In Vitro Performance Assessment of Distal Protection Filters: Pulsatile Flow Conditions
In Vitro Performance Assessment of Distal Protection Filters: Pulsatile Flow Conditions
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DOI：
10.1583/09-2874.1
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发表时间：
2009-12-01
影响因子：
2.6
通讯作者：
Finol, Ender A.
中科院分区：
文献类型：
--
作者：
Siewiorek, Gail M.;Wholey, Mark H.;Finol, Ender A.
目的：体外评估颈动脉支架置入术中使用的远端保护过滤器 (DPF) 的捕获效率，并检查 DPF 存在时的纵向血管阻抗。方法：在生理学真实的体外设置中评估四种经批准的 DPF（Spider RX、FilterWire EZ、RX Accunet 和 FiberNet）。脉动可编程活塞泵以代表人类颈总动脉的时变流速循环血液模拟物。具有平均人体尺寸的硅胶颈动脉分叉器被用于颈动脉血流模型。注射40至900μm的微球来模拟栓塞。纵向血管阻抗计算为 DPF 上随时间变化的压力梯度与颈内动脉随时间变化的流速之比。结果：RX Accunet 的捕获效率最高（99.4%），Spider FIX 最低（78.1%）。 Spider FIX 在部署后纵向血管阻抗增加最少（+23%），而 FilterWire EZ 在注射颗粒后纵向血管阻抗增加最少（+29%）。 FiberNet 增加了最大的纵向血管阻抗 (+84%)。结论：这项研究独特地研究了生理上真实的脉动流对 DPF 性能的影响，可以帮助开发下一代新型 DPF J Endovasc Ther。 2009;16:735-743
Purpose: To evaluate in vitro the capture efficiency of a distal protection filter (DPF) used during carotid artery stenting and examine the longitudinal vascular impedance in the presence of a DPF.Methods: Four approved DPFs (Spider RX, FilterWire EZ, RX Accunet, and FiberNet) were evaluated in a physiologically realistic in vitro setup. A pulsatile programmable piston pump circulated a blood analog at a time-varying flow rate representative of the human common carotid artery. A silicone carotid bifurcation having average human dimensions was used for the carotid flow model. Microspheres ranging from 40 to 900 mu m were injected to simulate embolization. The longitudinal vascular impedance was calculated as the ratio of the time-varying pressure gradient across the DPF to the time-varying flow rate in the internal carotid artery.Results: RX Accunet had the highest capture efficiency (99.4%) and Spider FIX the lowest (78.1%). Spider FIX increased the longitudinal vascular impedance the least after deployment (+23%), while FilterWire EZ increased the longitudinal vascular impedance the least after particles were injected (+29%). FiberNet increased longitudinal vascular impedance the most (+84%).Conclusion: This investigation, unique for examining the effects of physiologically realistic pulsatile flow on DPF performance, can aid in the development of future generations of novel DPFs J Endovasc Ther. 2009;16:735-743