MicroCT and contrast-enhanced microCT to study the in vivo degradation behavior and biocompatibility of candidate metallic intravascular stent materials

Biodegradable intravascular stents offer a promising alternative to permanent stents for treating atherosclerosis-related artery narrowing by potentially avoiding long-term complications. Identifying materials that degrade harmlessly and uniformly at a suitable rate is crucial. This study evaluated an advanced zinc alloy (Zn-Ag-Cu-Mn-Zr) alongside pure iron and pure zinc, using a simplified stent model of metallic wires implanted in the rat aorta. Assessments were made at 7, 24, and 84 days post-implantation using X-ray microfocus computed tomography (microCT) and contrast-enhanced microCT (CECT). For CECT, a contrast agent was chosen to provide optimal soft tissue contrast and minimal interaction with the wires. This combination of imaging techniques allowed us to evaluate degradation behavior, compare volume loss in various locations (outside the arterial lumen, inside the lumen, and encapsulated by neointima), compute degradation rates, and evaluate neointima tissue formation. Results showed that zinc and its alloy degrade less uniformly than iron, which demonstrates uniform surface degradation. The zinc alloy had a higher initial volume loss than the other materials but showed little increase over time. Neointima formation was similar for zinc and the zinc alloy, while iron provoked less tissue formation than both zinc and the reference cobalt-chromium alloy. Additionally, unlike cobalt-chromium and zinc, iron wires did not achieve consistent tissue encapsulation along their entire length, which may impair their performance. Mild inflammation was noted around zinc-based implants. Combining microCT and CECT provided 3D information on degradation uniformity, degradation products, and neointima morphometrics, highlighting the power of these imaging techniques to evaluate implant materials in a highly accurate way compared to previous 2D methods. STATEMENT OF SIGNIFICANCE: Biodegradable intravascular stents offer a promising solution to long-term complications associated with permanent stents by gradually dissolving in the body. To evaluate a novel zinc alloy (Zn-Ag-Cu-Mn-Zr) with improved mechanical properties, microstructure, and biocompatibility, we compared it to pure iron and zinc. We used advanced 3D imaging techniques, i.e., microCT and contrast-enhanced microCT, to assess the degradation behavior and the tissue response in a rat aorta model. The zinc alloy demonstrated promising properties despite less uniform degradation and mild inflammation compared to iron. Our findings highlight the superiority of 3D imaging over previously used 2D techniques in evaluating stent materials, offering critical insights into degradation processes and biocompatibility. These highly accurate measurements provide crucial information for developing improved biodegradable implants.