also highlight current constraints that must be surmounted to visualize the deployment of this technology in the pharmaceutical and healthcare industries.

Digital transformation of supply chain: a study on additive manufacturing practice in medical device in Australia

Purpose

Drawing on a dynamic capability view, this study develops a decision support model that determines the most suitable configuration of strategies and challenges to adopt additive manufacturing (AM) to expedite digital transformation and performance improvement of the surgical and medical device (SMD) supply chain.

Design/methodology/approach

To investigate the research objective, a multi-method and multi-study research design was deployed using quality function deployment and fuzzy set qualitative comparative analysis.

Findings

The study finds that only resilience strategies or negation (i.e. minimisation) of challenges are not enough; instead, a configuration of resilience strategies and negation of challenges is highly significant in enhancing performance.

Practical implications

SMD supply chain decision-makers will find the decision support model presented in this study as beneficial to be resilient against various challenges in the digital transformation of service delivery process.

Originality/value

This study builds new knowledge of the adoption of AM technology in the SMD supply chain. The decision support model developed in this study is unique and highly effective for fostering digital transformation and enhancing SMD supply chain performance.

A Parametric Tool for Studying a New Tracheobronchial Silicone Stent Prototype: Toward a Customized 3D Printable Prosthesis

The management of complex airway disorders is challenging, as the airway stent placement usually results in several complications. Tissue reaction to the foreign body, poor mechanical properties and inadequate fit of the stent in the airway are some of the reported problems. For this reason, the design of customized biomedical devices to improve the accuracy of the clinical results has recently gained interest. The aim of the present study is to introduce a parametric tool for the design of a new tracheo-bronchial stent that could be capable of improving some of the performances of the commercial devices. The proposed methodology is based on the computer aided design software and on the finite element modeling. The computational results are validated by a parallel experimental work that includes the production of selected stent configurations using the 3D printing technology and their compressive test.

Screening for extractables in additive-manufactured acrylonitrile butadiene styrene orthopedic cast

The use of additive-manufactured components in medical applications, specifically medical devices (e.g., orthopedic casts), has increased in recent years. Such devices may be fabricated at the point of care using consumer-grade additive manufacturing. Limited studies have been conducted to evaluate the extractable substances of these devices. Chemical characterization followed by toxicological risk assessment is one means of evaluating safety of devices. This study was designed to determine the extractables profile of additive-manufactured materials according to filament grade and post-processing method. Feedstocks for additive manufacturing were tested as filament and manufactured casts, while the cast from consumer-grade filament (CGF) was post-processed. Samples were extracted using three solvents of varying polarities. Extracts were analyzed by gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS) techniques. In GC/MS analysis, isopropanol extracts generated fewer compound identifications for USP Class VI filament (USPF)-based casts (3) compared with the respective filament (17) while hexane generated the most compound identifications for the finished cast manufactured from CGF. CGF was found to have the highest number of nonvolatile extractables for isopropanol (15) and hexane (34) by positive ion LC/MS. Additionally, CGF produced more non-polar extractables in hexane than the USPF. A known polymer byproduct and potential genotoxicant, styrene acrylonitrile (SAN) trimer, was one of the compounds identified in both GC/MS and LC/MS at quantities ranging from 19 to 270 μg g^-1. Overall these results suggested that the extractables profile was affected by the filament material, printing procedure, and post-processing method.

The role of 3D printing in pediatric airway obstruction: A systematic review

BACKGROUND

Tracheomalacia and tracheal stenosis are complicated, patient-specific diseases that require a multidisciplinary approach to diagnose and treat. Surgical interventions such as aortopexy, slide tracheoplasty, and stents potentially have high rates of morbidity. Given the emergence of three-dimensional (3D) printing as a versatile adjunct in managing complex pathology, there is a growing body of evidence that there is a strong role for 3D printing in both surgical planning and implant creation for pediatric airway obstruction.

METHODS

A structured PubMed.gov literature search was utilized, and a two-researcher systematic review was performed following the PRISMA criteria. The following search query was utilized: (((((3D printing) OR three-dimensional printing) OR 3D printed) OR three-dimensional printed) AND trachea) OR airway.

RESULTS

Over 23,000 publications were screened. Eight literature reviews and thirty-seven original papers met inclusion criteria. Of the thirty-seven original papers, eleven discussed 3D printing for surgical planning and twenty-six discussed 3D printing implants for interventions.

CONCLUSION

The reported application of 3D printing for management of pediatric airway obstruction is emerging with positive and broad applications. 3D printing for surgical planning not only improves pre-operative assessment of surgical approach and stent customization, but also helps facilitate patient/family education. 3D printing for custom implantable interventions is focused on bioresorbable external airway splints and biological grafts, with both animal studies and human case reports showing good results in improving symptoms.

Airway stenting: Technological advancements and its role in interventional pulmonology

AS offers rapid and sustained relief of symptoms in most patients treated for malignant or benign CAO and can also be curative in itself in cases of benign tracheobronchial stenosis. In the past 30 years, this field has seen significant progress, from the misuse of vascular non-covered metallic stents to the development of silicone airway stents with an increasingly large panel of shapes and of hybrid, partially or fully covered, SEMS customized to the airways. This study aims to offer an overview on: (i) the respective advantages and drawbacks of these two main categories of devices; (ii) the main indications for AS and the rationale behind the choice of stent in each situation; and (iii) the main promises borne from the progress made in the field in the past few years, including the development of drug-eluting, biodegradable or patient-specific customized AS.

Treatment of complex airway stenoses using patient-specific 3D-engineered stents: a proof-of-concept study

Anatomically complex airway stenosis (ACAS) represents a challenging situation in which commercially available stents often result in migration or granulation tissue reaction due to poor congruence. This proof-of-concept clinical trial investigated the feasibility and safety of computer-assisted designed (CAD) and manufactured personalised three-dimensional (3D) stents in patients with ACAS from various origins. After CAD of a virtual stent from a CT scan, a mould is manufactured using a 3D computer numerical control machine, from which a medical-grade silicone stent is made. Complication rate, dyspnoea, quality of life and respiratory function were followed after implantation. The congruence of the stent was assessed peroperatively and at 1 week postimplantation (CT scan). The stent could be implanted in all 10 patients. The 3-month complication rate was 40%, including one benign mucus plugging, one stent removal due to intense cough and two stent migrations. 9 of 10 stents showed great congruence within the airways, and 8 of 10 induced significant improvement in dyspnoea, quality of life and respiratory function. These promising outcomes in highly complex situations support further investigation on the subject, including technological improvements.​ TRIAL REGISTRATION NUMBER: NCT02889029.

The Role of 3D Printing in Medical Applications: A State of the Art

Three-dimensional (3D) printing refers to a number of manufacturing technologies that generate a physical model from digital information. Medical 3D printing was once an ambitious pipe dream. However, time and investment made it real. Nowadays, the 3D printing technology represents a big opportunity to help pharmaceutical and medical companies to create more specific drugs, enabling a rapid production of medical implants, and changing the way that doctors and surgeons plan procedures. Patient-specific 3D-printed anatomical models are becoming increasingly useful tools in today's practice of precision medicine and for personalized treatments. In the future, 3D-printed implantable organs will probably be available, reducing the waiting lists and increasing the number of lives saved. Additive manufacturing for healthcare is still very much a work in progress, but it is already applied in many different ways in medical field that, already reeling under immense pressure with regards to optimal performance and reduced costs, will stand to gain unprecedented benefits from this good-as-gold technology. The goal of this analysis is to demonstrate by a deep research of the 3D-printing applications in medical field the usefulness and drawbacks and how powerful technology it is.