Lin Cheng, Huang Zhipeng, Wang Qinglong, Zou Zhichen, Wang Wenbo, Liu Liwu, Liu Yanju, Leng Jinsong
Centre for Composite Materials and Structures, Harbin Institute of Technology, No. 2 Yikuang Street, Harbin, 150001, P. R. China.
Tangdu Hospital of the Air Force Military Medical University, No. 1, Xinsi Road, Xi'an, 710038, P. R. China.
Adv Healthc Mater. 2023 Feb;12(4):e2201999. doi: 10.1002/adhm.202201999. Epub 2022 Nov 15.
Percutaneous closure of ventricular septal defect (VSD) can effectively occlude abnormal blood flow between ventricles. However, commonly used Nitinol occlusion devices have non-negligible limitations, such as nondegradability leading to life-threatening embolization; limited device size predisposing to displacement and wear; only a few radiopaque markers resulting in inaccurate positioning. Nevertheless, the exploration of customized, biodegradable, and overall radiopaque occluders is still vacant. Here, overall radiopaque, biodegradable, and dynamic reconfigurable 4D printed VSD occluders are developed. Based on wavy bionic structures, various VSD occluders are designed and manufactured to adapt to the position diversity of VSD. The customized configuration, biocompatibility, and biodegradability of the developed 4D printed bionic occluders can eliminate the series of complications caused by traditional occluders. The overall radiopacity of 4D printed VSD occluders is validated ex vivo and in vivo, whereby accurate positioning can be assured. Notably, the preparation strategies for 4D printed occluders are scalable, eliminating the barriers to mass production, and marking a meaningful step in bridging the gap between modeling and clinical application of 4D printed occlusion devices. This work opens attractive perspectives for the rapid manufacturing of customized intelligent medical devices for which overall radiopacity, dynamic reconfigurability, biocompatibility, and biodegradability are sought.
经皮闭合室间隔缺损（VSD）可有效封堵心室间的异常血流。然而，常用的镍钛诺封堵装置存在不可忽视的局限性，如不可降解导致危及生命的栓塞；装置尺寸有限易导致移位和磨损；不透射线标记物较少导致定位不准确。尽管如此，定制化、可生物降解且整体不透射线封堵器的探索仍处于空白。在此，开发了整体不透射线、可生物降解且动态可重构的4D打印VSD封堵器。基于波浪形仿生结构，设计并制造了各种VSD封堵器以适应VSD的位置多样性。所开发的4D打印仿生封堵器的定制化构型、生物相容性和生物降解性可消除传统封堵器引起的一系列并发症。4D打印VSD封堵器的整体不透射线性能在体外和体内均得到验证，从而可确保准确定位。值得注意的是，4D打印封堵器的制备策略具有可扩展性，消除了大规模生产的障碍，并标志着在弥合4D打印封堵装置的建模与临床应用之间差距方面迈出了有意义的一步。这项工作为快速制造寻求整体不透射线、动态可重构、生物相容性和生物降解性的定制化智能医疗设备开辟了有吸引力的前景。
