Multiplicity of Morphologies in Poly (L-lactide) Bioresorbable Vascular Scaffolds

Julia A. Kornfield

California Institute of Technology, Chemistry & Chemical Engineering,  Pasadena CA 91125

Poly(L-lactide), PLLA, is the structural material of the first clinically approved bioresorbable vascular scaffold (BVS), a promising alternative to permanent metal stents for treatment of coronary heart disease. BVSs are transient implants that support the occluded artery for 6 months, and are completely resorbed in 2 years. Clinical trials of BVSs report restoration of arterial vasomotion and elimination of serious complications such as Late Stent Thrombosis. It is remarkable that a scaffold made from PLLA, known as a brittle polymer, does not fracture when crimped onto a balloon catheter or during deployment in the artery. X-ray microdiffraction revealed how PLLA acquired ductile character and that the crimping process creates localized regions of extreme anisotropy; PLLA chains in the scaffold change orientation from the hoop direction to the radial direction over micron-scale distances. The multiplicity of morphologies in the crimped scaffold enable a low-stress response during deployment, which avoids fracture of the PLLA hoops and leaves them with the strength needed to support the artery. Thus, the transformations of the semicrystalline PLLA microstructure during crimping explain the unexpected strength and ductility of the current BVS and point the way to thinner resorbable scaffolds in the future.

[1] Ailianou, A.; Ramachandran, K.; Kossuth, M.; Oberhauser, J.P.; Kornfield, J.A.*; “Multiplicity of Morphologies in Poly (L-lactide) Bioresorbable Vascular Scaffolds,” PNAS, 113, 11670-11675 (2016). (link)