Abstract

Bioresorbable stents (BRS) represent the latest generation of vascular scaffolds used for minimally invasive interventions. They aim to overcome the shortcomings of established bare-metal stents (BMS) and drug-eluting stents (DES). Recent advances in the field of bioprinting offer the possibility of combining biodegradable polymers to produce a composite BRS. Evaluation of the mechanical performance of the novel composite BRS is the focus of this study, based on the idea that they are a promising solution to improve the strength and flexibility performance of single material BRS. Finite element analysis of stent crimping and expansion was performed. Polylactic acid (PLA) and polycaprolactone (PCL) formed a composite stent divided into four layers, resulting in sixteen unique combinations. A comparison of the mechanical performance of the different composite configurations was performed. The resulting stresses, strains, elastic recoil, and foreshortening were evaluated and compared to existing experimental results. Similar behaviour was observed for material configurations that included at least one PLA layer. A pure PCL stent showed significant elastic recoil and less shortening compared to PLA and composite structures. The volumetric ratio of the materials was found to have a more significant effect on recoil and foreshortening than the arrangement of the material layers. Composite BRS offer the possibility of customising the mechanical behaviour of scaffolds. They also have the potential to support the fabrication of personalised or plaque-specific stents.

Highlights

  • Nowadays, cardiovascular diseases are among the most dangerous diseases in the world [1]

  • Available balloonexpandable stents are made of medical-grade stainless steel (316L), nickel-titanium alloy (NiTi), or cobalt-chromium alloy (CoCr)

  • The results showed that these four stents exhibited different mechanical performances during the crimping and expansion process due to their individual designs

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Summary

Introduction

Cardiovascular diseases are among the most dangerous diseases in the world [1]. Stenting interventions are used to restore normal blood flow through partially or completely blocked blood vessels. Coronary stents are usually tiny wire mesh tubes used to open arteries that have become blocked over time due to the accumulation of fat, cholesterol, or other substances. When the balloon is inflated, the stent expands, plastically deforms, locks in place, and forms a scaffold that keeps the artery open. Inserting stents into narrowed blood vessels to restore normal blood flow is a less invasive method of treating cardiovascular disease [2]. The latest high-performance coronary artery stents are made of improved metal alloys, often with a drug-eluting outer coating. These drugeluting stents (DES) offer better clinical performance than earlier technologies. Permanent stents are a chronic irritant to the host; they interfere with future cardiac interventions and do not conform to the natural behaviour of the vessel [3]

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