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Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds' Durability.

Pei-Jiang Wang1, Francesca Berti2,3, Luca Antonini3

  • 1Institute for Medical Engineering & Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building E25-442, Cambridge, MA, 02139, USA. wpj@bu.edu.

Annals of Biomedical Engineering
|October 30, 2020
PubMed
Summary

Bioresorbable vascular scaffolds face challenges due to thrombosis. Multimodal loading tests, including bending and axial compression, better predict scaffold failures than single loads, improving endovascular implant design.

Keywords:
Animal studyCoronary stents/scaffoldsDesign optimizationFinite elementPatient-specificPolylactic acidPolymer mechanicsScaffold fracture

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Materials Science

Background:

  • Bioresorbable vascular scaffolds (BVS) were expected to revolutionize cardiovascular interventions.
  • Clinical observations revealed high risks of scaffold thrombosis and myocardial infarctions, contrasting with benchtop predictions.
  • A gap exists between predicted and observed BVS performance in vivo.

Purpose of the Study:

  • To investigate scaffold behavior under multimodal mechanical loading conditions.
  • To understand the relationship between scaffold design, load types, and structural failure.
  • To improve the predictive accuracy of benchtop and computational testing for endovascular implants.

Main Methods:

  • Conducted animal and benchtop tests using industrial standard scaffolds under multimodal loading (bending, axial compression, torsion).
  • Performed finite element analysis to correlate structural failure with scaffold design and load types.
  • Compared multimodal loading conditions against traditional single-mode loads for predictive accuracy.

Main Results:

  • Multimodal loading, specifically bending, axial compression, and torsion, more accurately reflects in vivo scaffold behavior than single loads.
  • Predicting fracture locations improved significantly (>60%) when combining bending and axial compression in benchtop tests.
  • Structural failures may originate from implantation-induced damage and are exacerbated by cyclic cardiac loads.

Conclusions:

  • Current benchtop fatigue tests and computational models may overlook critical multi-modal loading environments, leading to undetected design defects.
  • Redefining consensus evaluation strategies for scaffold performance is necessary.
  • A robust evaluation strategy integrating in vivo, in vitro, and in silico data can optimize endovascular implant design for patient-specific needs.