Document Type : Original Article(s)

Authors

• Hamid Amoozgar ¹
• Hossein Hosseini ²
• Hamid Mohammadi ³
• Behrooz Fereidoonnezhad ⁴
• Mehdi Eynbeygui ⁵
• Jamal Arghavani ⁵
• Afshin Zare ⁶
• Nima Mehdizadegan ³
• Mohammad Reza Edraki ³
• Amir Naghshzan ³
• Elham Abedi ⁷
• Mohammadhossein Khorraminejad-Shirazi ^{8, 9, 10}

¹ Neonatal Research Center, Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

² Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

³ Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Department of Biomechanical Engineering, Delft University of Technology, Delft, 2628 CD, Netherlands

⁵ Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

⁶ Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran

⁷ Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

⁸ Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran

⁹ Department of Pathology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran

¹⁰ Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Patent ductus arteriosus (PDA) is a congenital defect characterized by abnormal blood flow between the aorta and pulmonary artery. Existing closure devices, such as the Amplatzer Duct Occluder (ADO), face challenges with affordability, biocompatibility, and anatomical adaptability. This study evaluates the safety and feasibility of a novel nitinol-based PDA occluder, the first developed sample in Iran, designed to enhance biocompatibility, reduce thrombogenicity, and improve durability.
Methods: This preclinical study was conducted in 2024 at the Large Animal Research Laboratory, Shiraz University of Medical Sciences, Shiraz, Iran. The occluder was fabricated from custom-made nitinol wires braided into a 72-wire conical mesh, ensuring flexibility and durability. Deployment was tested in a sheep model via femoral and pulmonary artery access. Post-procedure evaluations included angiography, clinical monitoring, and histopathological analyses to assess tissue integration, thrombogenicity, and biocompatibility.
Results: The device was successfully deployed in two target sites with stable positioning and no procedural complications. Angiographic imaging confirmed vessel patency, even in an artery with a size mismatch. The animal exhibited no adverse outcomes, maintaining normal pulses and activity over a three-month follow-up. Post-mortem analysis revealed secure device placement without migration, perforation, or aneurysm. Histopathological findings demonstrated mild inflammation, neointimal formation, and re-endothelialization, with no significant thrombus or granuloma, indicating excellent biocompatibility.
Conclusion: This study provides preliminary evidence supporting the feasibility, safety, and biocompatibility of the Iranian-developed PDA occluder. These findings suggest the device may serve as a viable, cost-effective alternative for PDA closure, addressing device shortages and advancing regional medical technology.

Highlights

Hamid Amoozgar (Google Scholar)

Hamid Mohammadi (Google Scholar)

Keywords

• Patent ductus arteriosus
• Nitinol
• Thrombosis
• Biocompatible materials
• Sheep