Beruflich Dokumente
Kultur Dokumente
MATSE 403 Final Project
Dan Cook Kevin Weikert
Dan Norris Deanna Jacoby
Background
• Need for Bioabsorbable magnesium stents as a
treatment for coronary heart disease
– Device should have the same strength and
ductility as a metal stent
– Ability to control the retention time of the
device in the patient
Figure 1. Bioabsorbable magnesium stent after expansion
– Ability to prevent thrombosis (blood clots) (A) and before expansion (B,C)
over time
Coronary Heart Disease
Demographics Risk Factors and Causes
• Leading cause of death among • Inheritance
men and women in America • Gender
• Age
• Men are slightly more at risk than • Lifestyle
women, while black males are
• Diet
more at risk than white males
• Smoking vs. non‐smoking
• Drinking habits
• According to the American Heart
Association more than 250,000
deaths were caused by this disease
in 2004
Symptoms
• Early in the condition there are little or no symptoms
• As the condition progresses:
– Chest Pain
– Shortness of Breath
– Heart Attack
Current Treatments
• Adjusting diet and lifestyle
• Medicines:
– cholesterol lowering medicines
– blood thinners
– aspirin
– blood pressure reducers,
– calcium channel blockers
– beta blockers
• Stents‐ metal or bioabsorbable
• Bypass Surgery
Bioabsorbable Stents
mean (SD), n p
• Controlled retention time in the After stenting
In‐segment minimal luminal diameter [mm ] 2·18 (0·38), 60 <0·0001†
In‐segment diameter stenosis [%] 20·50 (7·50), 60 <0·0001†
• In a study it was found that
In‐segment acute gain [mm] 1·12 (0·42), 59*
initially the stent is very successful
In‐stent minimal luminal diameter [mm] 2·47 (0·37), 60
At 4‐month follow‐up
• One study showed over time the Reference diameter [mm] 2·67 (0·46), 58* 0·21660‡
In‐stent diameter stenosis [%] 48·37 (17·00), 59* 0·00001‡
In‐stent minimal luminal diameter [mm] 1·38 (0·51), 59*
In‐stent late loss [mm] 1·08 (0·49), 59*
Restenosis rate, % of patients
In segment [%] (n) 47·5 (59)
In stent [%] (n) 47·5 (59)
References
1. “Biodegradable Magnesium Based Metallic Material for Medical Use” PatentDocs.
Wenderoth,Lind &Pollack L.L.P. Dec. 1, 2010. <http://www.faqs.org/patents/app/20090131540>.
2. Odle, Teresa “Coronary Heart Disease.” Diet.com. Dec. 1 2010. <http://www.diet.com/g/coronary‐
heart‐disease>.
3. Raimund Erbel, Carlo Di Mario, Jozef Bartunek, Johann Bonnier, Bernard de Bruyne, Franz R Eberli,
Paul Erne, Michael Haude, Bernd Heublein, Mark Horrigan, Charles Ilsley, Dirk Bose, Jacques
Koolen, Thomas F Luscher, Neil Weissman, Ron Waksman and for the PROGRESS‐AMS (Clinical
Performance and Angiographic Results of Coronary Stenting with Absorbable Metal Stents)
Investigators, Temporary scaffolding of coronary arteries with bioabsorbable magnesium stents: a
prospective, non‐randomised multicentre trial, The Lancet, Volume 369, Issue 9576, 2 June 2007‐
8 June 2007, Pages 1869‐1875, ISSN 0140‐6736, DOI: 10.1016/S0140‐6736(07)60853‐8.
<http://www.sciencedirect.com/science/article/B6T1B‐4NVVDHV‐
13/2/30568148786e40483ed8805cc53745e7>.
Physiology of the Affliction
Arteries carry the oxygenated blood from the heart to the
body.
Atherosclerosis is the hardening of arteries caused by a
buildup of plaque
Weak and damaged arteries can create arterial aneurysms
Larger aortic aneurysms can stem from the damage of the
aorta
Advances in Magnesium as a
Biomaterial
With a Focus on Cardiovascular Stent
Applications
Use of Coatings to Slow Corrosion
Active Environment
Corrosion Resistant
Coating
Standard Mg Thin
Film (Stent)
Stented Arteries require ~6 weeks to fully recover
One Coating is Mg(OH)2
Mg(OH)2
Pure Mg Thin
Film
Mg(OH)2 is formed through a simple chemical
reaction
2 →
This coating is formed by soaking a standard Mg thin film in 1M NaOH for 24 Hours
Lorenz, Carla, and Johannes Brunner. "Effects of Surface Pre‐treatments on
Biocompatibility of Magnesium." Acta Materialia 5 (2009): 2783‐789. Print.
Advantages of Mg(OH)2 Over Uncoated
This coating provides a 75% decrease in the Corrosion rate (100mpy to 25mpy)
Mg(OH)2 is beneficial to cell growth
MgF2 As An Alternative Coating
• Begin with Mg(OH)2
coating
• Treat this in 40% HF for
96H
Hassel, Thomas, and Christian Krause. "Corrosion Protection and Repassivation after the Deformation of
Magnesium Alloys Coated with a Protective Magnesium Fluoride Layer." Magnesium Technology (2005):
485‐90. Web.
Advantages of MgF2 Coating
Break Down Voltage for MgF2 is
significantly more positive than
uncoated Mg (and Mg(OH)2)
Cracks caused by
mechanical stress will
repassivate naturally
Hassel, Thomas, and Christian Krause. "Corrosion Protection and Repassivation after the Deformation of
Magnesium Alloys Coated with a Protective Magnesium Fluoride Layer." Magnesium Technology (2005):
485‐90. Web.
References
• Hassel, Thomas, and Christian Krause. "Corrosion Protection and
Repassivation after the Deformation of Magnesium Alloys Coated with a
Protective Magnesium Fluoride Layer." Magnesium Technology (2005):
485‐90. Web.
• Lorenz, Carla, and Johannes Brunner. "Effects of Surface Pre‐treatments on
Biocompatibility of Magnesium." Acta Materialia 5 (2009): 2783‐789.
Print.
• Staiger, M., A. Pietak, J. Huadmai, and G. Dias. "Magnesium and Its Alloys
as Orthopedic Biomaterials: A Review." Biomaterials 27.9 (2006): 1728‐
734. Print.
Properties and Clinical Test:
Magnesium Alloy Stents
Properties and Alloying Metals
Properties Alloying metals
• Biocompatible • Aluminum
• Magnesium is used in • Manganese
processes in the body • Zinc
• Degrades in the body safely • Lithium
• Need to use an alloy • Titanium
because Mg is very reactive • Rare earth elements
in body fluid (corrodes too
fast)
Clinical Test: PROGRESS‐AMS
• 63 patients with coronary artery disease
• Stents were place in their coronary artery
• Follow‐ups were conducted at 4, 6, and 12
months
Outcome
• Magnesium based stents can be safely
implanted and will degrade without blood
clotting, dead tissue formation, or death at
one year.
• There was some re‐constriction of the stent.