Zhao Fan, Sun Jing, Xue Wen, Wang Fujun, King Martin W, Yu Chenglong, Jiao Yongjie, Sun Kun, Wang Lu
College of Textiles, Donghua University, Shanghai, 201620, China.
Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Songjiang District, Shanghai, 201620, China.
Bioact Mater. 2021 Mar 1;6(9):2969-2982. doi: 10.1016/j.bioactmat.2021.02.017. eCollection 2021 Sep.
Recent progress in bioresorbable stents (BRSs) has provided a promising alternative for treating coronary artery disease. However, there is still lack of BRSs with satisfied compression and degradation performance for pediatric patients with congenital heart disease, leading to suboptimal therapy effects. Here, we developed a mechanically self-reinforced composite bioresorbable stent (cBRS) for congenital heart disease application. The cBRS consisted of poly(-dioxanone) monofilaments and polycaprolactone/poly(-dioxanone) core-shell composite yarns. Interlacing points in cBRS structure were partially bonded, offering the cBRS with significantly higher compression force compared to typical braids and remained good compliance. The suitable degradation profile of the cBRS can possibly preserve vascular remodeling and healing process. In addition, the controllable structural organization provides a method to customize the performance of the cBRS by altering the proportion of different components in the braids. The in vivo results suggested the cBRS supported the vessel wall similar to that of metallic stent. In both abdominal aorta and iliac artery of porcine, cBRS was entirely endothelialized within 1 month and maintained target vessels with good patency in the 12-month follow-up. The in vivo degradation profile of the cBRS is consistent with static degradation results in vitro. It is also demonstrated that there is minimal impact of pulsatile pressure of blood flow and variation of radial force on the degradation rate of the cBRS. Moreover, the lumen of cBRS implanted vessels were enlarged after 6 months, and significantly larger than the vessels implanted with metallic stent in 12 months.
生物可吸收支架（BRSs）的最新进展为治疗冠状动脉疾病提供了一种有前景的替代方案。然而，对于患有先天性心脏病的儿科患者，仍缺乏具有令人满意的压缩和降解性能的BRSs，导致治疗效果欠佳。在此，我们开发了一种用于先天性心脏病的机械自增强复合生物可吸收支架（cBRS）。cBRS由聚（-二氧六环酮）单丝和聚己内酯/聚（-二氧六环酮）核壳复合纱线组成。cBRS结构中的交织点部分粘结，与典型编织物相比，使cBRS具有显著更高的压缩力，并保持良好的顺应性。cBRS合适的降解特性可能有助于维持血管重塑和愈合过程。此外，可控的结构组织提供了一种通过改变编织物中不同成分的比例来定制cBRS性能的方法。体内结果表明，cBRS对血管壁的支撑作用与金属支架相似。在猪的腹主动脉和髂动脉中，cBRS在1个月内完全内皮化，并在12个月的随访中使靶血管保持良好的通畅性。cBRS的体内降解特性与体外静态降解结果一致。还表明，血流的脉动压力和径向力的变化对cBRS的降解速率影响极小。此外，植入cBRS的血管腔在6个月后扩大，且在12个月时明显大于植入金属支架的血管。
