Materials Today Chemistry 36 (2024) 101972

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Materials Today Chemistry

journal homepage: www.journals.elsevier.com/materials-today-chemistry/

Structural design optimization through finite element analysis of additive

manufactured bioresorbable polymeric stents
Ana M. Sousa , Ana M. Amaro , Ana P. Piedade *
University of Coimbra, CEMMPRE, Department of Mechanical Engineering, 3030-788, Coimbra, Portugal

A R T I C L E I N F O A B S T R A C T

Keywords: Coronary stents help to treat coronary artery disease. Polymeric-based stents are considered the next generation
Coronary stents of these medical devices since the materials are more compatible with human cells. Developing a polymeric
Polymers bioresorbable stent with a different and optimized design can improve the mechanical performance of polymeric
Additive manufacturing
additively manufactured coronary stents. In this study, two different polymers were processed by additive
Stent design
Finite element analysis
manufacturing, and their mechanical properties were analyzed: poly(lactic acid) (PLA) and poly(ε-caprolactone)
(PCL). Five different designs (A, B, C, D, and E) were then conceptualized with three different thicknesses. Finite
element analysis (FEA) of a stent implantation process, using the mechanical properties of the additively man­
ufactured materials, was used to evaluate the influence of the design, after the stent expansion, on the radial
recoil ratio (RRR) and foreshortening. The in-silico results demonstrated that reducing strut thickness originates
more plastic deformation, which reduces the RRR and increases the absolute value of foreshortening. PLA-based
stents presented less RRR but, simultaneously, more risk of fracture. In the case of PCL-based devices, only
designs A, B, and C presented acceptable recoil ratios. Design A is the chosen design as it reduces the RRR for
lower thicknesses without risk of fracture during the stent deployment.

1. Introduction
Cardiovascular diseases are considered the leading cause of death
globally, with coronary artery disease being the most prevalent disorder.
This disease results from the accumulation of atherosclerosis plaque
inside the arteries [1]. Currently, percutaneous coronary intervention
(PCI) and vascular stenting are the central therapy used to re-open
narrow arteries [2]. There are three main types of coronary stents
available on the market: bioresorbable stents (BRSs), drug-eluting stents
(DESs), and bare-metal stents (BMSs) being constructed with metallic
and/or polymeric materials [2]. The metallic-based stents have a higher
radial strength and a reduced elastic recoil when compared with poly­
mers. Also, it is known from the open literature that metallic stents have
thinner struts than polymeric devices due to their better radial strength
[3]. However, it became evident that some biological events after the
implantation, such as neointimal hyperplasia or thrombosis, lead to the
rejection of the stent. To overcome these biological effects and to
improve the long-term efficiency of coronary stents, polymeric BRSs
arose, having more compatibility with the human body and providing
temporary scaffolding to the artery. Despite their many advantages,
polymeric stents show lower stiffness and radial strength, which leads to
radial elastic recoil. As well, polymeric-based stents require thicker
struts which result in a reduced luminal area, causing disruption in
blood flow [4,5]. The ABSORB™ stent is the most commercial polymeric
stent on the market that already demonstrated long-term safety and
efficiency. Nevertheless, some clinical trials showed that the
cross-section area is too high and the loss of properties during the
different stages of the implant could affect the performance and integrity
of ABSORB™. The literature described that the design influences the
clinical performance of polymeric stents during those stages [6].
So, in the last few years, several scientists have been trying to opti­
mize the design parameters of coronary stents to increase the mechan­
ical performance of polymeric stents. An ideal geometry allows robust
mechanical support while maintaining radial strength throughout the
healing phase without triggering adverse biological effects. Some re­
searchers have studied and demonstrated that the stent geometry could
influence the stent flexibility, radial strength, scaffolding, and blood
flow dynamics [7,8]. An appropriate design is suggested as the key so­
lution to reducing the thickness of polymeric stents’ struts and
cross-sectional profile, thereby enhancing their performance [9].

* Corresponding author.
E-mail address: ana.piedade@dem.uc.pt (A.P. Piedade).

https://doi.org/10.1016/j.mtchem.2024.101972
Received 26 September 2023; Received in revised form 4 January 2024; Accepted 16 February 2024
Available online 24 February 2024
2468-5194/© 2024 Elsevier Ltd. All rights reserved.
A.M. Sousa et al.
Considering the advances in smart engineering, the importance of
designs, and the cost associated with the methodologies of producing
prototypes, one possible solution to overcome some problems is to use
numerical simulation by finite element analysis (FEA) [10]. In the case
of cardiovascular stents, this type of tool is worthwhile before the
fabrication of the prototype and its experimental tests and the stent
placement inside the human artery. FEA is applied to investigate and
estimate the behavior of stents inside the human artery, being the results
useful for optimization and improvement of the stent design and per­
formance, reducing time and costs [11]. The Food and Drug Adminis­
tration (FDA) recommends the experimental evaluation of several
characteristics and properties and the application of FEA to evaluate
some critical clinical attributes needed as a function of the stent design
parameters. FDA mentioned that with FEA and its results, a modified
stent drawing could be produced quickly, and the ideal stent design
parameters could be accomplished more easily than using only tradi­
tional approaches [12].
Despite the number of studies regarding the design of stents, there
remains a lack of an ideal geometry for coronary stents. The influence of
different designs and strut thickness of coronary stents throughout FEA
was evaluated, considering the properties of the PLA and PCL processed
by Fused Filament Fabrication (FFF) technology, which is starting to be
applied in the stents industry [13,14]. In the in-silico investigation of
coronary stents, using polymeric property values from tables in the
literature that list pure polymers is no longer considered a reliable
approach. Instead, the authors have taken a novel approach by char­
acterizing the materials and utilizing the results to simulate the stent
expansion with a balloon, thus achieving a level of accuracy that is
crucial in the medical field. In particular, this approach can aid in pre­
venting unwanted mechanical and biological reactions, making it an
essential tool for developing coronary stents. The elastic recoil and
foreshortening ratio and the stresses on the different stent designs were
evaluated after the plastic deformation.
2. Materials and methods
2.1. Materials
The PLA pellets (3D870) were purchased from Smartfill®, Spain. The
PLA filament (1.75 ± 0.05 mm) was made using the filament extruder
3Devo Composer 450 (Utrecht, Netherlands). The PCL filament with a
diameter of 1.75 ± 0.02 mm was acquired from 3D4Makers®, the
Netherlands.
2.2. Processing technology
3D printing technologies allow the use of several imaging techniques
to construct realistic and accurate 3D models that consider the arteries’
morphology and properties [15]. Therefore, the FFF technology will be
used to analyze the developed designs of coronary stents experimentally.
Consequently, instead of using literature values from standard tables of
polymeric materials, the mechanical properties were determined in test
specimens that were printed using a 3D printer Robo R2 with a closed
chamber and a nozzle with 0.4 mm of diameter. Table 1 presents the
main printing parameters used in this work. The lines infill pattern was
selected considering that it is the pattern for use when stents are
experimentally produced in future works.
Table 1
Printing parameters for the test samples.
Material Tprinting (◦ C) Tbed (◦ C) Vprinting (mm.s− 1)
PLA 200 60 60
PCL 130 30 10
2
Materials Today Chemistry 36 (2024) 101972
2.3. Thermal characterization of the materials
To determine the thermal events and the crystallinity percentage of
the printed materials, differential scanning calorimetry (DSC) tests were
performed. The measurements were made on a DSC Q100 V9.9 equip­
ment from TA instruments, with a scan rate of 10 ◦ C/min, from − 80 to
300 ◦ C, under a nitrogen flow of 50 mL/min. The degree of crystalli­
zation (Xc) was determined from the first heating curve according to the
methods described in previous works that followed Equation I [16] ΔHm
is defined as the melting enthalpy, ΔHcc is the cold crystallization
enthalpy and ΔH∞ is the reference enthalpy for the melting of a theo­
retical 100% crystalline polymer. The ΔH∞ was assumed to be 93.1 J.
g− 1 and 142 J. g− 1 for PLA and PCL, respectively [17,18]. The results
were analyzed using the TA Instruments Universal Analysis 2000
(version 4.5 A) software.
ΔHm − ΔHcc
Xc = × 100 (1)
ΔH∞
2.4. Mechanical characterization of the materials
The tensile specimens were printed according to ISO 527-2 [19] with
a total length of 170 mm, a width at the narrow portion of 20 mm, and a
thickness of 4 mm. The main goal was to determine the properties of the
printed materials, such as ultimate tensile strength (σTS), yield strength
(σy), or Young modulus (E). Furthermore, the acquired data was intro­
duced in the simulation software, providing more accurate outcomes
based on experimental work. The tensile tests were conducted using a
Shimadzu Autograph AGS-X universal tensile testing machine equipped
with a 5 kN load cell with a strain rate of 1 mm min− 1 at room tem­
perature (23 ◦ C), as also described in ISO standard. For each polymeric
material, at least five samples were tested. The data was collected in
Trapezium X software and the results were analyzed in OriginPro 2018
software.
The three-point bending (3 PB) tests were performed according to
the ASTM D790 [20] recommendations, with the following dimensions
60 × 10 × 2 mm. At least five specimens of each material were tested
using a Shimadzu Autograph AGS-X equipped with a 5 kN load cell with
a strain rate of 2 mm min− 1. The flexural strength (σf) and the flexural
modulus (Ef) were calculated according to previously described equa­
tions [17].
2.5. Design of stents - geometric models
The three-dimensional devices and the different designs of coronary
stents were created using the software Solidworks® 2020 (Dassault
Systèmes SOLIDWORKS Corporation, Waltham, MA, USA). All designs
were formed considering three different strut thicknesses (0.10, 0.15,
and 0.20 mm) to evaluate their influence on the mechanical properties.
2.6. Numerical simulation
2.6.1. Structural design
Each stent model was converted into a Parasolid model, and the
obtained file was imported into the ANSYS Workbench 2021 R2 soft­
ware. As there is symmetry in the model and to minimize computational
time, only a part of the 3D model was analyzed. Therefore, a frictionless
support boundary condition was applied on every plane of symmetricity.
To simulate the behavior of the stent, a balloon model was built inside of
Layer Height (mm) Shell Infill Density (%) Infill Pattern
0.1 1 100 Lines
0.1 1 100 Lines
A.M. Sousa et al. Materials Today Chemistry 36 (2024) 101972

each model using the Design Modeler in ANSYS (Fig. 1). The balloon was Table 2
designed with a thin surface of 0.10 mm, as recommended by the Properties considered for PLA and PCL.
literature [21]. Material Young σTS a σy a Poisson’s Theoretical
Modulus (MPa) (MPa) Ratio Density (g.cm− 3)
2.6.2. Materials and mesh (MPa)
A multilinear isotropic hardening elastic-plastic model was selected PLA 1335 19 15 0.3 1.240
for the thermoplastic materials processed by additive manufacturing. PCL 383 16 7 0.3 1.100
According to the literature, this model is suitable for large strain ap­ a
The values used were chosen from the representative stress-strain curve used
plications and to detect residual strain [22–24]. So, an intermediate in the multilinear isotropic hardening.
stress strain acquired from the tensile tests was chosen for data analysis
and around 26–28 points were entered in the ANSYS software to
construct the material model for each polymer as recommended by Table 3
Arriaga et al. [24]. Also, the material model included the value of the Mooney-Rivlin 2 coefficients for the balloon model [16].
Young modulus, σTS, and σy of the chosen representative stress-strain Material C10 (MPa) C01 (MPa) D1 (MPa)
curves, Poisson’s coefficient and the density of the polymeric mate­
Balloon 1.07 0.71 0
rials (Table 2).
The balloon was modelled under a Mooney-Rivlin 2 hyperplastic
model in which W is the strain potential energy, C10, C01, and D1 are the higher the radial strength, the less the probability of stent recoil. The
coefficients of the model, J is the volumetric stretch, and λi (i = 1,2,3) is percentage of elastic recoil can be calculated according to Equation (III)
the elongation ratio [Equation (II)] [25]. Table 3 lists the values of the provided by ASTM F2079-09 [26]:
coefficients of the balloon material, according to the literature [21].
d0 − d1
RRR(%) = × 100 (2)
1 d0
W = C10 (I1 − 3) + C01 (I2 − 3) + ( J − 3)2 (2)
D1
where d0 is the diameter right after the balloon deflation and d1 is the
I1 = λ21 + λ22 + λ23 diameter after a particular time after implantation [27]. During the
expansion of the stent, the precise placement inside the damaged artery
I2 = λ21 + λ22 λ23 + λ21 λ23 is essential, and, consequently, the device must have a minimum fore­
shortening (FR). The FR describes the variation in the length of the stent
The balloon and all the 3D stent parts were meshed using Solid186 during the deployment of the stent. This index is defined by Equation
elements with an element size of 0.035 mm for the stent part and 0.05 (IV), where Linitial and Lexpanded are the lengths before and after the
mm for the balloon part. An automatic frictionless contact algorithm, balloon expansion [28]:
chosen from tha available ANSYS options, was applied between the
inner surface of the stent (contact) and the outer surface of the balloon FR(%) =
Linitial − Lexpanded
× 100 (4)
(target) to simplify the expansion procedure, according to previous Linital
literature [21]. The target and contact elements were selected as Conta
174 and Targe 170, respectively. 3. Results and discussion

2.6.3. Simulation and stent expansion 3.1. Characterization of the materials

To evaluate the deformation of the stent after the expansion of the
balloon, a displacement of 0.5 mm was uniformly applied on the inner
surface of the balloon to mimic the placement of the stent. In the second
step, the displacement of the balloon was reduced to zero, simulating the
deflation of the balloon. The overall expansion of the balloon setup and
curve is shown in Fig. 2.
As previously described, the computational simulation can identify
some of the mechanical characteristics of coronary stents that are more
difficult to acquire with experimental tests. Because of that, the FDA
recommends computational tests as a validation tool by calculating
radial recoil ratio or critical locations with stresses caused by the plastic
deformation. Radial recoil ratio is defined as the reduction of the stent
diameter after implantation directly related to radial strength, as the
Fig. 1. Schematic illustration depicting a part of a 3D stent model equipped
onto a balloon (green). This scheme provides a clear visual representation of the
assembly used to place a stent in a narrowed artery.
3.1.1. Thermal characterization
The DSC was used to analyze the thermal events of the polymeric
materials and the percentage of crystallinity. Table 4 displays the tem­
peratures of the main thermal events of the polymeric materials. The
DSC curves are in the supplementary information section (Figure S1).
The range of temperatures of the thermal events of PLA and PCL are in
accordance with the literature [29]. Also, it is possible to notice that the
materials won’t be affected by the temperature of the human body
(37 ◦ C) since thermal events occur at higher temperatures.
The percentage of crystallinity is a critical parameter that requires
careful consideration in polymeric-based stents, because it significantly
impacts the mechanical performance and the biodegradation rate of
stents. Higher percentages of crystallinity typically correspond to slower
degradation rates [2]. Consequently, stents made from PCL, which has a
higher crystallinity percentage than PLA-based samples, will gradually
degrade. The literature also suggests that PCL-based stents take longer to
fully degrade in an environment like the human artery than PLA-based
stents [2]. Given the implications of these findings, it is crucial to
consider the percentage of crystallinity when selecting materials for
stent fabrication.
Following the printing process, the variance in the percentage of
crystallinity exhibited by PCL is inconsequential. Conversely, PLA ex­
periences a slight elevation, which could signify not only a potential
enhancement in the mechanical attributes of the printed object but also
a decrease in the degradation rate [30].

3
A.M. Sousa et al. Materials Today Chemistry 36 (2024) 101972

Fig. 2. Assembly of the balloon and stent during (a) and after (b) expansion. a) the stent is being expanded with a balloon, which is inflated to compress the plaque
against the artery wall and improve blood flow. The balloon is then deflated (b) and then removed, leaving the stent in place to keep the artery open.

Table 4 Table 6
Characteristic temperatures determined by DSC, where Tg is the glass transition Flexural mechanical properties of the printed samples presented as average and
temperature; Tm is the melting temperature; Tcc is the cold crystallization tem­ standard deviation values, where σf is the maximum flexural Strength and Ef is
perature; ΔHm is the melting enthalpy; ΔHcc is the cold crystallization enthalpy, the Flexural Modulus.
and Xc is the percentage of crystallinity. Polymer σf (MPa) Ef (MPa)
Sample Tg Tm ΔHm Tcc ΔHcc Xc
PLA 33.4 ± 2.9 1100 ± 200
(◦ C) (◦ C) (J.g− 1 ) (◦ C) (J.g− 1 ) (%)
PCL 25.9 ± 4.6a 450 ± 10
PLA 63.9 178.2 44.3 94.3 22.5 23.4
Filament a
Value of average flexural strength calculated at the maximum load (Y).
Printed PLA 66.6 177.7 45.9 90.2 19.2 28.7
PCL − 71.5 62.3 75.7 – – 53.3
Filament the higher the flexibility, meaning that it is easier to bend the material
Printed PCL − 63.9 65.1 75.5 – – 53.2 [35,36].
The acquired data indicates that PCL has higher flexibility than PLA,
3.1.2. Tensile test according to the results from the tensile tests. Therefore, there is more
Some mechanical properties of the printed polymers were studied probability of the stent passing through the arteries without impairing
through stress-strain curves, aiming to study the mechanical perfor­ the shape of the stent. There is no damage on the surface of the PCL
mance of the printed polymers. In the case of PCL, the tests were specimens, demonstrating the flexibility of this material. On the other
interrupted at a maximum displacement of 140 mm due to their extreme hand, PLA specimens showed small damage on the outer surface after
deformation. Table 5 summarizes some of the properties of printed PLA the bending test (Figure S2 - Supplementary Information).
and PCL.
The results demonstrated that PLA has a higher tensile strength than 3.2. Design of stents
PCL and, meaningfully, a superior Young Modulus coherent with pre­
vious studies [2]. Some studies use the tensile test and properties to One of the main challenges of polymeric-based stents is enhancing
predict radial strength by relating it with tensile strength [31]. the radial strength and reducing the radial recoil ratio [37]. The present
Al-Mangour et al. [32] explained that higher tensile strength leads to study includes two types: closed and open cells. Designs A, B, C, and D
superior radial strength that will support the artery wall. So, the out­ were designed as an open cell style. Design E was projected as a
comes from this study indicate that the PLA-based stent will have a closed-cell style. In the case of Design B, the connectors were interca­
higher radial strength than PCL-based stents, allowing better support to lated with straight-rod and C-shaped bridges. Designs C and D were
the artery wall and a lower radial elastic recoil ratio. Moreover, a ma­ projected with a strut crown defined as a curved area that facilitates
terial with greater tensile strength is described for tolerating stents with stent deformation during the deployment. The chosen thicknesses in this
thinner struts, reducing the blood flow disruptions [33,34]. work were based on previous studies that investigated metallic and
polymeric stents [3,38]. The 3D stent models, and the design parameters
3.1.3. Flexibility characterization used in this study are displayed in Table 7.
The bending properties of the materials should be studied to predict
the deformation of the material during the placement of the stent. Also,
3.3. Numerical simulation
the stent material should bend to pass inside the arteries, maintaining
the shape and the stent design. The bending properties of PLA and PCL
In this work, it was simulated the expansion of the stents to evaluate
are summarized in Table 6. In the case of PCL, there are no breaks on the
the mechanical deformation, radial recoil ratio, and foreshortening. The
outer surface of the specimen (Figure S2 – Supplementary Information).
researchers compared the five strut geometries, three different strut
So, the test was stopped, and the flexural strength was calculated using
thicknesses, and two bioresorbable polymeric materials. The study
the load acquired at the end of the test, as recommended by the
outcomes were compared with previous studies that used designs and
standard.
materials that are already a benchmark in the market.
For this study, only the flexural modulus, which measures the ca­
pacity of the material to bend under a specific load, was considered.
3.3.1. Evaluation of stent expansion and mechanical deformation
According to the standard and literature, the lower the flexural modulus,
The in-silico results were presented regarding equivalent von Mises
stress and equivalent plastic strain. According to Toong et al. [39], to
Table 5 guarantee that the stent will expand without the risk of failure, the von
Mechanical properties from the tensile tests of the printed samples. Mises stress values should be in the middle of the values of yield strength
(YS) and ultimate tensile strength (TS). Thus, the von Mises stress must
Polymer σTS (MPa) σy (MPa) E (MPa)
be between 7 and 16 MPa for PCL-based stents and 15 and 19 MPa for
PLA 18.6 ± 2.4 15.0 ± 1.6 1340 ± 140 PLA-based stents (Table 2). The plastic strain occurs in areas where the
PCL 15.5 ± 0.2 7.4 ± 0.8 380 ± 20
stress exceeds the yield limit of the materials. Table 8 presents the

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A.M. Sousa et al. Materials Today Chemistry 36 (2024) 101972

Table 7
The proposed 3D stent models with different geometries and dimensions.
Stent Stent Planar Strut Stent Inner Stent Outer Nº of Nº of Stent Volume Weight (mg) Stent Form
Name Model Thickness Diameter Diameter Struts Connectors Length (mm3) (Rolled Form)
PLA PCL
(mm) (mm) (mm) (mm)

Design 0.10 2.8 3 8 24 13.1 3.02 3.74 3.32

A 0.15 2.7 4.46 5.53 4.91
0.20 2.6 5.84 7.24 6.42

Design 0.10 2.8 3 8 21 13.8 2.48 3.08 2.72

B 0.15 2.7 3.66 4.54 4.03
0.20 2.6 4.79 5.94 5.27

Design 0.10 2.8 3 13 36 12.6 3.49 4.33 3.84

C 0.15 2.7 5.14 6.37 5.65
0.20 2.6 6.74 8.38 7.41

Design 0.10 2.8 3 14 39 13.8 4.38 5.43 4.82

D 0.15 2.7 6.46 8.01 7.11
0.20 2.6 8.46 10.49 9.31

Design 0.10 2.8 3 5 24 15.0 5.73 7.11 6.30

E 0.15 2.7 8.45 10.48 9.30
0.20 2.6 11.08 13.74 12.19

Table 8
Mechanical properties of the materials and FEA results.
Design Thickness PLA PCL
(mm)
YS UTS Peak Stress Residual Stress Plastic Strain YS UTS Peak Stress Residual Stress Plastic Strain
(MPa) (MPa) (MPa) (MPa) (a.u.) (MPa) (MPa) (MPa) (MPa) (a.u.)

A 0,2 15 19 19.00 19.00 0.89 7 16 15.65 15.57 0.76

0,15 19.00 19.00 0.91 15.65 15.55 0.77
0,1 19.00 18.99 0.84 15.65 14.68 0.74
B 0,2 19.00 19.00 0.89 15.65 15.65 0.55
0,15 19.65 18.98 1.00 15.65 15.64 0.59
0,1 19.18 18.98 1.08 15.65 15.59 0.69
C 0,2 19.00 19.13 1.91 15.65 15.54 1.20
0,15 19.00 18.99 1.90 15.65 15.49 1.30
0,1 19.00 18.99 2.20 15.64 15.64 1.37
D 0,2 20.95 18.97 0.56 15.65 13.81 0.32
0,15 19.00 18.95 0.61 15.65 13.35 0.33
0,1 19.00 18.95 0.76 15.65 13.16 0.36
E 0,2 21.38 18.98 1.44 15.65 15.61 1.09
0,15 20.85 18.98 1.82 15.65 15.62 1.08
0,1 19.04 18.98 2.32 15.65 15.58 1.08

maximum von Mises stress at maximum expansion (peak stress) and
after recoiling (residual stress) and the plastic strain experienced after
the recoil process for all design formulations. All the data images during
the different stages of stent placement in the computational simulation
are summarized in the supplementary information section
(Figures S3-S12).
Based on the representative von Mises stress contour images at
maximum expansion (Fig. 3), it was noticed that the higher stress was
found mainly in the curved regions and near bends and connectors. For
instance, design A (Fig. 4) shows a higher percentage of von Mises stress
at maximum expansion in rounded zones compared to the flat zones for
both materials and thicknesses that vary between 55 and 99%.
Regarding the plastic strain, it is possible to notice that the equivalent
plastic strain of the devices appears in the same regions where the von
Mises stresses are more concentrated (Fig. 4). In those areas of the de­
vice, the stress exceeds the yield strength value, resulting in permanent
plastic deformation. According to the literature, the curved areas are
more prone to plastic deformation during the deployment, being
labelled as indispensable for stent expansion. However, those areas are
also described as weak points that can induce fracture [33]. Another
example is Design C, in which the stent is increasingly straightened,
changing the curved shape to a linear shape, concentrating most of the
stresses in that area (Figure S7 in the supplementary information). Ac­
cording to Table 8, Design D is less deformed, followed by Design B and
A.
A similar tendency was proved in previous studies by different au­
thors. Qiu et al. [6] studied the expansion of several PLA-based stents
with the designs of commercially available devices, demonstrating that
all geometries experienced the highest stress values on the strut con­
nections and curved regions. More recently, Amnieh et al. [40] and
Toong et al. [31] demonstrated the same events in the U-shaped and
bent zones.
Considering the materials, the distribution of the stresses is more
marked for PLA than for PCL (Fig. 3). The designs with PLA as a base
material have more regions under higher stress values, exhibiting some
areas that overcome the maximum stress allowed, leading to a possible
fracture risk. Except for Design A, the data indicates that all PLA-based
stents own specific thicknesses with areas that overcome the TS value at

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A.M. Sousa et al. Materials Today Chemistry 36 (2024) 101972

Fig. 3. Representative images of the von Mises stress generated during the expansion step (peak stress) for different materials and thickness of design A. This figure
shows that the higher percentage of von Mises stress occurs at maximum expansion, mostly in rounded zones for both materials. Within these regions, the stress
surpasses the yield strength value, resulting in plastic deformation.

Fig. 4. Representative images of the plastic strain (bellow) generated during the expansion step (peak stress) and the correspondent images of the von Mises stress
(above) for the different thicknesses of the PCL-based Design A. It is possible to notice that the equivalent plastic strain appears in the same regions where the von
Mises stresses are more concentrated and with a higher percentage.

6
A.M. Sousa et al.
some moment during the expansion process, which can lead to the
collapse of the structure. The data also indicates that, after the expan­
sion, some of these designs are highly deformed in the ends, compro­
mising the safety of the stent, for instance, design C (Fig. 5). Design E
(Fig. 6) was also highly deformed in the middle of the cell during the
expansion.
On the other hand, the PCL-based stents demonstrated more areas
that do not suffer permanent deformation, implying that the stents can
recover from elastic deformation caused by the expansion (Fig. 6). Bear
in mind the flexural modulus (Table 6), PCL has shown higher flexibility
without visible damage, meaning that PCL-based stents withstand better
deformation without failure, justifying the behavior observed during the
simulation.
In general, it is possible to conclude that the thicker struts (0.20 mm)
experienced higher levels of von Mises stresses and plastic strain
(Table 8), mainly around bends and strut connections, indicated by the
warmer colors in all design configurations (Supplementary Informa­
tion). Comparing the PLA-based stents’ different configurations, the best
design is Design A with 0.10 mm of strut thickness because it enters
plastic deformation without overcoming the failure limits during all
phases of the stent deployment. In the case of PCL, all the designs have a
positive response during the stent placement, meaning there is no risk of
stent fracture.
Since PLA and PCL are responsive to temperature changes, further
research should investigate the mechanical performance of 4D-printed
stents. With 4D printing approach, it is possible to design and create
coronary stents capable of altering their structure in response to a spe­
cific signal. Consequently, there is the dual benefit of reducing assembly
costs and minimizing the risk of failure associated with balloon expan­
sion [41,42]. To comprehensively understand the mechanical behaviour
of each design during self-shrinking and self-expansion triggered by
body temperature, in-silico characterization must be performed [43].
This approach will open a new avenue of possibilities for efficient and
effective placement of stents.
Fig. 5. Representative images of the von Mises stress generated during the expansion step (peak stress) for PLA-based Design C stent at different thicknesses. The
illustration indicates that after the expansion of Design C, the stent became significantly deformed. This deformation can result in the failure of the stent function
after placement.
7
Materials Today Chemistry 36 (2024) 101972
3.3.2. Radial recoil ratio
The RRR was calculated after the deflation of the balloon. It is known
that this is an important parameter to characterize the stent since an
extreme RRR leads to a significant expansion that conducts to a massive
risk of mechanical failure of the device and artery injury. Additionally,
devices with higher values of elastic recoil are known for having lower
radial strength, and thus, it is more challenging to provide sufficient
support to the artery wall. Also, if there is a high level of elastic recoil,
several unfavorable effects can occur, such as blood flow disruption
and/or the displacement of the device to another location [2]. Fig. 7
displays the radial recoil ratio of the analyzed stents.
The recoiling effect is triggered by the recovery of the elastic
deformation after the deflation of the balloon [6]. The radial recoil effect
is determined not only by the base material but also by the stent design
[44].
As shown in Fig. 7, all the configurations made with PCL have the
highest percentage of radial recoil compared to PLA, being 29%–69%
superior in some cases. For instance, the PCL-based Design A with a strut
thickness of 0.10 mm has a recoil percentage that is 69.9% higher than
the same configuration with PLA. In the case of Design D with the same
thickness, the percentage o recoiling of PCL is 29.2% higher than in the
PLA-based configuration. Independently of the design outlines, the su­
perior values of RRR on PCL-based devices happen because they have
more areas where the peak stress and residual stress do not exceed the
yield limit of the materials and, thus, have more spots that only expe­
rienced elastic deformation. The same tendency was observed in a recent
study by Donik et al. [44] that compares PLA, PCL, and PLA-PCL stents,
proving that PCL suffers less permanent deformation and, consequently,
experiences higher levels of elastic recoil. Guerra and colleagues [45]
studied experimentally the recoil effect of 3D-printed PCL and PLA
stents and proved that, after expansion, PLA has less elastic recoil than
PCL. Furthermore, materials with superior bending flexibility are more
prone to have higher levels of radial recoil due to the lower stiffness,
which is supported by the results of the bending test previously analyzed
in this study (Table 6) [9].
Comparing the different stent configurations, Design C has the best
A.M. Sousa et al.
Fig. 6. Representative images of the von Mises stress generated during the expansion step (peak stress) for PLA-based (left) and PCL-based (right) Design E stents at
different thicknesses. The illustration indicates that after the expansion of Design E, the PLA-based stent became significantly distorted in the middle of the struts.
This deformation can result in the failure of the stent function after placement. On the other hand, PCL-based stent does not suffer distortion after the placement.
results regarding the recoil effect, as it presents lower values. Some
authors stated that the minor the crown curvature radius the higher will
be the deformation and, consequently, the lower will be the recoil effect
[34]. As seen in the planar configuration presented in Table 7, Design C
is the one with fewer curved regions. Also, this design suffers from
higher levels of plastic deformation (Table 8) which means that there
was less recovery after the deflation of the balloon. Nevertheless, the
thinner struts (0.15 and 0.10 mm) on the PLA-based stents demonstrated
an abnormal level of deformation on the ends of geometry which is not
desired (Fig. 6). In contrast, Design A and B have fewer deformation
rates and the recoiling results are closer to those of Design C. Further­
more, as explained in the previous section, Design A is the one with the
lower risk of fracture during expansion for both materials.
The chosen designs have better results, for both PLA and PCL than
the design ABSORB™ (Abbott Laboratories, Inc.) which is the
commercially available polymeric stent [4]. Comparing the findings
from this study with the literature, the outcomes seem to be promising.
Pauck et al. [46] tested different designs with 0.10 mm of strut thick­
ness, using PLA as the base material. One of the designs was based on an
already commercialized polymeric BRS stent (S1) and the second one
was based on a design of a metallic stent (S2), also on the market.
Considering the PLA with a Young modulus of 1.8 GPa, the elastic recoil
percentage was 15.1% and 24.3% for the S1 and S2 designs, respec­
tively. Reflecting on the results of the present study for the strut with
0.10 mm of thickness, our designs not only have lower Young modulus
but also have lower elastic recoil ratios, which proves our hypothesis
8
Materials Today Chemistry 36 (2024) 101972
that the design can influence the final properties of the stents. In the case
of PCL, designs A, B, C and demonstrate better results of recoil than the
design used for the commercially polymeric stent that used PLA as a base
material (S1). Qui et al. [6] also compared different designs of stents that
exist on the market, namely, ABSORB™ and Elixir™ (Elixir Medical
Corp.) with 0.15 mm of strut thickness and RevaMedical™ (REVA
Medical Inc.) with 0.17 mm. All of them are made up of PLA as base
material. The study demonstrated that ABSORB™ and Elixir™ have a
recoil percentage of around 17% and RevaMedical™ experienced a
recoil effect of 23%. Once again, the designs evaluated in this research
showed improvements regarding the recoiling effect when compared
with the designs of the polymeric stents that are already on the market.
Other researchers tried to create new designs to improve the me­
chanical performance of polymeric stents. For instance, Donik and col­
leagues [44] create a new design with 0.20 mm of strut thickness that
demonstrates a recoil ratio of 17% and 32% for PLA and PCL, respec­
tively. For the same thickness, the results acquired in this study
demonstrate that all the designs have better results for PLA and designs
A, B, C and E have superior outcomes for PCL. A lower recoil diminishes
will reduce the probability of stent displacement after the implantation.
Furthermore, a decreased recoiling effect means that the mechanical
strength of the stent will be sufficient to support loads exerted by the
artery wall. There are a lot of studies using FEA and PLA-based stents but
only a few studies used PCL as a base material to study the influence of
the design on the mechanical properties of stents. So, this research has a
very innovative character, as it not only helps to understand the
A.M. Sousa et al.
Fig. 7. RRR of the different analyzed stents (Color black: 0.10 mm of thickness;
colour red: 0.15 mm of thickness; color blue: 0.20 mm of thickness). The graphs
display the percentage of recoil resulting from stent diameter reduction,
demonstrating the lower recoiling effect of PLA-based stent compared to PCL-
based counterparts. Furthermore, the findings indicate that the RRR percent­
ages are lower for Design A and C.
difference between our design and the ones presented in previous
studies but also gives more knowledge about PCL-based stents.
A strut thickness of 0.10 mm minimizes the recoil of the stent after
the expansion. As demonstrated in the previous section, the reduction of
the thickness makes the stent structure more prone to suffer plastic
deformation. These results subscribe to the equivalent plastic strain
outcomes because the stents with higher values of plastic strain have
lower recoil percentages. This is important data since it is necessary to
decrease the thickness of commercialized polymeric stents to minimize
some of their drawbacks on clinical performance. For instance, thicker
struts lead to a lower luminal area that disrupts the bloodstream and
higher shear stress. Additionally, thicker struts imply a greater amount
of material in contact with the organism, which can initiate a cascade of
biological events that increase the risk of restenosis or thrombosis [7]. In
this study, Design A allowed the reduction of the strut thickness without
originating the collapse of the device which will reduce or avoid also the
described biological events. The best material appears to be PLA, how­
ever, there is a higher risk of fracture according to the von Mises stress
analysis of the different designs.
One possible solution to reduce the risk of damage in PLA-based
stents, while maintaining the recoil percentage and radial strength, is
to combine PLA with PCL. Previous studies demonstrate that the recoil
percentage doesn’t increase substantially when PCL is added to PLA-
based stents and reduces the stress on areas more susceptible to frac­
ture [44]. Additionally, future research should include the artery model
to analyze the damage caused by the expansion of the balloon along with
the influence of the vessel on the recoiling effect.
3.3.3. Foreshortening ratio
The foreshortening is a result of the expansion and is related to the
recoiling effect since greater percentages of foreshortening indicate to
lower radial recoil ratio. According to previous studies, this is a conse­
quence of the amount of plastic deformation suffered by the stent after
the expansion of the balloon and consequent deflation [44]. To analyze
the foreshortening of the stent the length variation was calculated. It is
important to analyze this index because a large percentage of fore­
shortening can provoke damage to the artery during employment.
Additionally, to ensure that all atherosclerotic damage is treated, the
9
Materials Today Chemistry 36 (2024) 101972
stent must not significantly contract. Fig. 8 displays the foreshortening
percentage of the analyzed stents that were calculated after the
recoiling.
After the expansion, the stent length for the different designs was
changed. In the case of designs A, B, and E, the foreshortening ratio is
negative, which means that the stent length became shorter after the
expansion. On the other hand, the foreshortening rate for designs C and
D is positive, with the final length higher than the initial length of the
stent. This increase occurs because the curved area on the strut helps
change the curved shape to a linear shape, increasing the stent length.
The absolute values acquired from the simulation indicate that PLA
has higher percentages of foreshortening than PCL-based stents, varying
from 3 to 47% depending on the design and strut thickness. In general,
the increase in the thickness leads to a lower percentage of fore­
shortening. Overall, the results follow the RRR results because the
samples with a higher level of foreshortening have smaller recoil.
According to the literature, commercial stents have a foreshortening
percentage inferior to 5% [47,48]. However, in their study, Soong et al.
[25] referred that the ABSORB™ stent has a foreshortening rate between
6.3 and 6.9%. So, the present study demonstrates that designs B, D, and
E have a better foreshortening rate than the polymeric stent already on
the market. Once again, this study provides outcomes for PCL-based
stents, introducing a new alternative for polymeric stents mostly made
up of PLA.
Nevertheless, the mentioned designs have a higher risk of failure
after the expansion, especially in PLA-based stents. Design A has the best
results since it combines the best recoil ratio without risk of failure for
both materials and all thicknesses studied. However, the absolute fore­
shortening ratio for the mentioned design is too high compared to the
commercial stent, indicating that the maximum length reduction is 2.24
mm (PCL) and 1.68 mm (PLA). Changing the scaffold length by adding
more struts to the design is one possible solution. As described in the
FDA approval for ABSORB™, the device size selection can be made
according to the target lesion length and the physician’s opinion [49].
So, in many cases, the therapy comes from the combination of several
stent sizes, which can make design A suitable to be applied as coronary
stents.
Fig. 8. Foreshortening of the different analyzed stents (Color black: 0.10 mm of
thickness; color red: 0.15 mm of thickness; color blue: 0.20 mm of thickness).
The graphs display the percentage of foreshortening resulting from the stent
length variation after the expansion. As expected, the findings indicate that
PCL-based designs have lower percentages since they have a higher recoil­
ing effect.
A.M. Sousa et al.
4. Conclusion
The main goal of this research was to study the influence of two
different bioresorbable polymeric materials processed by FFF and the
influence of different stent designs on the mechanical performance of
implantable devices.
Regarding the mechanical tests post-printing, it was proved that PCL
has higher flexibility than PLA, favoring the stents’ deformation during
the placement. On the other hand, the tensile test indicates that PLA
provides better radial strength than PCL.
The second part had the objective of studying the response of the
different designs when subjected to the expansion with a balloon and
followed by its deflation, using FEA. After processing the materials by
FFF, the experimental approach allowed us to determine the material
properties used for FEA. The different designs highly influenced the
recoiling effect and the deformation of the stent. A lower strut thickness
originates more plastic deformation on the stent, which reduces the
elastic recoil but increases the foreshortening percentage. Although PLA
presented lower elastic recoil than PCL, there is a higher risk of stent
fracture on the curved areas. On the other hand, there is no apparent
fracture risk for PCL stents. All PLA-based designs of this study presented
better recoil percentages than the commercial polymeric stent
(ABSORB™), and for PCL-based designs A, B, and C presented recoil
ratios lower than 17% (ABSORB™). Unlike this commercial standard,
designs B, D, and E have acceptable foreshortening percentages
(≤6.9%). In final remarks, Design A is the safest model because it can be
used for both materials with the minimum thickness without risk of
failure, providing an elastic recoil rate better than ABSORB™. Also,
there may be a possibility to overcome the foreshortening of this design
by adding more struts to the device structure and increasing the stent
length.
The bioresorbable stents must be tested in an environment that
mimics the biological conditions to study the influence of blood com­
ponents on biodegradation and, consequently, mechanical properties
during this process. Future research must study 4D-printed tubular
structures triggered by body temperature. The authors also suggest the
combination of PLA and PCL to merge the best recoil results and lower
the risk of failure. Also, further studies should comprise the artery model
to study the damage provoked by the expansion and its influence on the
recoil of the stent.
Funding
AMS acknowledges Fundação para a Ciência e a Tecnologia (FCT) for
the financial support through PhD grant UI/BD/150913/2021.
CRediT authorship contribution statement
Ana M. Sousa: Formal analysis, Investigation, Methodology, Writing
– original draft. Ana M. Amaro: Formal analysis, Supervision, Writing –
review & editing. Ana P. Piedade: Conceptualization, Funding acqui­
sition, Project administration, Supervision, Writing – review & editing.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Data availability
No data was used for the research described in the article.
Acknowledgements
The authors acknowledge Fundação para a Ciência e Tecnologia
10
Materials Today Chemistry 36 (2024) 101972
(FCT), Portugal for the support of the Research Center CEMMPRE -
UIDB/00285/2020.
Appendix A. Supplementary data
Supplementary data to this article can be found online at https://doi.
org/10.1016/j.mtchem.2024.101972.
References
[1] J. Henriques, A.M. Amaro, A.P. Piedade, Understanding atherosclerosis
pathophysiology: can additive manufacturing Be helpful? Polymers 15 (2023) 480,
https://doi.org/10.3390/polym15030480.
[2] A.M. Sousa, A.M. Amaro, A.P. Piedade, 3D printing of polymeric bioresorbable
stents: a strategy to improve both cellular compatibility and mechanical properties,
Polymers 14 (2022) 1099, https://doi.org/10.3390/polym14061099.
[3] R.W. Blair, N.J. Dunne, A.B. Lennon, G.H. Menary, Multi-objective optimisation of
material properties and strut geometry for poly(L-lactic acid) coronary stents using
response surface methodology, PLoS One 14 (2019) e0218768, https://doi.org/
10.1371/journal.pone.0218768.
[4] I. Cockerill, C.W. See, M.L. Young, Y. Wang, D. Zhu, Designing better
cardiovascular stent materials: a learning curve, Adv. Funct. Mater. 31 (2021)
2005361, https://doi.org/10.1002/adfm.202005361.
[5] S. Borhani, S. Hassanajili, S.H. Tafti, S. Rabbani, Cardiovascular stents: overview,
evolution, and next generation, Prog. Biomater. 7 (2018) 175–205, https://doi.
org/10.1007/s40204-018-0097-y.
[6] T.Y. Qiu, L.G. Zhao, M. Song, A computational study of mechanical performance of
bioresorbable polymeric stents with design variations, Cardiovasc. Eng. Technol.
10 (2019) 46–60, https://doi.org/10.1007/s13239-018-00397-9.
[7] N. Bink, V.B. Mohan, S. Fakirov, Recent advances in plastic stents: a comprehensive
review, Int. J. Polym. Mater. Polym. Biomater. 70 (2021) 54–74, https://doi.org/
10.1080/00914037.2019.1685519.
[8] S. McMahon, N. Bertollo, E.D.O. Cearbhaill, J. Salber, L. Pierucci, P. Duffy,
T. Dürig, V. Bi, W. Wang, Bio-resorbable polymer stents: a review of material
progress and prospects, Prog. Polym. Sci. 83 (2018) 79–96, https://doi.org/
10.1016/j.progpolymsci.2018.05.002.
[9] C. Pan, Y. Han, J. Lu, Structural design of vascular stents: a review, Micromachines
12 (2021) 770, https://doi.org/10.3390/mi12070770.
[10] S. Lounansa, H. Ameddah, H. Mazouz, E.A.A. Alkebsi, Computational analysis of
designing an improved coronary stents of biodegradable Poly-lactic Acid (PLA),
Aust. J. Mech. Eng. (2022) 1–10, https://doi.org/10.1080/
14484846.2022.2135582.
[11] M.M. Torki, S. Hassanajili, M.M. Jalisi, Design optimizations of PLA stent structure
by FEM and investigating its function in a simulated plaque artery, Math. Comput.
Simulat. 169 (2020) 103–116, https://doi.org/10.1016/j.matcom.2019.09.011.
[12] H.-M. Hsiao, Y.-H. Chiu, K.-H. Lee, C.-H. Lin, Computational modeling of effects of
intravascular stent design on key mechanical and hemodynamic behavior, Comput.
Des. 44 (2012) 757–765, https://doi.org/10.1016/j.cad.2012.03.009.
[13] F. Ahadi, M. Azadi, M. Biglari, M. Bodaghi, A. Khaleghian, Evaluation of coronary
stents: a review of types, materials, processing techniques, design, and problems,
Heliyon 9 (2023) e13575, https://doi.org/10.1016/j.heliyon.2023.e13575.
[14] W. Hua, W. Shi, K. Mitchell, L. Raymond, R. Coulter, D. Zhao, Y. Jin, 3D printing of
biodegradable polymer vascular stents: a review, Chinese J. Mech. Eng. Addit.
Manuf. Front. 1 (2022) 100020, https://doi.org/10.1016/j.cjmeam.2022.100020.
[15] T.R. Yeazel, M.L. Becker, Advancing toward 3D printing of bioresorbable shape
memory polymer stents, Biomacromolecules 21 (2020) 3957–3965, https://doi.
org/10.1021/acs.biomac.0c01082.
[16] Y. Kong, J.N. Hay, The measurement of the crystallinity of polymers by DSC,
Polymer 43 (2002) 3873–3878, https://doi.org/10.1016/S0032-3861(02)00235-
5.
[17] A.M. Sousa, A.C. Pinho, A.P. Piedade, Mechanical properties of 3D printed
mouthguards: influence of layer height and device thickness, Mater. Des. 203
(2021) 109624, https://doi.org/10.1016/j.matdes.2021.109624.
[18] A. Abdallah, A. Kallel, F. Gamaoun, A. Tcharkhtchi, Enzymatic hydrolysis of poly
(caprolactone) and its blend with styrene–butadiene–styrene (40% PCL/60% SBS),
J. Polym. Environ. 27 (2019) 2341–2351, https://doi.org/10.1007/s10924-019-
01522-y.
[19] ISO - International Organization for Standardization, 527-2.
Plastics—Determination of Tensile Properties—Part 2: Test Conditions for
Moulding and Extrusion Plastics, Organ. Stand. Geneva, Switz., 2012.
[20] ASTM International, ASTM d790-17- standard test methods for flexural properties
of unreinforced and reinforced plastics and electrical insulating materials, West
Conshohocken 12 (2017), https://doi.org/10.1520/D0790-17.
[21] N. Kumar, M. Sreekumar, Design and analysis of new stent patterns for enhanced
performance, J. Mech. Med. Biol. 20 (2020) 2050039, https://doi.org/10.1142/
S0219519420500396.
[22] M. Zoumaki, M.T. Mansour, K. Tsongas, D. Tzetzis, G. Mansour, Mechanical
characterization and finite element analysis of hierarchical sandwich structures
with PLA 3D-printed core and composite maize starch biodegradable skins,
J. Compos. Sci. 6 (2022) 118, https://doi.org/10.3390/jcs6040118.
[23] M.T. Birosz, M. Andó, S. Jeganmohan, Finite element method modeling of additive
manufactured compressor wheel, J. Inst. Eng. Ser. D. 102 (2021) 79–85, https://
doi.org/10.1007/s40033-021-00251-8.
A.M. Sousa et al.
[24] A. Arriaga, J.M. Lazkano, R. Pagaldai, A.M. Zaldua, R. Hernandez, R. Atxurra,
A. Chrysostomou, Finite-element analysis of quasi-static characterisation tests in
thermoplastic materials: experimental and numerical analysis results correlation
with ANSYS, Polym. Test. 26 (2007) 284–305, https://doi.org/10.1016/j.
polymertesting.2006.10.012.
[25] K. Song, Y. Bi, H. Zhao, T. Wu, F. Xu, G. Zhao, Structural optimization and finite
element analysis of poly-l-lactide acid coronary stent with improved radial strength
and acute recoil rate, J. Biomed. Mater. Res. Part B Appl. Biomater. 108 (2020)
2754–2764, https://doi.org/10.1002/jbm.b.34605.
[26] ASTM International, ASTM F2079-09 -standard test method for measuring intrinsic
elastic recoil of balloon-expandable stents, West Conshohocken 3 (2017), https://
doi.org/10.1520/F2079-09R17.
[27] T.Y. Qiu, M. Song, L.G. Zhao, A computational study of crimping and expansion of
bioresorbable polymeric stents, Mech. Time-Dependent Mater. 22 (2018) 273–290,
https://doi.org/10.1007/s11043-017-9371-y.
[28] A. Kumar, N. Bhatnagar, Finite element simulation and testing of cobalt-chromium
stent: a parametric study on radial strength, recoil, foreshortening, and dogboning,
Comput. Methods Biomech. Biomed. Eng. 24 (2021) 245–259, https://doi.org/
10.1080/10255842.2020.1822823.
[29] S. Wachirahuttapong, C. Thongpin, N. Sombatsompop, Effect of PCL and
compatibility contents on the morphology, crystallization and mechanical
properties of PLA/PCL blends, Energy Proc. 89 (2016) 198–206, https://doi.org/
10.1016/j.egypro.2016.05.026.
[30] L. McKeen, 3 - introduction to the physical, mechanical, and thermal properties of
plastics and elastomers, in: L. McKeen (Ed.), Eff. Steriliz. Plast. Elastomers, third
ed., third ed., William Andrew Publishing, Boston, 2012, pp. 57–84, https://doi.
org/10.1016/B978-1-4557-2598-4.00003-4.
[31] D.W.Y. Toong, J.C.K. Ng, Y. Huang, P.E.H. Wong, H.L. Leo, S.S. Venkatraman, H.
Y. Ang, Bioresorbable metals in cardiovascular stents: material insights and
progress, Materialia 12 (2020) 100727, https://doi.org/10.1016/j.
mtla.2020.100727.
[32] B. Al-Mangour, R. Mongrain, S. Yue, Coronary stents fracture: an engineering
approach, Mater. Sci. Appl. 4 (2013) 606–621, https://doi.org/10.4236/
msa.2013.410075 (Review).
[33] N. Beshchasna, M. Saqib, H. Kraskiewicz, Ł. Wasyluk, O. Kuzmin, O.C. Duta,
D. Ficai, Z. Ghizdavet, A. Marin, A. Ficai, Z. Sun, V.F. Pichugin, J. Opitz,
E. Andronescu, Recent advances in manufacturing innovative stents,
Pharmaceutics 12 (2020) 349, https://doi.org/10.3390/pharmaceutics12040349.
[34] A. Jayswal, S. Adanur, Effect of heat treatment on crystallinity and mechanical
properties of flexible structures 3D printed with fused deposition modeling, J. Ind.
Text. 51 (2022) 2616S–2641S, https://doi.org/10.1177/15280837211064937.
[35] W. Brantley, D. Berzins, M. Iijima, E. Tufekçi, Z. Cai, 1 - structure/property
relationships in orthodontic alloys, in: T. Eliades, W.A. Brantley (Eds.), Orthod.
Appl. Biomater., Woodhead Publishing, 2017, pp. 3–38, https://doi.org/10.1016/
B978-0-08-100383-1.00001-1.
[36] B.C. Chakraborty, D. Ratna, Chapter 6 - experimental techniques and instruments
for vibration damping, in: B.C. Chakraborty, D. Ratna (Eds.), Polym. Vib. Damping
11
Materials Today Chemistry 36 (2024) 101972
Appl., Elsevier, 2020, pp. 281–325, https://doi.org/10.1016/B978-0-12-819252-
8.00006-9.
[37] J. Zong, Q. He, Y. Liu, M. Qiu, J. Wu, B. Hu, Advances in the development of
biodegradable coronary stents: a translational perspective, Mater, Today Bio 16
(2022) 100368, https://doi.org/10.1016/j.mtbio.2022.100368.
[38] Y. Li, J. Wang, K. Sheng, F. Miao, Y. Wang, Y. Zhang, R. Hou, D. Mei, Y. Sun,
Y. Zheng, S. Guan, Optimizing structural design on biodegradable magnesium alloy
vascular stent for reducing strut thickness and raising radial strength, Mater. Des.
220 (2022) 110843, https://doi.org/10.1016/j.matdes.2022.110843.
[39] D.W.Y. Toong, J.C.K. Ng, F. Cui, H.L. Leo, L. Zhong, S.S. Lian, S. Venkatraman, L.
P. Tan, Y.Y. Huang, H.Y. Ang, Nanoparticles-reinforced poly-l-lactic acid composite
materials as bioresorbable scaffold candidates for coronary stents: insights from
mechanical and finite element analysis, J. Mech. Behav. Biomed. Mater. 125
(2022) 104977, https://doi.org/10.1016/j.jmbbm.2021.104977.
[40] S. Khalaj Amnieh, M. Mashayekhi, E. Shahnooshi, M. Tavafoghi, P. Mosaddegh,
Biodegradable performance of PLA stents affected by geometrical parameters: the
risk of fracture and fragment separation, J. Biomech. 122 (2021) 110489, https://
doi.org/10.1016/j.jbiomech.2021.110489.
[41] M. Afzali Naniz, M. Askari, A. Zolfagharian, M. Afzali Naniz, M. Bodaghi, 4D
printing: a cutting-edge platform for biomedical applications, Biomed, Mater 17
(2022) 62001, https://doi.org/10.1088/1748-605X/ac8e42.
[42] M. Bodaghi, A.R. Damanpack, W.H. Liao, Self-expanding/shrinking structures by
4D printing, Smart Mater. Struct. 25 (2016) 105034, https://doi.org/10.1088/
0964-1726/25/10/105034.
[43] M. Mohammadi, A.Z. Kouzani, M. Bodaghi, Y. Xiang, A. Zolfagharian, 3D-Printed
phase-change artificial muscles with autonomous vibration control, Adv. Mater.
Technol. 8 (2023) 2300199, https://doi.org/10.1002/admt.202300199.
[44] Ž. Donik, B. Nečemer, S. Glodež, J. Kramberger, Finite element analysis of the
mechanical performance of a two-layer polymer composite stent structure, Eng.
Fail. Anal. 137 (2022) 106267, https://doi.org/10.1016/j.
engfailanal.2022.106267.
[45] A.J. Guerra, P. Cano, M. Rabionet, T. Puig, J. Ciurana, 3D-Printed PCL/PLA
composite stents: towards a new solution to cardiovascular problems, Materials 11
(2018) 1679, https://doi.org/10.3390/ma11091679.
[46] R.G. Pauck, B.D. Reddy, Computational analysis of the radial mechanical
performance of PLLA coronary artery stents, Med. Eng. Phys. 37 (2015) 7–12,
https://doi.org/10.1016/j.medengphy.2014.09.014.
[47] C. Chen, Y. Xiong, W. Jiang, Y. Wang, Z. Wang, Y. Chen, Experimental and
numerical simulation of biodegradable stents with different strut geometries,
Cardiovasc. Eng. Technol. 11 (2020) 36–46, https://doi.org/10.1007/s13239-019-
00433-2.
[48] C. Wang, L. Zhang, Y. Fang, W. Sun, Design, characterization, and 3D printing of
cardiovascular stents with zero Poisson’s ratio in longitudinal deformation,
Engineering 7 (2021) 979–990, https://doi.org/10.1016/j.eng.2020.02.013.
[49] Food and Drug Administration (FDA), FDA Approval - ABSORB GT1
BIORESORBABLE VASCULAR SCAFFOLD (BVS) SYSTEM, 2016. https://www.acc
essdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P150023. accessed
November 30, 2022.