Defining biomaterial-driven design principles for bioabsorbable flow diverters: current state and perspectives

Area of Science:

• Biomaterials Science
• Neurovascular Surgery
• Medical Device Design

Background:

• Current permanent metallic flow diverters (FDs) for intracranial aneurysms present limitations including chronic inflammation, thrombotic risk, and poor vessel integration due to their material properties.
• Addressing these challenges requires innovative solutions that improve biocompatibility and long-term device performance.

Purpose of the Study:

• To review and establish a rational design roadmap for bioactive bioabsorbable flow diverters (FDs) that overcome the limitations of current permanent devices.
• To analyze material-driven design challenges and propose solutions balancing scaffold resorption with aneurysm occlusion.

Main Methods:

• Comprehensive review of existing literature on flow diverter materials and design.
• Analysis of material properties, degradation kinetics, and architectural considerations for bioabsorbable FDs.
• Examination of mechanical-biological trade-offs and hybrid strategies for device development.

Main Results:

• Bioabsorbable materials can overcome limitations of permanent FDs by balancing resorption with aneurysm occlusion.
• Synchronized degradation kinetics and neointimal encapsulation are crucial for device functionality and safety.
• Hybrid strategies combining transient and permanent components offer a balance between mechanical reliability and controlled resorption.

Conclusions:

• Rational design of bioabsorbable FDs requires converging bulk material selection with advanced interfacial engineering.
• These principles enable the development of next-generation neurovascular implants with optimized safety and translational potential.
• A materials-driven approach is key to advancing intracranial aneurysm management.