Hemodynamics and Wall Mechanics of a Compliance Matching Stent: In Vitro and In Vivo Analysis

Berry, Joel L.; Manoach, Emil; Mekkaoui, Choukri; Rolland, Pierre H.; Moore, James E.; Rachev, Alexander

doi:10.1016/s1051-0443(07)60015-3

Cited by 101 publications

(69 citation statements)

References 11 publications

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“…7,8,10,17 Kinking and fractures tend to occur at sites of repeated stress, and neointimal hyperplasia and restenosis may occur where the stent forces are greatest. 18,19 These forces are not distributed evenly across the slotted-tube stent; as a result, stress is not effectively dissipated within the stent mesh network. Native arteries contain (within the vessel wall) a reticular network of interconnected collagen and elastin fibers that dissipates radial, axial, and torsional forces and prevents the creation of focal areas of high wall stress.…”

Section: Wire-interwoven Nitinol Stent In Peripheral Arterymentioning

confidence: 99%

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries

Garcia

Jaff

Metzger

et al. 2015

Circ: Cardiovascular Interventions

130

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P eripheral artery disease (PAD) is common, affecting between 8 and 12 million US residents. [1][2][3] Treatment strategies are well defined for aortoiliac vessels, 4 yet the initial success and durability of endovascular therapy in the femoropopliteal artery is limited by the diffuse nature of the disease, presence of calcification, heavy plaque burden, and high prevalence of total occlusion. Furthermore, dynamic forces (compression, torsion, bending, lengthening, Background

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Section: Wire-interwoven Nitinol Stent In Peripheral Arterymentioning

confidence: 99%

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries

Garcia

Jaff

Metzger

et al. 2015

Circ: Cardiovascular Interventions

130

View full text Add to dashboard Cite

show abstract

“…However, even in the presence of a stent, cellular proliferation remains a contributing factor of restenosis and can be caused by the stretching and damaging of the wall during angioplasty [6], the body's response to the stent material [9], and a compliance mismatch between the stent and artery [9][10][11]. Drug-eluting stents (DES) are the most recent breakthrough in stent technology.…”

Section: Introductionmentioning

confidence: 99%

Unconstrained recovery characterization of shape-memory polymer networks for cardiovascular applications

et al. 2007

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Shape-memory materials have been proposed in biomedical device design due to their ability to facilitate minimally invasive surgery and recover to a predetermined shape in-vivo. Use of the shapememory effect in polymers is proposed for cardiovascular stent interventions to reduce the catheter size for delivery and offer highly controlled and tailored deployment at body temperature. Shapememory polymer networks were synthesized via photopolymerization of tert-butyl acrylate and poly (ethylene glycol) dimethacrylate to provide precise control over the thermomechanical response of the system. The free recovery response of the polymer stents at body temperature was studied as a function of glass transition temperature (T g ), crosslink density, geometrical perforation, and deformation temperature, all of which can be independently controlled. Room temperature storage of the stents was shown to be highly dependent on T g and crosslink density. The pressurized response of the stents is also demonstrated to depend on crosslink density. This polymer system exhibits a wide range of shape-memory and thermomechanical responses to adapt and meet specific needs of minimally invasive cardiovascular devices.

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“…Comparisons of the mechanical properties between stented and unstented arteries showed a better match over a 316L stent -compliance mismatch has been shown to be correlated with intimal hyperplasia, which also leads to restenosis. [ 37 ] Corrosion resistance in PBS was signifi cantly improved over 316L SS in vitro, due to the formation of a ZrO 2 -rich oxide fi lm, [ 35 ] thus overcoming the relatively poor results that were summarized in an earlier report [ 12 ] for different compositions. Improved cell adhesion over that on 316L SS was observed, together with slower growth of smooth muscle cells, again reducing the potential incidence of restenosis.…”

Section: Stentsmentioning

confidence: 91%

Bulk Metallic Glasses for Implantable Medical Devices and Surgical Tools

et al. 2016

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Their inherent lack of dislocations and hence slip planes leads to exceptionally high strength and elasticity, approaching the theoretical limit. While oxide glasses and ceramics exhibit low toughness and brittle failure, BMGs can display toughness comparable to crystalline metals. [ 2 ] The lack of grain structure means that BMGs are homogeneous and exhibit isotropic behavior, even at sub-micrometer length scales, and, without grain boundaries or precipitates as oxidation sites, corrosion rates are significantly reduced compared to conventional metals.BMGs soften above an alloy-specifi c glass-transition temperature ( T g ) before eventual, time-dependent, crystallization at a higher, crystallization temperature ( T x ). In this supercooled liquid region (SCLR) between T g and T x , the viscous BMGs may be plastically shaped under low applied forces using polymer-processing techniques, such as hot embossing, extrusion, foaming, and injection and blow moulding, before again cooling to a solid metallic glass. With relatively low processing temperatures and no solidifi cation shrinkage, parts can be formed to netshape with excellent accuracy, and geometries, and surface patterns previously diffi cult in metals can be achieved with ease. [3][4][5][6][7] Such remarkable properties and behavior have led to significant interest in BMGs as engineering materials over the past 20 years, but it is only recently that their potential for use as a biomaterial has been studied. [ 8 ] To date, our understanding of material biocompatiblity has evolved mainly through empirical testing, observing the interaction of materials with cells and host tissue in vitro and in vivo. Materials can induce host responses varying from local and systemic infl ammation, hypersensistivity, toxicity, and even tumorogenesis, meaning that thorough evidence of material safety is required before regulatory approval and clinical translation. We now largely recognise the material characteristics that generate both favorable and undesired host responses, as outlined by Williams, [ 9 ] offering the opportunity for informed material design, while being cognisant that biocompatibility is specifi c to the application and host environment. [ 10 ] The original requirement of fi rst generation "biocompatible" materials was bio-inertness. [ 11 ] This included a resistance to corrosion in the body, and here Ti-and Co-based alloys scored highly. [ 12 ] Less-inert metals, such as Mg, were therefore not deemed suitable, although the ions released on dissolution are generally not harmful to the human body. However, current design requirements for biomaterials, including most recently biometals, include eliciting an appropriate host response, [ 13 ] and this can include the need to biodegrade and resorb. There are potential advantages for BMGs that span applications of With increasing knowledge of the materials science of bulk metallic glasses (BMGs) and improvements in their properties and processing, they have started to become candidate materials for biomedical dev...

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Hemodynamics and Wall Mechanics of a Compliance Matching Stent: In Vitro and In Vivo Analysis

Cited by 101 publications

References 11 publications

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries

Unconstrained recovery characterization of shape-memory polymer networks for cardiovascular applications

Bulk Metallic Glasses for Implantable Medical Devices and Surgical Tools

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