Research of Customized Aortic Stent Graft Manufacture

An Integrative Experimental Approach to Design Optimization and Removal Strategies of Supporting Structures Used during L-PBF of SS316L Aortic Stents

One of the fundamental challenges in L-PBF of filigree geometries, such as aortic stents used in biomedical applications, is the requirement for a robust yet easily removable support structure that allows each component to be successfully fabricated without distortion. To solve this challenge, an integrative experimental approach was attempted in the present study by identifying an optimal support structure design and an optimized support removal strategy for this design. The specimens were manufactured using four different support structure designs based on the geometry exposed to the laser beam during the L-PBF. Support removal procedures included sand blasting (SB), glass bead blasting (GB), and electrochemical polishing (ECP). The two best-performing designs (line and cross) were chosen due to shorter lead times and lower material consumption. As an additional factor that indicates a stable design, the breaking load requirement to remove the support structures was determined. A modified line support with a 145° included angle was shown to be the best support structure design in terms of breaking load, material consumption, and manufacturing time. All three procedures were used to ensure residue-free support removal for this modified line support design, with ECP proving to be the most effective.

Long-term results of triple-layered small diameter vascular grafts in sheep carotid arteries

There is an urgent clinical for small diameter vascular grafts (SDVGs) for use in the treatment of coronary artery disease. Moreover, biodegradable SDVGs are drawing increasing attention because they have the potential to restore vascular function with the degradation of vascular graft and tissue regeneration. In this study, we designed triple-layered SDVGs to mimic the native arterial structure, with each layer contributing its unique porosity to the porous structure. We evaluated triple-layered SDVGs in a sheep carotid arterial replacement model. After implantation for 12 months, two grafts were patent and indicated the feasibility of using grafts in large animals. Nevertheless, it was determined that both grafts formed aneurysms at the proximal end. The prevention of such aneurysms remains a challenge for future investigation.

Customized stent-grafts for endovascular aneurysm repair with challenging necks: A numerical proof of concept

Endovascular aortic repair (EVAR) is a challenging intervention whose long-term success strongly depends on the appropriate stent-graft (SG) selection and sizing. Most off-the-shelf SGs are straight and cylindrical. Especially in challenging vessel morphologies, the morphology of off-the-shelf SGs is not able to meet the patient-specific demands. Advanced manufacturing technologies facilitate the development of highly customized SGs. Customized SGs that have the same morphology as the luminal vessel surface could considerably improve the quality of the EVAR outcome with reduced likelihoods of EVAR related complications such as endoleaks type I and SG migration. In this contribution, we use an in silico EVAR methodology that approximates the deployed state of the elastically deformable SG in a hyperelastic, anisotropic vessel. The in silico EVAR results of off-the-shelf SGs and customized SGs are compared qualitatively and quantitatively in terms of mechanical and geometrical parameters such as stent stresses, contact tractions, SG fixation forces and the SG-vessel attachment. In a numerical proof of concept, eight different vessel morphologies, such as a conical vessel, a barrel shaped vessel and a curved vessel, are used to demonstrate the added value of customized SGs compared to off-the-shelf SGs. The numerical investigation has shown large benefits of the highly customized SGs compared to off-the-shelf SGs with respect to a better SG-vessel attachment and a considerable increase in SG fixation forces of up to 50% which indicate decreased likelihoods of EVAR related complications. Hence, this numerical proof of concept motivates further research and development of highly customized SGs for the use in challenging vessel morphologies.