开口式取栓支架的生物力学研究
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上海市生物医学工程研究生示范实践基地(1017308011)


Biomechanical Study of the Open-Type Stent Retriever
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    摘要:

    目的 对开口式取栓支架的取栓过程进行仿真分析,为取栓支架的设计以及临床选择提供理论支持。方法 建立支撑单元个数分别为3、4、5的K3、K4和K5开口式取栓支架、压握工具、模拟血管和模拟血栓(3种类型)的有限元模型。对压握工具的径向施加位移载荷,取栓支架外径压握至0.5 mm,分析支架的最大主应变(maximum principal strain,MPS)峰值和径向支反力(radial force, RF);恢复压握工具的位移,取栓支架自膨胀与血管接触,分析支架MPS和血管von Mises应力(von Mises stress, VMS);对取栓支架的近端施加轴向位移,让支架带动血栓进行迁移,分析血管VMS和支架的回撤力(捕获血栓的能力)。结果 压握过程中3款取栓支架MPS峰值分别为6.94%、8.30%和5.48%,都小于断裂极限12%;支架外径为3 mm时(等于血管内径),K4支架的RF最大;自膨胀释放过程结果表明,取栓支架的支撑单元数越多,对应血管的VMS越大,但均小于血管的极限应力;在迁移取栓阶段,血管VMS普遍较小且集中在血栓所在部位;在迁移取栓的初始阶段,取栓支架的回撤力达到最大,后渐渐下降趋于平稳,其中K4支架的回撤力峰值大于K3、K5支架。结论虽然3款取栓支架在取栓模拟中的MPS以及血管VMS均在安全范围内,但K4支架在RF、拉取3种血栓的回撤力方面表现更优。研究结果可为优化开口式取栓支架提供分析方法及思路,避免血管损伤等临床并发症,提高取栓支架安全性和有效性。

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    Objective To simulate the process of thrombus removal from the open-type stent retrievers, so as to provide theoretical references for the design and clinical application of the open-type stent retrievers. Methods Finite element models of the open-type stent retrievers with 3,4,5 supporting units (K3,K4,K5), the crimping tools, simulated vessels and simulated thrombus (three types) were established. Radial displacement load was applied on the crimping tool until the stent was crimped to 0.5 mm, and the maximum principal strain (MPS) peak and radial force (RF)of the stent were analyzed. When displacement of the crimping tool was restored, the stent self-expanded and contacted with blood vessels, and MPS of the stent and von Mises stress (VMS) of blood vessels were analyzed. Axial displacement was applied to proximal end of the stents to allow the stent to drive the clots to migrate, and the blood vessel VMS and withdrawal force of the stents (the ability to capture thrombus) were analyzed. ResultsThe MPS peaks for 3 types of stent retrievers during crimping process were 6.94%, 8.30% and 5.48%, which were all smaller than the 12% fracture limit. When the outer diameter of the stent was 3 mm (equal to the inner diameter of blood vessels), the K4 stent had the largest RF. The results of self-expanding release process showed that the larger the number of support units, the greater the VMS of blood vessels. At the stage of thrombus migration and removal,the VMS of blood vessels was generally small and concentrated on the thrombus. The withdrawal force of the stent reached the maximum at the initial stage of thrombus migration and removal, then gradually decreased. The peak withdrawal force of the K4 stent was larger than that of the K5 and K3 stent. Conclusions Although the MPS and VMS for 3 types of open-type stent retrievers were within the safe range, the K4 stent showed better performance in RF and withdrawal force with the three types of thrombus. The research findings can provide the analysis methods and ideas for optimizing the open-type stent retrievers, to avoid clinical complications such as vascular injury and improve safety and effectiveness of the stent retrievers.

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张晓颖,谷雪莲,田浩,孟繁鹤.开口式取栓支架的生物力学研究[J].医用生物力学,2021,36(4):589-595

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  • 收稿日期:2020-08-10
  • 最后修改日期:2020-09-19
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  • 在线发布日期: 2021-08-23
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