Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability
Abstract Bioresorbable vascular scaffolds were considered the fourth generation of endovascular implants deemed to revolutionize cardiovascular interventions. Yet, unexpected high risk of scaffold thrombosis and post-procedural myocardial infractions quenched the early enthusiasm and...
| Main Authors: | , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Article |
| Language: | English |
| Published: |
Springer International Publishing
2021
|
| Online Access: | https://hdl.handle.net/1721.1/136774 |
| _version_ | 1826203497313337344 |
|---|---|
| author | Wang, Pei-Jiang Berti, Francesca Antonini, Luca Nezami, Farhad R Petrini, Lorenza Migliavacca, Francesco Edelman, Elazer R |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Wang, Pei-Jiang Berti, Francesca Antonini, Luca Nezami, Farhad R Petrini, Lorenza Migliavacca, Francesco Edelman, Elazer R |
| author_sort | Wang, Pei-Jiang |
| collection | MIT |
| description | Abstract
Bioresorbable vascular scaffolds were considered the fourth generation of endovascular implants deemed to revolutionize cardiovascular interventions. Yet, unexpected high risk of scaffold thrombosis and post-procedural myocardial infractions quenched the early enthusiasm and highlighted the gap between benchtop predictions and clinical observations. To better understand scaffold behavior in the mechanical environment of vessels, animal, and benchtop tests with multimodal loading environment were conducted using industrial standard scaffolds. Finite element analysis was also performed to study the relationship among structural failure, scaffold design, and load types. We identified that applying the combination of bending, axial compression, and torsion better reflects incidence observed in-vivo, far more than tranditional single mode loads. Predication of fracture locations is also more accurate when at least bending and axial compression are applied during benchtop tests (>60% fractures at connected peak). These structural failures may be initiated by implantation-induced microstructural damages and worsened by cyclic loads from the beating heart. Ignoring the multi-modal loading environment in benchtop fatigue tests and computational platforms can lead to undetected potential design defects, calling for redefining consensus evaluation strategies for scaffold performance. With the robust evaluation strategy presented herein, which exploits the results of in-vivo, in-vitro and in-silico investigations, we may be able to compare alternative designs of prototypes at the early stages of device development and optimize the performance of endovascular implants according to patients-specific vessel dynamics and lesion configurations in the future. |
| first_indexed | 2024-09-23T12:37:58Z |
| format | Article |
| id | mit-1721.1/136774 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T12:37:58Z |
| publishDate | 2021 |
| publisher | Springer International Publishing |
| record_format | dspace |
| spelling | mit-1721.1/1367742024-03-19T14:18:16Z Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability Wang, Pei-Jiang Berti, Francesca Antonini, Luca Nezami, Farhad R Petrini, Lorenza Migliavacca, Francesco Edelman, Elazer R Massachusetts Institute of Technology. Institute for Medical Engineering & Science Abstract Bioresorbable vascular scaffolds were considered the fourth generation of endovascular implants deemed to revolutionize cardiovascular interventions. Yet, unexpected high risk of scaffold thrombosis and post-procedural myocardial infractions quenched the early enthusiasm and highlighted the gap between benchtop predictions and clinical observations. To better understand scaffold behavior in the mechanical environment of vessels, animal, and benchtop tests with multimodal loading environment were conducted using industrial standard scaffolds. Finite element analysis was also performed to study the relationship among structural failure, scaffold design, and load types. We identified that applying the combination of bending, axial compression, and torsion better reflects incidence observed in-vivo, far more than tranditional single mode loads. Predication of fracture locations is also more accurate when at least bending and axial compression are applied during benchtop tests (>60% fractures at connected peak). These structural failures may be initiated by implantation-induced microstructural damages and worsened by cyclic loads from the beating heart. Ignoring the multi-modal loading environment in benchtop fatigue tests and computational platforms can lead to undetected potential design defects, calling for redefining consensus evaluation strategies for scaffold performance. With the robust evaluation strategy presented herein, which exploits the results of in-vivo, in-vitro and in-silico investigations, we may be able to compare alternative designs of prototypes at the early stages of device development and optimize the performance of endovascular implants according to patients-specific vessel dynamics and lesion configurations in the future. 2021-11-01T14:33:17Z 2021-11-01T14:33:17Z 2020-10-29 2021-04-21T03:35:30Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/136774 en https://doi.org/10.1007/s10439-020-02673-z Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ Biomedical Engineering Society application/pdf Springer International Publishing Springer International Publishing |
| spellingShingle | Wang, Pei-Jiang Berti, Francesca Antonini, Luca Nezami, Farhad R Petrini, Lorenza Migliavacca, Francesco Edelman, Elazer R Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title | Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title_full | Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title_fullStr | Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title_full_unstemmed | Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title_short | Multimodal Loading Environment Predicts Bioresorbable Vascular Scaffolds’ Durability |
| title_sort | multimodal loading environment predicts bioresorbable vascular scaffolds durability |
| url | https://hdl.handle.net/1721.1/136774 |
| work_keys_str_mv | AT wangpeijiang multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT bertifrancesca multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT antoniniluca multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT nezamifarhadr multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT petrinilorenza multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT migliavaccafrancesco multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability AT edelmanelazerr multimodalloadingenvironmentpredictsbioresorbablevascularscaffoldsdurability |