Knitted nitinol represents a new generation of constrictive external vein graft meshes.
Knitted nitinol represents a new generation of constrictive external vein graft meshes.
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针织镍钛诺代表了新一代收缩性外静脉移植网。
DOI：
10.1016/j.jvs.2011.05.023
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发表时间：
2011
影响因子：
4.3
通讯作者：
Franz,Thomas
中科院分区：
文献类型：
--
作者：
Zilla,Peter;Moodley,Loven;Wolf,MichaelF;Bezuidenhout,Deon;Sirry,MazinS;Rafiee,Nasser;Lichtenberg,Wilhelm;Black,Melanie;Franz,Thomas
目的 以前，用编织的外部镍钛诺网收缩静脉移植物可以成功消除新内膜组织的形成。我们研究了是否可以通过编织网而不是编织来实现脉冲顺应性、更小的无扭结弯曲半径和更轻微的内侧萎缩，同时又不失去对内膜增生的抑制作用。方法比较编织和针织镍钛诺的脉冲顺应性、弯曲刚度和弯曲半径，以及纵向-径向变形耦合和径向压缩 网格。与之前使用编织网状移植物的研究相同，使用模拟静脉移植物和径流动脉之间的临床尺寸不匹配的衰老非人类灵长类动物模型（查克马狒狒；双侧股骨插入移植物/6个月）来检查编织外部网状物对静脉移植物的影响：镍钛诺网状物收缩（组1）；镍钛诺网状收缩和纤维蛋白密封剂 (FS) 喷涂用于网状附着（第 2 组）；未经处理的对照静脉（第 3 组）和 FS 喷涂的对照静脉（第 4 组）。 结果与编织网相比，针织网的脉搏顺应性高出 3.8 倍（3.43 ± 0.53 vs 0.94 ± 0.12%/100 mm Hg；P = .00002）；弯曲刚度降低 30 倍（0.015 ± 0.002 对比 0.462 ± 0.077 Nmm2；P = .0006）；无扭结弯曲半径缩小 9.2 倍（15.3 ± 0.4 对比 140.8 ± 22.4 毫米；P = .0006），由轴向膨胀引起的径向狭窄缩小 4.3 倍（18.0% ± 1.0% 对比 77.0% ± 3.7%；P = .00001）。与网片支撑的移植物相比，I组的新内膜组织厚8.5倍（195±45μm），而第III组（23.0±21.0μm；P<0.001）则相当于第I组的新内膜面积（4330±957×103μm2）比第III组（303±221×103）大14.3倍。 微米2; P < .00004)。 FS没有显着影响。编织网中的内侧肌肉质量保持在 43.4%，而之前在编织网中观察到的 28.1%。 结论 与编织网相比，将抑制内膜增生与更生理性的中层重塑过程、更高的抗扭结性和更低的磨损相结合，使得针织镍钛诺成为外静脉移植物保护中有吸引力的概念。
OBJECTIVEConstriction of vein grafts with braided external nitinol meshes had previously led to the successful elimination of neointimal tissue formation. We investigated whether pulse compliance, smaller kink-free bending radius, and milder medial atrophy can be achieved by knitting the meshes rather than braiding, without losing the suppressive effect on intimal hyperplasia.METHODSPulse compliance, bending stiffness, and bending radius, as well as longitudinal-radial deformation-coupling and radial compression, were compared in braided and knitted nitinol meshes. Identical to previous studies with braided mesh grafts, a senescent nonhuman primate model (Chacma baboons; bilateral femoral interposition grafts/6 months) mimicking the clinical size mismatch between vein grafts and runoff arteries was used to examine the effect of knitted external meshes on vein grafts: nitinol mesh-constricted (group 1); nitinol mesh-constricted and fibrin sealant (FS) spray-coated for mesh attachment (group 2); untreated control veins (group 3), and FS spray-coated control veins (group 4).RESULTSCompared with braided meshes, knitted meshes had 3.8-times higher pulse compliance (3.43 ± 0.53 vs 0.94 ± 0.12%/100 mm Hg; P = .00002); 30-times lower bending stiffness (0.015 ± 0.002 vs 0.462 ± 0.077 Nmm2; P = .0006); 9.2-times narrower kink-free bending radius (15.3 ± 0.4 vs 140.8 ± 22.4 mm; P = .0006), and 4.3-times lower radial narrowing caused by axial distension (18.0% ± 1.0% vs 77.0% ± 3.7%; P = .00001). Compared with mesh-supported grafts, neointimal tissue was 8.5-times thicker in group I (195 ± 45 μm) vs group III (23.0 ± 21.0 μm; P < .001) corresponding with a 14.3-times larger neointimal area in group I (4330 ± 957 × 103 μm2) vs group III (303 ± 221× 103 μm2; P < .00004). FS had no significant influence. Medial muscle mass remained at 43.4% in knitted meshes vs the 28.1% previously observed in braided meshes.CONCLUSIONCombining the suppression of intimal hyperplasia with a more physiologic remodeling process of the media, manifold higher kink-resistance, and lower fraying than in braided meshes makes knitted nitinol an attractive concept in external vein graft protection.