Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Department of Otolaryngology-Head and Neck Surgery, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.
Biomaterials. 2022 Oct;289:121702. doi: 10.1016/j.biomaterials.2022.121702. Epub 2022 Aug 21.
Implantable patient-specific devices are the next frontier of personalized medicine, positioned to improve the quality of care across multiple clinical disciplines. Translation of patient-specific devices requires time- and cost-effective processes to design, verify and validate in adherence to FDA guidance for medical device manufacture. In this study, we present a generalized strategy for selective laser sintering (SLS) of patient-specific medical devices following the prescribed guidance for additive manufacturing of medical devices issued by the FDA in 2018. We contextualize this process for manufacturing an Airway Support Device, a life-saving tracheal and bronchial implant restoring airway patency for pediatric patients diagnosed with tracheobronchomalacia and exhibiting partial or complete airway collapse. The process covers image-based modeling, design inputs, design verification, material inputs and verification, device verification, and device validation, including clinical results. We demonstrate how design and material assessment lead to verified Airway Support Devices that achieve desired airway patency and reduction in required Positive End-Expiratory Pressure (PEEP) after patient implantation. We propose this process as a template for general quality control of patient-specific, 3D printed implants.
可植入的个体化患者专用设备是个性化医疗的下一个前沿领域,有望改善多个临床学科的护理质量。将患者专用设备进行翻译需要耗时且耗费成本的设计、验证和验证过程,以符合 FDA 对医疗器械制造的指导。在这项研究中,我们提出了一种基于选择性激光烧结(SLS)的个体化医疗设备的通用策略,该策略遵循 FDA 在 2018 年发布的医疗器械增材制造的规定指导。我们将这一过程用于制造气道支持装置,这是一种救生气管和支气管植入物,用于治疗患有气管支气管软化症并表现出部分或完全气道塌陷的儿科患者,以恢复气道通畅性。该过程涵盖基于图像的建模、设计输入、设计验证、材料输入和验证、设备验证以及设备验证,包括临床结果。我们展示了如何通过设计和材料评估来制造经过验证的气道支持设备,以实现所需的气道通畅性,并在患者植入后降低所需的呼气末正压(PEEP)。我们提出该过程作为个体化、3D 打印植入物的通用质量控制模板。