Experimental and computational studies of poly-L-lactic acid for cardiovascular applications: recent progress

Stents are commonly used in medical procedures to alleviate the symptoms of coronary heart disease, a prevalent modern society disease. These structures are employed to maintain vessel patency and restore blood flow. Traditionally stents are made of metals such as stainless steel or cobalt chromium; however, these scaffolds have known disadvantages. An emergence of transient scaffolds is gaining popularity, with the structure engaged for a required period whilst healing of the diseased arterial wall occurs. Polymers dominate a medical device sector, with incorporation in sutures, scaffolds and screws. Thanks to their good mechanical and biological properties and their ability to degrade naturally. Polylactic acid is an extremely versatile polymer, with its properties easily tailored to applications. Its dominance in the stenting field increases continually, with the first polymer scaffold gaining FDA approval in 2016. Still some challenges with PLLA bioresorbable materials remain, especially with regard to understanding their mechanical response, assessment of its changes with degradation and comparison of their performance with that of metallic drug-eluting stent. Currently, there is still a lack of works on evaluating both the pre-degradation properties and degradation performance of these scaffolds. Additionally, there are no established material models incorporating non-linear viscoelastic behaviour of PLLA and its evolution with in-service degradation. Assessing these features through experimental analysis accompanied by analytical and numerical studies will provide powerful tools for design and optimisation of these structures endorsing their broader use in stenting. This overview assesses the recent studies investigating mechanical and computational performance of poly(l-lactic) acid and its use in stenting applications

Quantifying the mechanical properties of polymeric tubing and scaffold using atomic force microscopy and nanoindentation

Measurement of mechanical parameters of polymeric scaffolds presents a significant challenge due to their intricate shape and small characteristics dimensions of their elements – around 100μm. In this study, mechanical properties of polymeric tubing and scaffold, made of biodegradable poly (l-lactic) acid (PLLA), were characterised using atomic force microscopy (AFM) and nanoindentation, complemented with tensile testing. AFM was employed to assess the properties of the tube and scaffold locally, whilst nanoindentation produced results with a dependency on the depth of indentation. As a result, the AFM-measured elastic modulus differs from the nanoindentation data due to a substantial difference in indentation depth between the two methods. With AFM, a modulus between 2 and 2.5 GPa was measured, while a wide range was obtained from nanoindentation on both the tube and scaffold, depending on the indentation scale. Changes in the elastic modulus with in-vitro degradation and ageing were observed over the one-year period. To complement the indentation measurements, tensile testing was used to study the structural behaviour of the tube, demonstrating the yielding, hardening and fracture properties of the material

Mechanical and chemical characterisation of bioresorbable polymeric stent over two-year in vitro degradation

Polymeric stent is a temporary cardiovascular scaffold, made of biodegradable poly (l-lactic) acid, to treat coronary artery stenosis, with expected resorption by the human body over two to three years. In this paper, the mechanical properties of a polymeric stent over two-year in vitro degradation were studied and characterised using atomic force microscopy and nanoindentation techniques, complemented with analyses of weight loss, gel permeation chromatography and differential scanning calorimetry. Atomic force microscopy assessed stent degradation at the surface, whilst nanoindentation was able to investigate the property at a greater depth into the material. No significant changes to the Young’s modulus were observed with the atomic force microscopy due to bulk degradation nature of the polymer. Chemical analyses demonstrated a reduction of molecular weight and an increase of crystallinity, indicating degradation of the stents. Berkovich nanoindentation showed a trend of reduction in modulus over in vitro degradation, which was, however, not continuous due to the variations of measurements associated with the pyramidal indenter tip and the semi-crystalline structure of the polymer