胸主动脉腔内隔绝术中支架远端流出道力学性质分析  

Analysis of mechanical properties of the stent’s outflow segment in endovascular isolation of thoracic aorta

作　　者：沈毓 陈政 陆清声 SHEN Yu;CHEN Zheng;LU Qingsheng(Department of General Surgery,Zhenjiang Medical District,Eastern Theater Command General Hospital,Zhenjiang,Jiangsu Province 212001,China;Department of Vascular Surgery,Affiliated Changhai Hospital of Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]东部战区总医院镇江医疗区普外科,江苏212001 [2]海军军医大学附属长海医院血管外科

出　　处：《介入放射学杂志》2022年第8期787-790,共4页Journal of Interventional Radiology

摘　　要：目的 通过支架移植物体外力学测试,探讨支架力学性质并优化联合置入段支架的选择方案。方法 采用径向力测试仪测量不同主体支架、裸支架及两者联合的径向力(RF)。绘制支架远端RF与支架放大率间线性关系。通过力学模拟直观地评估支架作用于主动脉壁的应力。结果 胸主动脉覆膜支架远端RF曲线反映出主动脉支架的超弹性特点,镍钛合金支架超弹性特点比不锈钢支架更明显;不同尺寸Hercules支架与相同尺寸限制性裸支架配合时联合置入段放大率相同,RF相近;初始压缩直径下,联合支架置入能在一定程度上改善慢性外扩张力(COF),高压缩程度下联合置入段支架COF高于单一支架置入。结论 基于支架体外力学模拟,可更直观地了解支架置入后血管壁应力。限制性裸支架应用可通过降低支架移植物远端放大率改变联合置入段RF,但在较高压缩程度下可能增加内膜损伤风险。Objective To discuss the mechanical properties of stents and to optimize the stent selection scheme of the overlapping segment through in vitro mechanical testing of the stent grafts. Methods The radial force tester was used to measure the radial force(RF) of different aortic covered stents, bare stents and the combination of the two. The linear relationship between the RF at the distal end of stent and the stent oversize rate was plotted. The stent-induced aortic wall shear stress was intuitively evaluated by mechanical simulation.Results The RF curve of the distal end of the thoracic aortic covered stent reflected the superelastic characteristics of aortic stent, and the characteristics were more obvious in the stents composed of nickel-titanium than stainless. When different size of Hercules stents were combined with the same sized restrictive bare stent, the oversize rate of overlapping segment was the same, and the RF was similar. At the initial compression diameter, the use of restrictive bare stent could improve the chronic outward force(COF), but at high compression level the COF of the overlapping segment was higher than that of the individual aortic covered stent. Conclusion Based on in vitro mechanical simulation, the stent-vessel wall interaction after implantation can be more intuitively understood. The application of restrictive bare stents can change the RF of the overlapping segment of the stents by reducing the oversize rate of the distal end of the stent-graft, but at higher compression level it may increase the risk of vascular intimal injury.

关 键 词：胸主动脉腔内修复术 限制性裸支架 支架流出道 慢性外扩张力 放大率 

分 类 号：R6543.3[医药卫生—外科学]