Vascular Engineering Laboratory, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and the UWA Centre for Medical Research, The University of Western Australia, Perth, 6009, Australia.
School of Engineering, The University of Western Australia, Perth, 6009, Australia.
Adv Healthc Mater. 2022 Jul;11(13):e2200271. doi: 10.1002/adhm.202200271. Epub 2022 May 16.
Endovascular treatment of aortic disorders has gained wide acceptance due to reduced physiological burden to the patient compared to open surgery, and ongoing stent-graft evolution has made aortic repair an option for patients with more complex anatomies. To date, commercial stent-grafts are typically developed from established production techniques with simple design structures and limited material ranges. Despite the numerous updated versions of stent-grafts by manufacturers, the reoccurrence of device-related complications raises questions about whether the current manfacturing methods are technically able to eliminate these problems. The technology trend to produce efficient medical devices, including stent-grafts and all similar implants, should eventually change direction to advanced manufacturing techniques. It is expected that through recent advancements, especially the emergence of 4D-printing and smart materials, unprecedented features can be defined for cardiovascular medical implants, like shape change and remote battery-free self-monitoring. 4D-printing technology promises adaptive functionality, a highly desirable feature enabling printed cardiovascular implants to physically transform with time to perform a programmed task. This review provides a thorough assessment of the established technologies for existing stent-grafts and provides technical commentaries on known failure modes. They then discuss the future of advanced technologies and the efforts needed to produce next-generation endovascular implants.
血管内治疗主动脉疾病因其对患者生理负担较小而得到广泛认可，而支架移植物的不断发展使得主动脉修复成为更复杂解剖结构患者的一种选择。迄今为止，商业支架移植物通常是基于成熟的生产技术开发的，具有简单的设计结构和有限的材料范围。尽管制造商对支架移植物进行了多次更新，但设备相关并发症的再次发生引发了人们对当前制造方法是否有技术能力来消除这些问题的质疑。生产高效医疗器械（包括支架移植物和所有类似植入物）的技术趋势最终应该转向先进的制造技术。预计通过最近的进步，特别是 4D 打印和智能材料的出现，心血管医疗植入物可以定义出前所未有的特性，如形状变化和远程无电池自我监测。4D 打印技术有望实现自适应功能，这是一个非常理想的特性，使打印心血管植入物能够随着时间的推移进行物理变形，以执行预定的任务。本综述全面评估了现有支架移植物的现有技术，并对已知的失效模式提供了技术评论。然后，他们讨论了先进技术的未来以及生产下一代血管内植入物所需的努力。
