Degradation of a novel magnesium alloy-based bioresorbable coronary scaffold in a swine coronary artery model

• Published in: Cardiovascular intervention and therapeutics Vol. 39; no. 4; pp. 428 - 437
• Main Authors: Torii, Sho, Yamamoto, Akiko, Yoshikawa, Ayako, Lu, Linhai, Sasaki, Makoto, Obuchi, Shoko, Wada, Akira, Tsukamoto, Hideo, Nakazawa, Gaku
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.10.2024
• Subjects: Absorbable Implants; Alloys; Animals; Cardiology; Coronary Angiography; Coronary Vessels - diagnostic imaging; Coronary Vessels - surgery; Interventional Radiology; Magnesium; Medicine; Medicine & Public Health; Microscopy, Electron, Scanning; Original; Original Article; Prosthesis Design; Swine; Tissue Scaffolds; Tomography, Optical Coherence - methods; X-Ray Microtomography; Preclinical study; Percutaneous coronary intervention; Elemental mapping; Controlled degradation profile; Bioabsorbable magnesium scaffolds
• ISSN: 1868-4300; 1868-4297; 1868-4297
• DOI: 10.1007/s12928-024-01023-3

The objective of the study is to investigate the safety, feasibility, and degradation profile of a novel Mg alloy-based bioresorbable coronary scaffold (JFK-PRODUCT BRS) with thin struts (110 μm). Polymer- or Mg alloy-based BRSs have not replaced nondegradable metal stents because of the higher prevalence of scaffold thrombosis and restenosis in clinical practice; these poor clinical outcomes were due to inadequate scaffold designs, including thick struts (more than 150 μm) and their inappropriate degradation processes. Fourteen healthy pigs received 17 JFK-PRODUCT BRSs in the coronary arteries and were sacrificed at 1, 6, 12, 18, and 26 months after implantation. Angiography, optical coherence tomography, microfocus X-ray computed tomography (µCT), scanning electron microscopy with energy-dispersive X-ray spectrometry (SEM–EDX), and histopathological evaluation were performed. The JFK-PRODUCT had a median percent late recoil of 11.28% at 1 month. The µCT observation confirmed that scaffold discontinuity reached 64.8% at 12 months with increased scaffold inner area thereafter, suggesting artery positive remodeling. The inflammation was mild, peaked at 18 months, and decreased thereafter. The SEM–EDX analysis demonstrated gradual degradation of the scaffold with formation of inorganic deposits, presumed to be calcium phosphates. It also revealed the disappearance of calcium phosphates at 26 months, achieving almost complete replacement of the scaffold by biocomponents. The current study demonstrated the safety and feasibility of JFK-PRODUCT with a lower acute recoil rate despite its thin struts. The scaffolds were almost completely disappeared at 26 months after implantation. Graphical abstract