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Zinc (Zn) has emerged as a promising bioresorbable stent material because of its satisfactory corrosion behavior and excellent biocompatibility. However, for load-bearing implant applications, alloying is required to boost its mechanical properties as pure Zn exhibits poor strength. Unfortunately, an increase in inflammation relative to pure Zn is a commonly observed side effect of Zn alloys. Consequently, the development of a Zn-based alloy that can simultaneously feature improved mechanical properties and suppress inflammatory responses is a big challenge. Here, a bioresorbable, biocompatible Zn–Ag-based quinary alloy was comprehensively evaluated in vivo, in comparison to reference materials. The inflammatory and smooth muscle cellular response was characterized and correlated to metrics of neointimal (NI) growth. We found that implantation of the quinary alloy was associated with significantly improved inflammatory activities relative to the reference materials. Additionally, we found that inflammation, but not smooth muscle cell hyperplasia, significantly correlates to NI growth for Zn alloys. The results suggest that inflammation is the main driver of NI growth for Zn-based alloys and that the quinary Zn–Ag–Mn–Zr–Cu alloy may impart inflammation-resistance properties to arterial implants.

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