Cardiovascular disease is a major threat to human health worldwide, and vascular transplantation surgery is a treatment method for this disease. Often, autologous blood vessels cannot meet the needs of surgery. However, allogeneic blood vessels have limited availability or may cause rejection reactions. Therefore, the development of biocompatible artificial blood vessels is needed to solve the problem of donor shortage. Tubular fabrics prepared by textile structures have flexible compliance, which cannot be matched by other structural blood vessels. Therefore, biomedical artificial blood vessels have been widely studied in recent decades up to the present. This article focuses on reviewing four textile methods used, at present, in the manufacture of artificial blood vessels: knitting, weaving, braiding, and electrospinning. The article mainly introduces the particular effects of different structural characteristics possessed by various textile methods on the production of artificial blood vessels, such as compliance, mechanical properties, and pore size. It was concluded that woven blood vessels possess superior mechanical properties and dimensional stability, while the knitted fabrication method facilitates excellent compliance, elasticity, and porosity of blood vessels. Additionally, the study prominently showcases the ease of rebound and compression of braided tubes, as well as the significant biological benefits of electrospinning. Moreover, moderate porosity and good mechanical strength can be achieved by changing the original structural parameters; increasing the floating warp, enlarging the braiding angle, and reducing the fiber fineness and diameter can achieve greater compliance. Furthermore, physical, chemical, or biological methods can be used to further improve the biocompatibility, antibacterial, anti-inflammatory, and endothelialization of blood vessels, thereby improving their functionality. The aim is to provide some guidance for the further development of artificial blood vessels.

The Influence of Textile Structure Characteristics on the Performance of Artificial Blood Vessels

Evaluation of poly (L-lactic acid) monofilaments with high mechanical performance in vitro degradation

A study of the radial and bending performance for poly (L-lactic acid) braided stents with innovative runners

Poly(l-lactic acid) (PLLA) has been widely used in constructing biodegradable braided stents due to high biocompatibility and biodegradability. However, poor mechanical properties of this stent are main weaknesses. In this paper, the mechanical properties of PLLA braided stents containing axial stiffeners were evaluated. The stents with stiffener diameters of 0.11, 0.19 and 0.28 mm are named SS11, SS19 and SS28, respectively, and the stent without stiffener is named SS00 as control. The results show that compared with SS00, the bending stiffness of SS11, SS19 and SS28 is increased by 0.77, 1.76, and 2.70 times, respectively. Meanwhile, chronic outward force at an indicated use diameter of 5 mm is increased by 0.83, 0.50, and 0.21 times, but elastic recovery rate is decreased by 5.6%, 14.6%, 22.5%. In addition, radial stiffness of SS11, SS19, and SS28 are increased by 2.81, 2.08 and 1.62 times, respectively. Therefore, the radial support performance is improved and the bending flexibility is weakened by adding stiffeners. Taken together, SS11 can provide sufficient radial support force and low axial force in clinical applications. This study may provide a reference for optimizing the mechanical properties of the biodegradable braided stents. 

Evaluation of mechanical properties of poly(
 L
 ‐lactic acid) braided stents with axial stiffeners

Objective and Design: The search for improved stenting technologies to treat peripheral artery disease is trending toward biodegradable self-expanding shape-memory stents that, as of now, still suffer from the acute trade-off between deliverability and luminal stability: Higher deliverability leads to lower lumen stability, vessel recoil, and stent breakage. This study was aimed at the development and testing of a self-expanding bioresorbable poly(l,l-lactide-co-ε-caprolactone) stent that was designed to produce confident self-expansion after efficient crimping, as well as quick bioresorption, and sufficient radial force. Materials and Methods: Bench tests were employed to measure shape-memory properties, radial force, and hydrolytic degradation of the stent. The porcine model was employed to study deliverability, lumen stability, biocompatibility, and stent integrity. A total of 32 stents were implanted in the iliac arteries of 16 pigs with 15 to 180 day follow-up periods. The stented vessels were studied by angiography and histological evaluation. Results: Recovery of the diameter of the stent due to shape-memory effect was equal to 90.6% after 6Fr crimping and storage in refrigeration for 1 week. Radial force measured after storage was equal to 0.7 N/mm. Technical success of implantation in pigs (after the delivery implemented by pusher) was 94%. At 180 days, no implanted stents were found to be fragmented: All of the devices remained at the site of implantation with no stent migration and all stents retained their luminal support. Only moderate inflammation and neoepithelialization were detected by histological assessment at 60, 90, 120, and 180 days. Lumen loss at 180 days was less than 25% of the vessel diameter. Conclusions: The stent with the mechanical and chemical properties described in this study may present the optimal solution of the trade-off between deliverability and luminal stability that is necessary for designing the next generation stent for endovascular therapy of peripheral arterial disease.

https://journals.sagepub.com/doi/pdf/10.1177/15266028221077001

Novel Self-expanding Shape-Memory Bioresorbable Peripheral Stent Displays Efficient Delivery, Accelerated Resorption, and Low Luminal Loss in a Porcine Model

Effects of constraint between filaments on the radial compression properties of poly (l-lactic acid) self-expandable braided stents

Compared with traditional metal stents, biodegradable polymer stents have better biocompatibility but poorer mechanical properties in the treatment of vascular stenosis. It is necessary to improve the mechanical properties of biodegradable polymer stents for further application. For this purpose, we prepared a poly(L-lactide) braided stent covered with six-arm poly(L-lactide-co-ε-caprolactone) (6S-PLCL) coating cross-linked by hexamethylene diisocyanate (HDI) in different proportions. The coating causes an effective constraint on the movement of the monofilaments in the axial direction at the intersection. Due to this constraint, the coating enhanced mechanical properties of the stent and effectively reduced the axial elongation after crimping. Furthermore, the coated stent with the mass ratio of 5:1 (6S-PLCL:HDI) showed the highest chronic outward force and the lowest axial elongation compared to the other mass ratios. The results can provide suggestions for improving the mechanical properties of polymer-braided stents as compared to traditional metal stents. 

Enhanced mechanical properties of poly(L‐lactide) braided stent with six‐arm poly(L‐lactide‐co‐ε‐caprolactone) coating cross‐linked by hexamethylene diisocyanate

Biodegradable materials are widely used in biomedical application. Blending polymers have become a promising strategy to regulate degradation rate and expand material properties. In this study, the poly(D, L-lactic acid) (PDLLA) and polyCL-lactide-co-ɛ-caprolactone) (PLcCL) blend films with different ratios were prepared by the ultrasonic spray technology and the in vitro hydrolytic degradation tests of these films were then carried out in phosphate buffered saline with 37°C and 50°C. The in vitro degradation of the blend films were investigated via mass loss, gel permeation chromatography (GPC), scanning electron microscopy (SEM). It was found that the blended film had good miscibility and uniformity through SEM tests. Besides, the 50/50 PLcCL/PDLLA film showed the slowest degradation rate at 37°C, while at 50°C, the 100 PLcCL film had the slowest degradation. This work can provide helpful suggestions for the evaluation of biodegradable polymer coating materials in degradable polymer coated stent.

In vitro hydrolytic degradation properties of poly(D, L-lactic acid) / poly(L-lactide-co-ε-caprolactone) blend films

Benefiting from their good biosafety and bioabsorbability, polymeric biodegradable stents (BDSs) have promising application prospects in the treatment of cardiovascular diseases. However, due to the low density of the polymer itself, it is difficult to visualize with medical imaging techniques such as CT and MRI, which leads to difficulties in accurate BDS localization and subsequent non-invasive evaluation. Therefore, modification of BDSs to adapt to monitoring techniques for clinical use without affecting their biocompatibility and mechanical properties is a promising strategy to support the clinical translation of BDSs. In this study, Fe3O4 superparamagnetic iron oxide nanoparticles (SPIONs) were synthesized to modify the BDS by ultrasonic spraying. Due to the T2-weighted MR imaging enhancement capability of SPIONs, the fabricated SPION-BDS can be entirely visualized and long-term monitored under MR imaging. Further, a stent degradation assessment method based on the analysis of image gray value changes was established. In conclusion, the constructed SPION-BDS provides a possible solution for precise localization of BDSs after implantation, and furthermore, opens up opportunities for long-term non-invasive monitoring of in vivo BDS degradation and multimodal imaging assessment of vascular endothelial remodeling.

Magnetic nanoparticle loaded biodegradable vascular stents for magnetic resonance imaging and long-term visualization.

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Effects of constraint between filaments on the radial compression properties of poly (l-lactic acid) self-expandable braided stents

Enhanced mechanical properties of poly(L‐lactide) braided stent with six‐arm poly(L‐lactide‐co‐ε‐caprolactone) coating cross‐linked by hexamethylene diisocyanate

In vitro hydrolytic degradation properties of poly(D, L-lactic acid) / poly(L-lactide-co-ε-caprolactone) blend films

Magnetic nanoparticle loaded biodegradable vascular stents for magnetic resonance imaging and long-term visualization.