Smart fibrous implantable medical devices

Figure 13.1 Textile science contribution to smart fibrous implantable medical devices designing. Biocompatibility and well-functioning implants in the postoperative stage will be focused on in this review.

Permanent materials could be thus designed to provide smart fibrous implantable medical devices with improved performance and decreased amount of particle release to give better biocompatibihty. 

Smart features in fibrous implantable medical devices... 

This example of vascular grafts devices points out the evolution of fibrous implantable medical devices and highlights the great potential offered by each scale level of fibrous structures for biocompatibility improvements. Fibers as well as whole fibrous stmctures should be considered as implantable devices that have inherent abilities to interact with the biological environment at each of the three predetermined scale levels. Study of characteristics and specificities of fibers, fibrous siuface, and fibrous volume should then provide a more forward-looking approach in the textile substitute s area for design and achievement of smart medical implantable textile devices. 

One simple but smart example of a fibrous implantable medical device that uses the high surface ratio feature of fibers is embolization coil. Such devices are intended for many endovascular treatments of aneurysms, hemorrhages of peripheral lesions, and arteriovenous malformations. The procedure involves the threading of thin coils through a catheter into the affected area of the brain, filling the weakened portion of the vessel. Once in place, the body responds by forming a clot around the coil, further reducing the pressure and risk of rupmre. 

These examples underscore the wide range of material physical characteristics that remain to be explored to improve fibrous implantable medical devices and make them even smarter for each intended application. While some of these smart characteristics could be easily identified, such as radio-opacity, radioresistance, and resistance to sterilization, wettability, the fibrous material area is a vast exploratory field that is not as well known and described as the fibrous stmctures area. 

Depending on the expected use of the implantable medical device, the ageing of the material could be favorable or detrimental. In the aim to design smart fibrous biomaterial that best fits with the particular needs of implantable medical devices, understanding of biomaterial degradation stages is required. 

Carbon nanotubes are the subject of many research studies from drug delivery systems to many other medical applications. Only a few references and examples have been mentioned here. This dmg delivery application by CNTs constitutes in itself the wide potential of fibrous material for smart implantable medical device designing, going beyond just the biological response impact and including physical and mechanical features. 

In this chapter we have chosen not to focus on specific examples of smart textiles application in order to avoid narrowing the field of smart implantable fibrous medical devices to a few innovative textile properties. Contrariwise, fiber characteristics are pointed out to show that all of them, in a prospective designing approach, could achieve smart features in the implantable device area. However, we are limited in exploratory areas using new materials because a decline is needed to be certain that a material is accepted by the body. Given the diversity of appreciation of smart appearance, as well as the implantable medical device aspect, we have focused on the biocompatibility and biointegration of substitutes in their environment. This theme therefore needs to be complemented by other approaches such as the concepts of smart attitude and implantable device as related in Fig. 13.1. 

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