The Technological Advancement to Engineer Next‐Generation Stent‐Grafts: Design, Material, and Fabrication Techniques

Abstract Endovascular treatment of aortic disorders has gained wide acceptance due to reduced physiological burden to the patient compared to open surgery, and ongoing stent‐graft evolution has made aortic repair an option for patients with more complex anatomies. To date, commercial stent‐grafts are typically developed from established production techniques with simple design structures and limited material ranges. Despite the numerous updated versions of stent‐grafts by manufacturers, the reoccurrence of device‐related complications raises questions about whether the current manfacturing methods are technically able to eliminate these problems. The technology trend to produce efficient medical devices, including stent‐grafts and all similar implants, should eventually change direction to advanced manufacturing techniques. It is expected that through recent advancements, especially the emergence of 4D‐printing and smart materials, unprecedented features can be defined for cardiovascular medical implants, like shape change and remote battery‐free self‐monitoring. 4D‐printing technology promises adaptive functionality, a highly desirable feature enabling printed cardiovascular implants to physically transform with time to perform a programmed task. This review provides a thorough assessment of the established technologies for existing stent‐grafts and provides technical commentaries on known failure modes. They then discuss the future of advanced technologies and the efforts needed to produce next‐generation endovascular implants.