Scientists from different disciplines from the Sarrià Chemical Institute (IQS), the Polytechnic University of Catalonia (UPC), the Sant Joan de Déu Hospital and the Boston Children’s Hospital have joined forces in the Polycoartc project to find a solution for childhood aortic coarctation .
The objective is to improve the current solutions for aortic coarctation in children, adapted to their growth and to reduce the number of new surgical interventions that this pathology requires.
Aortic coarctation is an abnormal narrowing of the aorta artery, the main artery in the body, a type of chronic lesion that occurs in newborns and that, if left untreated, can lead to other short- or long-term health problems, such as renal or cardiac insufficiency among others.
The treatment of this disease can be carried out from two approaches: open-heart surgery, or the implantation of an endovascular stent, which requires frequent surgical reinterventions.
This aortic lesion occurs occasionally in newborns, due to an immaturity of the germ cells that remain in fetal size, leaving a narrowed and hardened artery.
As it is a pediatric disease, children’s arteries are very small, as are the stents, so that when the child grows, and his aorta as well, the implanted stents remain small and various reinterventions and frequent stent openings are required.
To solve this problem, the project has arisen to design and develop new polymeric stents adapted to the arterial growth needs of children affected by aortic coarctation, reducing or avoiding new surgical interventions.
The project is led by Jordi Martorell, from the IQS Vascular Engineering and Applied Biomedicine Group (GEVAB), with the participation of Mercedes Balcells –a researcher at the Harvard-MIT Biomedical Engineering Center and GEVAB–; Jose J. Molins (GEVAB); Andrés García (IQS) and Marta Pegueroles, expert in biomaterials for cardiovascular applications and professor of Engineering at the UPC.
“This is an ambitious project that can only be approached from a multidisciplinary perspective, with contributions from engineering, chemistry, materials science, vascular biology, and medicine,” the researchers explained.
The IQS researchers will be in charge of creating a CAD-CAM platform to replicate different types of coarctation and design and 3D-print stents with an auxetic design that fit their geometry.
An auxetic material is one that presents a negative Poisson’s ratio, which implies that, when producing traction in one direction, the perpendicular section of the material increases.
For its part, the UPC will develop an alternative to auxetic stents, specifically, degradable polymeric stents with shape memory, using 3D printing techniques.
Shape memory polymers are capable of changing their physical shape in response to an external stimulus, such as body temperature, due to a structural change.
They will also develop coatings that promote re-endothelialization –accelerating the coating of the stent surface with endothelial cells, key to avoiding thrombosis–, facilitating its integration into the artery, to later degrade.