颈内动脉 Y 形分叉处双支架并联取栓术的有限元模拟
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国家自然科学基金项目(11872152)


Finite Element Simulation of Double-Stent Parallel Thrombectomy at Y-Shaped Bifurcation of Internal Carotid Artery
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    摘要:

    目的 利用有限元方法模拟单、双支架在理想颈内动脉Y形分叉处血管取栓过程,依据仿真结果分析取栓过程中支架-血栓-血管相互作用,为改善分叉处支架取栓效果提供指导。方法 利用CAD软件建立模型,利用有限元分析软件模拟单、双支架取栓过程。结果 单支架模型取栓失败,双支架模型取栓成功,并且取栓过程中血栓的最大应力是单支架的2倍,最大应变是单支架的1.12倍,血管壁表面的最大接触压强大约是单支架的2倍。结论 Solitaire双支架能够有效防止分叉处血栓移位并且成功取出血栓,但血栓中段应力水平较高存在断裂风险;取栓过程中前动脉侧血管接触压强更大,血管壁损伤风险更大。因此,有必要优化取栓支架的设计以提高其柔顺性。

    Abstract:

    Objective To study the process of single stent and double-stent thrombectomy at the Y-shaped bifurcation of the ideal internal carotid artery by finite element simulation, analyze the stent-thrombus-vessel interaction during the thrombectomy process based on the simulation results, and provide guidance for improving the effect of stent thrombectomy at the bifurcation. Methods The CAD software was used to build the model and the finite element analysis software was used to simulate the process of single stent and double-stent thrombectomy. Results Thrombectomy was unsuccessful in single stent model and successful in double-stent model, and the maximum stress of thrombus during embolus retrieval was twice that of single stent, the maximum strain was 1.12 times that of single stent, and the maximum contact pressure on the surface of vessel was approximately twice that of single stent. Conclusions Double Solitaire stents can effectively prevent thrombus displacement at the bifurcation and successfully retrieve the thrombus, but there is a risk of fracture due to the high stress level in the middle section of the thrombus. The contact pressure of the vessel on the anterior artery side is higher during thrombectomy, and the risk of vessel damage is greater. Therefore, it is necessary to optimize the design of the stent-retriever to improve its flexibility.

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赵可佳,蔡云寒,颜文涛,王盛章.颈内动脉 Y 形分叉处双支架并联取栓术的有限元模拟[J].医用生物力学,2023,38(3):465-471

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  • 收稿日期:2022-11-20
  • 最后修改日期:2022-12-12
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  • 在线发布日期: 2023-06-27
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