In-vitro Study of Effect of the Design of the Stent on the Arterial Waveforms
In-vitro Study of Effect of the Design of the Stent on the Arterial Waveforms
复制标题
支架设计对动脉波形影响的体外研究
DOI：
10.1016/j.prostr.2019.07.007
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Kendall J
中科院分区：
文献类型：
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作者：
Kendall J
外周动脉疾病(PAD)是动脉粥样硬化的结果，它涉及动脉内壁形成斑块。这会缩小血管管腔的大小，限制血液流向腿部肌肉，导致疼痛、组织死亡，甚至小腿截肢。PAD的一种治疗方法是放置支架，支架充当支撑打开动脉的脚手架，增加流向下肢的血液。然而，由于复杂的生物力学条件，如严重的钙化和长时间的动脉粥样硬化病变，PAD支架失败的可能性更大。外周动脉支架植入术2年后仍有25%的血管失败。影响再狭窄率的主要因素之一是血小板被激活的速率。这种激活受控于壁面切应力的变化，而壁面切应力又受流量和压力的影响。这项研究假设，支架在动脉中可以引起波形的反射，这会改变流量和压力波形，导致再狭窄率增加。这可能就是为什么各种体内研究发现支架较厚会导致再狭窄水平增加的原因。在这项研究中，将研究支架设计对血流的影响，目的是优化目前在医学上使用的设计。通过建立人工动脉的体外实验，可以记录支架对血流的流量、直径和压力的变化。在这项实验中，它打算使用一系列两种设计(Palmaz和Z字形)的3D打印支架，这些支架具有不同的支柱厚度，以确定哪种支架导致最大的反射，以尝试优化支架设计。
Peripheral arterial disease (PAD) occurs as a result of atherosclerosis, which involves plaque formation on the inner walls of the arteries. This reduces the size of the vessel’s lumen and restricts blood flow to the leg muscles, leading to pain, the death of tissue and even the amputation of the lower leg. One treatment method for PAD is the placement of a stent, which acts as a scaffold holding open the artery, increasing blood flow to the lower extremities. However, the stents for PAD are known to fail more regularly due to the complicated biomechanical conditions such as heavy calcified and long atherosclerotic lesions. Stenting in the peripheral arteries still fail in 25% of vessels after 2 years. One of the major influences on the rate of restenosis is the rate at which the platelets become activated. This activation is controlled by changes of wall shear stress, which is in turn influenced by the flow rate, and pressure. This study hypothesizes that stents in the arteries can cause the reflection of the waveform, which would alter the flow rate and pressure waveforms, causing increase in the rate of restenosis. This is potentially why various in-vivo studies have found that stents with thicker struts cause increased levels of restenosis.In this study, the effect of stent design on haemodynamic flow will be investigated, with the intention of optimising the designs currently in use in medicine. By setting up an in-vitro experiment, with an artificial artery, it is possible to record the flow rate, change in diameter and pressure caused to the blood flow by the stent. In this experiment, it is intended to use a series of 3D printed stents of two designs (Palmaz and Zigzag), with differing, strut thickness to determine which causes the most reflection, in an attempt to optimise the stent design.