on the effect of macromolecular composition and drug loading on thermal and tensile mechanical...
TRANSCRIPT
ORI GIN AL PA PER
On the effect of macromolecular composition and drugloading on thermal and tensile mechanical propertiesof methyl methacrylate and butyl methacrylatecopolymers
Mariacristina Gagliardi
Received: 29 May 2013 / Revised: 26 September 2013 / Accepted: 7 November 2013 /
Published online: 14 November 2013
� Springer-Verlag Berlin Heidelberg 2013
Abstract In the last years, drug-eluting stents (DES) were considered as an
important biomedical technology for cardiovascular intervention. In these devices, a
thin polymer coating covers the metallic structure, aiming at the release of one or
more active principles with controlled delivery kinetics. During DES implantation,
structural failures on the thin coating may occur because of the mechanical
expansion of the structure. The presence of a drug in the polymer matrix could
severely influence mechanical properties, thus a mechanical characterisation of
polymers and drug-loaded matrices results fundamental. To characterise a material
produced for the manufacturing of drug-loaded coatings for DES, in the present
work the thermomechanical analysis of an acrylic copolymer loaded with a drug is
proposed. Obtained results showed that macromolecular composition could be
varied to obtain the desired mechanical compliance; in addition, the drug can act as
plasticiser. The present study would underline that it is possible to control
mechanical properties by synthesising a tailored copolymer; furthermore, the
importance of the study of the final system is fundamental when a polymer is
considered as potential candidate to obtain coatings for DES.
Keywords Coatings � Thermal properties � Mechanical properties �Drug eluting stents � Poly(methylmethacrylate-co-butylmethacrylate)
M. Gagliardi
Department of Chemical Engineering, Industrial Chemistry and Materials Science,
University of Pisa, Largo Lucio Lazzarino, 56126 Pisa, Italy
Present Address:
M. Gagliardi (&)
Center for Micro-BioRobotics @SSSA, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio,
34, 56025 Pontedera, PI, Italy
e-mail: [email protected]
123
Polym. Bull. (2014) 71:533–544
DOI 10.1007/s00289-013-1075-0
Introduction
Drug-eluting stents (DES) are small-slotted devices generally coated with a thin
polymeric layer loaded with one or more active principles [1]. These devices are
used in the treatment of coronary artery diseases and are implanted via balloon
angioplasty, an intravascular procedure based on the use of a catheter, equipped by a
balloon that is inflated to expand the stent in the site of the pathology, restoring the
perviety of the blood vessel. The presence of drugs in the coating is requested to
prevent the restenosis post-stenting [2], caused by a negative response to the
intervention. When released from the coating, therapeutic agents are directly at the
target site, increasing the pharmacological potential of the treatment [3–5]. The use
of a polymer to coat the metallic device causes several problems related to the
haemo- and cyto-compatibility [6, 7], the potential release of products of the
degradation of the coatings [8, 9] and the possibility of cracking or delamination
during the stent deployment and implantation [10–12], thus a tight control of the
drug delivery kinetics resulted fundamental [13, 14] to justify the introduction of the
polymeric component in a complex system such as a coronary stent. Concerning the
integrity of the coating, several studies are reported in literature [10–12, 15, 16],
concluding that a complete analysis of the mechanical properties of the final drug-
loaded system is important to prevent the cracking of the coating. During the
implant of a stent, a plastic deformation of the metallic structure is performed and
the diameter of the device is increased by 200–300 % in respect to the starting
diameter. If the coating covers the whole structure, there are several zones of the
device where high deformations occur. Then, a good material to obtain coatings for
drug eluting stents has to be soft and highly ductile; also, it has to show high
toughness to absorb a greater amount of energy before reaching the rupture. The
presence of active principles cannot be neglected in the mechanical characterisation
of the material, considering that the drug molecules could interact with the
polymeric chains. Interactions are affected by the chemical composition of both
polymeric matrix and drug and, basing on their differences, adhesion between
molecules could be different by varying the polymeric platform and the active
principle. Some recent studies reported the analysis of mechanical properties of
polymer matrices loaded with drugs [17, 18], underlining that a significant variation
may occur in the presence of both plasticisers and anti-plasticisers, also by varying
their concentration in the polymer matrix.
Among the large number of polymers suitable to obtain controlled delivery
kinetics, polymethylmethacrylate (PMMA) is a good candidate able to furnish a
prolonged drug release over time. It is an interesting characteristic for a drug-eluting
polymer platform for DES because the pharmacological treatment may be necessary
for several months after implantation [19, 20]. On the other hand, PMMA is a stiff
and low ductile polymer and it could lead to coating ruptures during production
processes and stent implantation. Another interesting polymer is polybutylmethac-
rylate (PBMA) that is already used in a FDA-approved DES (Cypher stent, Johnson
and Johnson) [21] thanks to its adhesive properties; in addition, literature reports
that its copolymers show interesting properties for other different biomedical
applications, such as in drug delivery systems [22] and biosensors [23]. Considering
534 Polym. Bull. (2014) 71:533–544
123
that drug delivery kinetics of PMMA and PBMA was found to be significantly
different [24], it is reasonable to consider a copolymer of methylmethacrylate and
butylmethacrylate to tune this characteristic. However, drug release kinetics cannot
be considered as the most important characteristic of a DES coating. Other different
properties have to be analysed, such as biocompatibility and drug release efficacy on
cells [25], but also the possibility to realise a coating and the mechanical strength of
the final product. In the present work, the mechanical analysis of a copolymer
synthesised using methyl methacrylate (MMA) and butyl methacrylate (BMA) in
three different macromolecular compositions is reported, evaluating in the first part
of the work the effect of the macromolecular composition on mechanical properties.
Then, the analysis of drug-loaded specimens is reported to evaluate how the
presence of the drug affects the mechanical behaviour of the materials. In the last
part of the work, the prediction of the Young’s modulus, as a function of
macromolecular composition and drug loading, using mathematical models is
reported and an empirical model was developed for this aim.
Materials and methods
Polymeric materials used in the present work were poly(methyl methacrylate),
poly(butyl methacrylate) and three of their copolymers poly(methyl methacrylate-
co-butyl methacrylate) [P(MMA-co-BMA)]. Materials were synthesised as
described in a previous work [26]. In Table 1, the composition of the starting
monomer mixture used to synthesise copolymers and the final macromolecular
composition, together with the nomenclature that will be used in this work to
identify the materials, is reported. Folic acid (FA, Sigma�) was used as drug model.
Three different percentage of loading ratios were selected: 1, 5 and 10 % w/w in
respect to the polymer.
Preparation of dog-bone samples
Samples not containing the drug were prepared by casting from polymeric solutions
in tetrahydrofuran (THF, Carlo Erba Reagenti). Polymeric solutions with concen-
tration of 2 % w/v of polymer were prepared. When polymeric powders were
completely dissolved, solutions were poured onto silicon moulds to obtain dog-bone
Table 1 Poly(methyl methacrylate-co-butyl methacrylate) copolymer percentage compositions and
nomenclature that will be used in the present work
Nomenclature % molar composition
in the starting reaction
recipe (MMA/BMA)
Final % molar
composition
(MMA/BMA)
Final % weight
composition
(MMA/BMA)
P(MMA-co-BMA) 87.5/12.5 87.5/12.5 86.9/13.1 82.4/17.6
P(MMA-co-BMA) 75/25 75/25 74.3/25.7 67.1/32.9
P(MMA-co-BMA) 50/50 50/50 50.8/49.2 42.1/57.9
Polym. Bull. (2014) 71:533–544 535
123
samples. 4 ml of solution was poured in each mould to obtain one specimen. The
casting procedure was carried out in a vented oven maintained at 40 ± 1 �C for 5 h.
In Fig. 1, the mould used and dimensions of obtained samples are reported. Drug-
loaded samples were prepared with the same technique used to obtain not-loaded
samples, changing the starting solution. In this case, the starting solution was
prepared dissolving a blend of polymeric powder and FA in THF. The amount of
polymer was maintained fixed (2 % w/v), while three different amounts of FA were
considered: 1, 5 and 10 % in weight of drug in respect to the polymer weight. Five
specimens were tested for each system and the results following reported represent
the mean value of these tests. The thicknesses of obtained samples are reported in
Table 2.
Thermal and tensile mechanical characterisation
Glass transition temperatures (Tg) for synthesised copolymers were evaluated by
differential scanning calorimetry (DSC). Calorimetric analyses were carried out
using a Perkin Elmer DSC 7 instrument. Five film-shaped samples (6.3 ± 1.2 mg)
for each polymeric system were analysed. The thermal behaviour of the materials
was followed from 0 to 200 �C (heating and cooling) at a rate of 10 �C/min under
N2 flux (10 mL/min). Results obtained from the second heating scan were
considered to evaluate the Tg.
Fig. 1 a Silicon mould used to prepare dog-bone samples and b geometric characteristics of obtainedsamples
Table 2 Thicknesses of specimens (lm) obtained using the dog-bone mould by varying the percentage
amount (w/w) of folic acid loaded in the starting solution
Material FA 0 % FA 1 % FA 5 % FA 10 %
PMMA 15.2 ± 3.2 20.4 ± 5.6 13.6 ± 4.4 19.6 ± 6.4
P(MMA-co-BMA) 87.5/12.5 16.2 ± 3.2 25.6 ± 5.6 30.2 ± 2.8 30.4 ± 2.6
P(MMA-co-BMA) 75/25 19.4 ± 6.4 20.4 ± 0.6 23.4 ± 4.6 26.0 ± 4.0
P(MMA-co-BMA) 50/50 14.0 ± 4.0 16.6 ± 3.4 13.0 ± 3.0 15.4 ± 4.6
PBMA 12.8 ± 0.8 15.8 ± 7.2 19.6 ± 8.4 12.8 ± 3.2
536 Polym. Bull. (2014) 71:533–544
123
Tensile strength tests were performed using the isotonic transducers Ugo Basile
Biological Research Apparatus. Load applied was ramped from 0 to 5 N in 3 h
(loading rate: 0.028 N/min). Tests were performed at controlled room temperature
(22 �C).
Results and discussion
In Fig. 2, values of Tg obtained for analysed samples are reported for each
polymeric platform by varying the amount of FA loaded into systems. It was
possible to underline two different plasticising effects arising by increasing: (1) the
BMA units into the copolymeric chains and (2) the amount of FA loaded into
systems. The first effect can be directly related to the presence of the lateral
substituents that are more flexible for BMA units than MMA. n-butyl substituents,
in fact, can entangle nearby polymer chains, causing a decrease of the glass
transition temperature [26]. Considering the effect of FA loading, a slight decrease
of the Tg was registered for each system with the increase of the solute loading. The
decrease of the Tg could be directly related to a plasticiser effect of FA molecules
[27]. In fact, after the addition of FA, solute molecules come between polymer
chains, pushing them apart from each other. The presence of solute molecules into
the macromolecular spaces causes an increase of the free volume, thus polymer
macromolecules can more easily slide past each other. As a final result, polymer
chains can move around at a lower temperature than pure polymer, consequently a
lower Tg can be recorded.
Figure 3a shows the uniaxial stretching response exhibited by the different
P(MMA-co-BMA) copolymers compared to homopolymers. Mechanical properties
were found to be strongly dependent on the macromolecular composition (Table 3).
In particular, in respect to r-e curves of PMMA and PBMA, copolymers showed
intermediate properties. The shape of the stress–strain curve gradually was modified
by increasing the BMA amount in the molecular composition and ductility increased
Fig. 2 Glass transition temperatures (Tg) evaluated for pure materials and FA-loaded specimens byvarying the amount of solute introduced in polymeric matrices; error bars (reported) were found to beB1.0 % for each measurement
Polym. Bull. (2014) 71:533–544 537
123
gradually by increasing the BMA amount, while the ultimate stress decreased. In
fact, in copolymers 87.5/12.5 and 75/25, containing a low BMA amount, a
homogeneous deformation with a negligible plastic region was observed; while in
the copolymer 50/50, the plastic region become more evident, showing a behaviour
more similar to PBMA. In particular, PMMA showed to be fragile and the rupture
occurred without plastic effects and the same behaviour occurred in the analysis of
the copolymer 87.5/12.5. On the contrary, increasing the BMA amount a plastic
deformation occurred and the plastic strain increased gradually with the increase in
BMA content. According to these observations, Young’s modulus (E), first yield
stress (r0,ys) and strength at break (ru) increased with the increase in MMA fraction
while deformation at break (eu) decreased with this parameter, due to the greater
stiffness introduced in the materials by the MMA units. Another important
mechanical parameter is the toughness. This parameter can be defined as an
indication of the energy that a material can absorb before the breaking occurrence
and it could be evaluated as the area under the r–e curve. Obtained values are
reported in Fig. 3b. Also in this case, a correlation between this mechanical
parameter and the macromolecular composition can be highlighted; increasing the
BMA amount toughness increased rapidly for low BMA amount, but a smaller
difference between copolymer 75/25 and 50/50 was found.
Figure 3c reports as example the uniaxial stretching response exhibited by the
copolymer P(MMA-co-BMA) 87.5/12.5 by varying the FA loading. Other materials
showed a similar trend, with a decrease of the Young’s modulus, the first yield
stress, the strength at break and an increase in the deformation at break. Numerical
Fig. 3 Mechanical parameters in function of the actual BMA molar fraction in the macromolecularcomposition: a r–e curves obtained from tensile tests (one single experiment); b toughness of thematerials, evaluated measuring the area under the r–e curve. Mechanical parameters in function of the FAloading: c r–e curves obtained from tensile tests (one single experiment) copolymer 87.5/12.5;d toughness of the materials
538 Polym. Bull. (2014) 71:533–544
123
data are summarised in Table 4. Considering the effect of the percentage FA
loading, the overall highlighted trend was the same registered for copolymer 87.5/
12.5. Concerning the energy at break (Fig. 3d), also in this case toughness increased
with the increase in BMA amount and decreased with the increase in FA fraction.
Even if a trend of mechanical properties by varying the amount of drug loaded was
underlined, a comparison of obtained data showed that the plasticizer effect of the
drug did not significantly increase with concentration. It may be due to the solubility
of the drug in the polymeric matrices, higher than the amount of drug loaded; the
good solubility led to a homogeneous distribution of FA, thus interactions between
polymer molecules decreased, because of the increase of the free volume caused by
the presence of FA, but not significantly.
Mathematical modelling of Young’s modulus
The effect of macromolecular composition on the elastic modulus of copolymers
was evaluated using two different equations:
1
E¼ x1
E1
þ 1� x1
E2
ð1Þ
Where x1 is the weight fraction of the component 1, while E1 and E2 are the elastic
modulus of the component 1 and 2 (homopolymers), respectively.
E ¼ x1 � E1 þ c � ð1� x1Þ � E2
x1 þ c � ð1� x1Þð2Þ
where c is a fitting parameter obtained by the plot of ðE � E1Þ vs. ðE2 � EÞ � 1�x1
x1.
For the proposed system, c was found to be 0.519. Obtained results found with cited
models are reported in Fig. 4. Equations used to predict the Young’s modulus were
derived from two models generally used in the prediction of the thermal behaviour
of copolymers, in particular from Fox (Eq. 1) and Gordon–Taylor (Eq. 2) models
[28]. Models seem to fit well also with mechanical properties and it allowed hy-
pothesising that both equations could be extended also to the prediction of Young’s
modulus of copolymers.
Table 3 Young’s modulus E (MPa), first yield stress r0,ys (MPa), strength at break ru (MPa) and
deformation at break eu evaluated through tensile tests; mean values were evaluated from five experi-
mental tests; r0,ys was identified as the last point of the linear region showing a correlation between
experimental data and linear curve fitting [0.97
Material E (MPa) r0,ys (MPa) ru (MPa) eu
PMMA 780 ± 8 48 ± 4 70 ± 6 0.06 ± 0.01
P(MMA-co-BMA) 87.5/12.5 580 ± 6 44 ± 4 65 ± 8 0.08 ± 0.02
P(MMA-co-BMA) 75/25 476 ± 7 29 ± 3 53 ± 9 0.14 ± 0.03
P(MMA-co-BMA) 50/50 351 ± 9 19 ± 5 38 ± 5 0.18 ± 0.02
PBMA 130 ± 8 14 ± 3 27 ± 5 0.38 ± 0.03
Polym. Bull. (2014) 71:533–544 539
123
Table 4 Young’s modulus E (MPa), first yield stress r0,ys (MPa), strength at break ru (MPa) and
deformation at break eu evaluated through tensile tests on specimens by varying the percentage FA
loading; mean values were evaluated from five experimental tests
Material FA loading
1 % 5 % 10 %
Young’s modulus E (MPa)
PMMA 531 ± 19 476 ± 13 402 ± 18
P(MMA-co-BMA) 87.5/12.5 327 ± 11 236 ± 12 225 ± 16
P(MMA-co-BMA) 75/25 242 ± 12 228 ± 11 181 ± 12
P(MMA-co-BMA) 50/50 160 ± 10 123 ± 8 118 ± 9
PBMA 70 ± 6 46 ± 5 33 ± 8
First yield stress r0,ys (MPa)
PMMA 19 ± 6 16 ± 4 13 ± 1
P(MMA-co-BMA) 87.5/12.5 15 ± 3 14 ± 2 12 ± 3
P(MMA-co-BMA) 75/25 10 ± 4 7 ± 4 4 ± 2
P(MMA-co-BMA) 50/50 5 ± 2 3 ± 2 2 ± 1
PBMA 5 ± 3 2 ± 1 2 ± 1
Strength at break ru (MPa)
PMMA 35 ± 8 34 ± 6 31 ± 7
P(MMA-co-BMA) 87.5/12.5 34 ± 6 33 ± 4 29 ± 5
P(MMA-co-BMA) 75/25 31 ± 2 28 ± 8 27 ± 3
P(MMA-co-BMA) 50/50 23 ± 4 15 ± 4 14 ± 5
PBMA 19 ± 1 14 ± 3 13 ± 3
Deformation at break eu
PMMA 0.07 ± 0.02 0.08 ± 0.01 0.09 ± 0.01
P(MMA-co-BMA) 87.5/12.5 0.08 ± 0.02 0.09 ± 0.01 0.12 ± 0.02
P(MMA-co-BMA) 75/25 0.15 ± 0.02 0.16 ± 0.03 0.18 ± 0.01
P(MMA-co-BMA) 50/50 0.20 ± 0.03 0.22 ± 0.02 0.40 ± 0.03
PBMA 0.39 ± 0.01 0.41 ± 0.01 0.45 ± 0.02
Fig. 4 Theoretical models used for the prediction of Young’s modulus by varying the macromolecularcomposition; correlations between experimental data and mathematical models were found to be 0.965and 0.997 for models described by Eqs. (1) and (2), respectively
540 Polym. Bull. (2014) 71:533–544
123
To predict the effect of FA loading, six different mathematical models already
described in literature [29] were used. Studied models are summarised in Table 5.
Reported equations describe the prediction of the Young’s modulus of polymeric
Table 5 Mathematical models used to describe the Young’s modulus by varying the volume fraction of
filler; u is the volume fraction of the filler
Model Equation Conditions
Einstein E ¼ Em � ð1þ 2:5 � uÞ Perfect adhesion
filler/matrixGuth-Smallwood E ¼ Em � ð1þ 2:5 � uþ 14:1 � u2ÞSlip condition E ¼ Em � ð1þ uÞ Polymer matrix slips
by filler particles
Sato-Furukawa E ¼ Em � 1þ u2=3
2�ð1�u1=3Þ
� �� 1þ w � fð Þ � u2=3�w�f
1�u1=3ð Þ�u
h iPoor adhesion
filler/matrix
where w ¼ u3
� �� 1þu1=3�u2=3
1�u1=3þu2=3 and 0 B f B 1
Series/parallel E ¼ Em � um and E ¼ Em
umrespectively
Fig. 5 Theoretical models used for the prediction of Young’s modulus: a Einstein; b Guth-Smallwood;c slip condition; d Sato Furukawa; e series/parallel; reported plots referred to polymeric systems loadedwith 1 % of FA
Polym. Bull. (2014) 71:533–544 541
123
matrices loaded with a plasticiser composed of rigid fillers. In the present work,
copolymers were loaded with an active principle and previously reported models
were unreliable for this aim. In Fig. 5, obtained results for copolymers loaded with
1 % of FA are reported, for other drug loadings results were similar and were not
reported. Thus, a novel empirical model was developed, expressed by Eq. (3):
E ¼ k � Em � ð1� uÞ½ � 1þ2=3ð Þ ð3Þ
Where k is a fitting parameter and value from experimental data was found to be
0.825 ± 0.003 for all systems, by varying both macromolecular composition and
drug loading. Proposed model resulted in good agreement with experimental data
(Fig. 6). However, this model did not expressly take the polymer/drug adhesion into
account. It is reasonable to consider that this characteristic only affected the value of
k because no significant differences between different drug loadings were found. For
this reason, the value of k may significantly vary if other polymer/drug systems are
considered.
Conclusion
In the present work, the effect of macromolecular composition and drug loading on
thermomechanical properties of acrylic copolymers was analysed. It was reported
that, similar to the effect obtained on drug delivery kinetics, it was possible to
modulate mechanical properties of materials by varying the molar ratio between co-
monomers. Results showed that the effect of macromolecular composition on the
mechanical behaviour could be studied using the equations derived from the thermal
Fig. 6 Empirical model proposed for all FA loadings: a 1 % (correlation: 1.000); b 5 % (0.996); c 10 %(0.997)
542 Polym. Bull. (2014) 71:533–544
123
analysis. In particular, Eq. (2), derived from the Gordon–Taylor model, could be
used to predict the variation of the Young’s modulus by varying the weight fraction
of the two co-monomers with a good correlation between experimental data. It is
significant to point out that the same model was previously used to predict the Tg in
these copolymers with good results. In addition, the effect of a solute loaded within
matrices acted as plasticiser and caused a lowering of both the glass transition
temperature and the Young’s modulus. Results suggested that the thermomechanical
characterisation of drug-loaded matrices results fundamental when a polymer is
considered a potential candidate to obtain coatings for DES because mechanical
strength may significantly vary. However, tensile tests are not sufficient to
understand the behaviour of a complex thin coating for a DES. As reported,
copolymers analysed in the present work were previously characterised to evaluate
drug release properties [23], cyto- and haemo-compatibility [25] and some in silico
models were already studied to evaluate stresses and strains occurring after the stent
deployment in an occluded artery [30]. The future application of the present study
will be the accurate description of the structural behaviour of these copolymers in
silico models. In addition, in future works other different properties, such as the
adhesion of the coating on the metallic surface of the stent, the feasibility of a
coating on commercial DES and the optimisation of polymer/drugs formulations,
will be explored to evaluate the possibility to realise a commercial device using the
novel synthesised P(MMA-co-BMA) copolymers.
References
1. Youssefian S, Rahbar N (2012) Nano-scale adhesion in multilayered drug eluting stents. J Mech
Behav Biomed Mater 18C:1–11
2. Nakatani M, Takeyama Y, Shibata M, Yorozuya M, Suzuki H, Koba S, Katagiri T (2003) Mecha-
nisms of restenosis after coronary intervention: difference between plain old balloon angioplasty and
stenting. Cardiovasc Pathol 12(1):40–48
3. Lambert TL, Dev V, Rechavia E, Forrester JS, Litvack F, Eigler NL (1994) Localized arterial wall
drug delivery from a polymer-coated removable metallic stent. Kinetics, distribution, and bioactivity
of forskolin. Circulation 90(2):1003–1011
4. Puranik AS, Dawson ER, Peppas NA (2013) Recent advances in drug eluting stents. Inter J Pharm
441(1–2):665–679
5. Huang Y, Venkatraman SS, Boey FY, Lahti EM, Umashankar PR, Mohanty M, Arumugam S,
Khanolkar L, Vaishnav S (2010) In vitro and in vivo performance of a dual drug-eluting stent
(DDES). Biomater 31(15):4382–4391
6. Carlsson J, von Wagenheim B, Linder R, Anwari TM, Qvist J, Petersson I, Magounakis T, Lagerqvist
B (2007) Is late stent thrombosis in drug-eluting stents a real clinical issue? A single-center expe-
rience and review of the literature. Clin Res Cardiol 96(2):86–93
7. Pfisterer M, Brunner La Rocca HP, Rickenbacher P, Hunziker P, Mueller C, Nietlispach F, Lei-
bundgut G, Bader F, Kaiser C (2009) BASKET. Long-term benefit-risk balance of drug-eluting vs.
bare-metal stents in daily practice: does stent diameter matter? Three-year follow-up of BASKET.
Eur Heart J 30(1):16–24
8. Katti DS, Lakshmi S, Langer R, Laurencin CT (2002) Toxicity, biodegradation and elimination of
polyanhydrides. Adv Drug Deliv Rev 54(7):933–961
9. Fischer D, Li Y, Ahlemeyer B, Krieglstein J, Kissel T (2003) In vitro cytotoxicity testing of poly-
cations: influence of polymer structure on cell viability and hemolysis. Biomaterials
24(7):1121–1131
Polym. Bull. (2014) 71:533–544 543
123
10. Hopkins CG, McHugh PE, McGarry JP (2010) Computational investigation of the delamination of
polymer coatings during stent deployment. Ann Biomed Eng 38(7):2263–2273
11. Wiemer M, Butz T, Schmidt W, Schmitz KP, Horstkotte D, Langer C (2010) Scanning electron
microscopic analysis of different drug eluting stents after failed implantation: from nearly undam-
aged to major damaged polymers. Catheter Cardiovasc Inter 75(6):905–911
12. Basalus MW, Tandjung K, van Westen T, Sen H, van der Jagt PK, Grijpma DW, van Apeldoorn AA,
von Birgelen C (2012) Scanning electron microscopic assessment of coating irregularities and their
precursors in unexpanded durable polymer-based drug-eluting stents. Catheter Cardiovasc Inter
79(4):644–653
13. Finkelstein A, McClean D, Kar S, Takizawa K, Varghese K, Baek N, Park K, Fishbein MC, Makkar
R, Litvack F, Eigler NL (2003) Local drug delivery via a coronary stent with programmable release
pharmacokinetics. Circulation 107(5):777–784
14. Acharya G, Lee CH, Lee Y (2012) Optimization of cardiovascular stent against restenosis: factorial
design-based statistical analysis of polymer coating conditions. PLoS One 7(8):e43100
15. Basalus MW, Ankone MJ, van Houwelingen GK, de Man FH, von Birgelen C (2009) Coating
irregularities of durable polymer-based drug-eluting stents as assessed by scanning electron
microscopy. EuroIntervention 5(1):157–165
16. Otsuka Y, Chronos NA, Apkarian RP, Robinson KA (2007) Scanning electron microscopic analysis
of defects in polymer coatings of three commercially available stents: comparison of BiodivYsio,
Taxus and Cypher stents. J Inv Cardiol 19(2):71–76
17. Lamm MS, Simpson A, McNevin M, Frankenfeld C, Nay R, Variankaval N (2012) Probing the effect
of drug loading and humidity on the mechanical properties of solid dispersions with nanoindentation:
antiplasticization of a polymer by a drug molecule. Molec Pharmacol 9(11):3396–3402
18. van Drooge DJ, Hinrichs WL, Visser MR, Frijlink HW (2006) Characterization of the molecular
distribution of drugs in glassy solid dispersions at the nano-meter scale, using differential scanning
calorimetry and gravimetric water vapour sorption techniques. Int J Pharm 310(1–2):220–229
19. Gwon HC, Hahn JY, Park KW, Song YB, Chae IH, Lim DS et al (2012) Six-month versus 12-month
dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus
versus cypher to reduce late loss after stenting (EXCELLENT) randomized, multicenter study.
Circulation 125(3):505–513
20. Costa MA, Simon DI (2005) Molecular basis of restenosis and drug-eluting stents. Circulation
111(17):2257–2273
21. FDA (2013) http://www.accessdata.fda.gov/cdrh_docs/pdf2/P020026c.pdf. Accessed 24 Sept 2013
22. Qiu Y, Park K (2001) Environment-sensitive hydrogels for drug delivery. Adv Drug Deliv Rev
53(3):321–339
23. Perez JP, Lopez-Cabarcos E, Lopez-Ruiz B (2006) The application of methacrylate-based polymers
to enzyme biosensors. Biomol Eng 23(5):233–245
24. Gagliardi M, Silvestri D, Cristallini C (2010) Macromolecular composition and drug-loading effect
on the delivery of paclitaxel and folic acid from acrylic matrices. Drug Deliv 17(6):452–465
25. Gagliardi M (2012) In vitro haematic proteins adsorption and cytocompatibility study on acrylic
copolymer to realise coatings for drug-eluting stents. Mater Sci Eng C 32(8):2445–2451
26. Silvestri D, Gagliardi M, Cristallini C, Barbani N, Giusti P (2009) Different composition poly(methyl
methacrylate-co-butyl methacrylate) copolymers through a seeded semi-batch emulsion polymeri-
zation. Polym Bull 63(3):423–439
27. Jadhav NR, Gaikwad VL, Nair KJ, Kadam HM (2009) Glass transition temperature: basics and
application in pharmaceutical sector. Asian J Pharm 3(2):82–89
28. Brostow W, Chiu R, Kalogeras IM, Vassilikou-Dova A (2008) Prediction of glass transition tem-
peratures: binary blends and copolymers. Mater Lett 62(17–18):3152–3155
29. Bliznakov ED, White CC, Shaw MT (2000) Mechanical properties of blends of HDPE and recycled
urea-formaldehyde resin. J Appl Polym Sci 77(14):3220–3227
30. Gagliardi M (2011) Computational models for the in silico analysis of drug delivery from drug-
eluting stents. Therap Deliv 2(1):1–3
544 Polym. Bull. (2014) 71:533–544
123