FULL PAPER
1700292 (1 of 6) ©
2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
www.mbs-journal.de
Development of a Polymer-Based Biodegradable
Neurovascular Stent Prototype: A Preliminary
In Vitro and In Vivo Study
Omid Nikoubashman,* Sarah Heringer, Katalin Feher, Marc-Alexander Brockmann,
Bernd Sellhaus, Alice Dreser, Kathrin Kurtenbach, Rastislav Pjontek, Stefan Jockenhövel,
Joachim Weis, Fabian Kießling, Thomas Gries, and Martin Wiesmann
DOI: 10.1002/mabi.201700292
As vessel remodeling is complete after
3–6 months, mechanical stent support
is only necessary during this period.
[2]
This is why a biodegradable stent that is
resorbed after six months may be pre-
ferred to a permanently implanted stent.
[3]
A dissolvable stent facilitates follow-up
imaging and consecutive surgery.
[4]
These
advantages make biodegradable stents a
promising option for interventional neu-
rovascular procedures.
Studies with biodegradable cardio-
vascular stents implied that such stents
may improve vessel remodeling, lumen
gain, and long-term arterial healing
compared to metallic stents.
[5]
In recent
years, lactic acid-based polymer stents
have emerged as the most common type
of biodegradable stent.
[3,6]
Currently, two
lactic acid-based stents (ABSORB stent;
Abbott Vascular, Santa Clara, CA and
DESolve stent; Elixir Medical Corpora-
tion, Sunnyvale, CA) have received CE
mark approval for coronary artery use.
[7]
While biodegradable stents are becoming more common in
cardiovascular interventions, biodegradable stents are not
established in neurovascular interventions, yet. Cardiovascular
stents cannot simply be used in neurovascular procedures, as
Biodegradable Stents
Biodegradable stents are not established in neurovascular interventions. In this
study, mechanical, radiological, and histological characteristics of a stent proto-
type developed for neurovascular use are presented. The elasticity and brittle-
ness of PLA 96/4, PLDL 70/30, PCL, and PLGA 85/15 and 10/90 polymers in in
vitro experiments are first analyzed. After excluding the inapt polymers, degra-
dability and mechanical characteristics of 78 PLGA 85/15 and PLGA 10/90 stent
prototypes are analyzed. After excluding PLGA 10/90 stents because of rapid
loss of mass PLGA 85/15 stents in porcine in vivo experiments are analyzed.
Angiographic occlusion rates 7 d, 1 month, 3 months, and 6 months after stent
implantation are assessed. Histological outcome measures are the presence of
signs of inflammation, endothelialization, and the homogeneity of degradation
after six months. One case of stent occlusion occurs within the first 7 d. There
is a prominent foreign-body reaction with considerable mononuclear and minor
granulocytic inflammation combined with incomplete fragmental degradation
of the struts. It is possible to produce a stent prototype with dimensions that
fit the typical size of carotid arteries. Major improvements concerning throm-
bogenicity, degradation, and inflammatory response are required to produce
biodegradable stents that are suitable for neurovascular interventions.
Prof. O. Nikoubashman, S. Heringer, Dr. R. Pjontek, Prof. M. Wiesmann
Department of Diagnostic and Interventional Neuroradiology
University Hospital
RWTH Aachen University
Pauwelsstr. 30, 52074 Aachen, Germany
E-mail: onikoubashman@ukaachen.de
K. Feher, Dr. K. Kurtenbach, Prof. S. Jockenhövel, Prof. T. Gries
Institute of Tissue Engineering and Textile Implants
RWTH Aachen University
Otto-Blumenthal-Str. 1, 52074 Aachen, Germany
Prof. M.-A. Brockmann
Department of Diagnostic and Interventional Neuroradiology
University Hospital Mainz
55131 Mainz, Germany
Dr. B. Sellhaus, A. Dreser, Dr. K. Kurtenbach, Dr. R. Pjontek,
Prof. S. Jockenhövel, Prof. J. Weis
Institute of Neuropathology
University Hospital
RWTH Aachen University
Pauwelsstr. 30, 52074 Aachen, Germany
Prof. S. Jockenhövel
Institute of Applied Medical Engineering
University Hospital
RWTH Aachen University
Pauwelsstr. 20, 52074 Aachen, Germany
Prof. F. Kießling
Institute of Experimental Molecular Imaging
University Hospital
RWTH Aachen University
Pauwelsstr. 30, 52074 Aachen, Germany
The ORCID identification number(s) for the author(s) of this article
can be found under https://doi.org/10.1002/mabi.201700292.
1. Introduction
Endovascular stenting is a common treatment option for
extracranial and intracranial neurovascular arterial stenosis.
[1]
Macromol. Biosci. 2018, 1700292