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Bioresorbable Polymeric Scaffold in Cardiovascular Applications.

ABSTRACT: Advances in material science and innovative medical technologies have allowed the development of less invasive interventional procedures for deploying implant devices, including scaffolds for cardiac tissue engineering. Biodegradable materials (e.g., resorbable polymers) are employed in devices that are only needed for a transient period. In the case of coronary stents, the device is only required for 6-8 months before positive remodelling takes place. Hence, biodegradable polymeric stents have been considered to promote this positive remodelling and eliminate the issue of permanent caging of the vessel. In tissue engineering, the role of the scaffold is to support favourable cell-scaffold interaction to stimulate formation of functional tissue. The ideal outcome is for the cells to produce their own extracellular matrix over time and eventually replace the implanted scaffold or tissue engineered construct. Synthetic biodegradable polymers are the favoured candidates as scaffolds, because their degradation rates can be manipulated over a broad time scale, and they may be functionalised easily. This review presents an overview of coronary heart disease, the limitations of current interventions and how biomaterials can be used to potentially circumvent these shortcomings in bioresorbable stents, vascular grafts and cardiac patches. The material specifications, type of polymers used, current progress and future challenges for each application will be discussed in this manuscript.

SUBMITTER: Toong DWY

PROVIDER: S-EPMC7279389 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Bioresorbable Polymeric Scaffold in Cardiovascular Applications.

Toong Daniel Wee Yee DWY Toh Han Wei HW Ng Jaryl Chen Koon JCK Wong Philip En Hou PEH Leo Hwa Liang HL Venkatraman Subramanian S Tan Lay Poh LP Ang Hui Ying HY Huang Yingying Y

International journal of molecular sciences 20200513 10

Advances in material science and innovative medical technologies have allowed the development of less invasive interventional procedures for deploying implant devices, including scaffolds for cardiac tissue engineering. Biodegradable materials (e.g., resorbable polymers) are employed in devices that are only needed for a transient period. In the case of coronary stents, the device is only required for 6-8 months before positive remodelling takes place. Hence, biodegradable polymeric stents have ...[more]

PMID: 32414114

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Project description:Structural cardiac lesions are often surgically repaired using prosthetic patches, which can be of biological or synthetic nature. In the current clinical scenario, amongst biological patches, are gaining very much interest those derived from decellularization of xenogeneic scaffold. These patches maintain their natural architecture of the extracellular matrix (ECM) after the removal of their native cells. Moreover, once implanted in the host, they promote tissue regeneration and repair, encourage angiogenesis, migration, proliferation, and host’s cell differentiation mechanisms. Finally, in the host, decellularized xenogeneic patches, after cells repopulation, reduce immuno-mediated response against the graft thus preventing device failure. Small intestinal submucosa (SIS) from porcine showed such properties in alternative clinical scenarios. The US FDA approved its use in humans for urogenital procedures, such as hernia repair, cystoplasties, ureteral reconstructions, stress incontinence, Peyronie’s disease, penile chordee, and urethral reconstruction for hypospadias and strictures. In addition, it has also been successfully used for the skeletal muscle tissue reconstruction in young patients. However, for cardiovascular applications, the results are still controversial. In this study, we aimed to validate our decellularization protocols for SIS, which is based on the use of Tergitol 15 S 9, by comparing it to our previous and efficient method (Triton X 100) which is not more available on the market. For both treatments, we evaluated the preservation of the ECM ultrastructure, mechanics, biocompatibility and final bioinductive capabilities. The overall analysis shows that the SIS tissue is macroscopically distinguishable into two regions, smooth or wrinkle, which are equivalent for ultrastructure and biochemical profile. Furthermore, Tergitol 15 S 9 treatment do not modify the mechanics of the tissue, resulting comparable to the native one and confirming the superior preservation of the collagen fibers. In summary, our study showed that the SIS decellularized with Tergitol 15 S 9 guarantees higher performance compared to Triton X 100 in all the fields of characterization explored and for all the components of the SIS: wrinkled and smooth.

Project description:Drug-eluting bioresorbable vascular scaffolds (BVSs) have the potential to restore lumen patency, enable recovery of the native vascular environment, and circumvent late complications associated with permanent endovascular devices. To ensure therapeutic effects persist for sufficient times prior to scaffold resorption and resultant functional loss, many factors dictating BVS performance must be identified, characterized and optimized. While some factors relate to BVS design and manufacturing, others depend on device deployment and intrinsic vascular properties. Importantly, these factors interact and cannot be considered in isolation. The objective of this study is to quantify the extent to which degree of radial expansion modulates BVS performance, specifically in the context of modifying device erosion kinetics and evolution of structural mechanics and local drug elution. We systematically varied degree of radial expansion in model BVS constructs composed of poly dl-lactide-glycolide and generated in vitro metrics of device microstructure, degradation, erosion, mechanics and drug release. Experimental data permitted development of computational models that predicted transient concentrations of scaffold-derived soluble species and drug in the arterial wall, thus enabling speculation on the short- and long-term effects of differential expansion. We demonstrate that degree of expansion significantly affects scaffold properties critical to functionality, underscoring its relevance in BVS design and optimization.Bioresorbable vascular scaffold (BVS) therapy is beginning to transform the treatment of obstructive artery disease, owing to effective treatment of short term vessel closure while avoiding long term consequences such as in situ, late stent thrombosis - a fatal event associated with permanent implants such as drug-eluting stents. As device scaffolding and drug elution are temporary for BVS, the notion of using this therapy in lieu of existing, clinically approved devices seems attractive. However, there is still a limited understanding regarding the optimal lifetime and performance characteristics of erodible endovascular implants. Several engineering criteria must be met and clinical endpoints confirmed to ensure these devices are both safe and effective. In this manuscript, we sought to establish general principles for the design and deployment of erodible, drug-eluting endovascular scaffolds, with focus on how differential expansion can modulate device performance.

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Bioresorbable Polymeric Scaffold in Cardiovascular Applications.

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Bioresorbable Polymeric Scaffold in Cardiovascular Applications.

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