Predicting the In Vivo Performance of Cardiovascular Biomaterials: Current Approaches In Vitro Evaluation of Blood-Biomaterial Interactions

The therapeutic efficacy of a cardiovascular device after implantation is highly dependent on the host-initiated complement and coagulation cascade. Both can eventually trigger thrombosis and inflammation. Therefore, understanding these initial responses of the body is of great importance for newly developed biomaterials. Subtle modulation of the associated biological processes could optimize clinical outcomes. However, our failure to produce truly blood compatible materials may reflect our inability to properly understand the mechanisms of thrombosis and inflammation associated with biomaterials. In vitro models mimicking these processes provide valuable insights into the mechanisms of biomaterial-induced complement activation and coagulation. Here, we review (i) the influence of biomaterials on complement and coagulation cascades, (ii) the significance of complement-coagulation interactions for the clinical success of cardiovascular implants, (iii) the modulation of complement activation by surface modifications, and (iv) in vitro testing strategies.

Automation of online particle measurement during the simulated use of catheters and stent systems

The assessment of the coating integrity of cardiovascular implants such as catheters and stent systems is of crucial importance for device approval. Released particles may represent a potential health risk for the patients. Thus, an analysis of the particles released at simulated in-vivo conditions depending on their size and number is required by international standards (ISO, ASTM) as well as national authorities. In this study, an automated test bench for online particle measurement is presented. For software controlled automation, sensor data transmission and solenoid valves were implemented. A user interface was created for setting test parameters and data recording. The setup was validated by investigating standard particles as well as those released during the simulated application of non-industrial coated balloons. The measurement data were compared with results generated using the previous manual test routine. The results show an improvement in the reproducibility of the measurements, which can be attributed to the simplified handling for the user.

Failure Analysis of Medical Devices

Bearing in mind the three-legged stool approach of device design/manufacturing, patient factors, and surgical technique, this article aims to inform the failure analyst of the metallurgical and materials engineering aspects of a medical device failure investigation. It focuses on the device "failures" that include fracture, wear, and corrosion. The article first discusses failure modes of long-term orthopedic and cardiovascular implants. The article then focuses on short-term implants, typically bone screws and plates. Lastly, failure modes of surgical tools are discussed. The conclusion of this article presents several case studies illustrating the various failure modes discussed throughout.