A Growth-Accommodating Implant for Paediatric Applications.
A Growth-Accommodating Implant for Paediatric Applications.
复制标题
用于小儿应用的生长植入物。
DOI：
10.1038/s41551-017-0142-5
复制
发表时间：
2017
影响因子：
28.1
通讯作者：
Del Nido PJ
中科院分区：
文献类型：
--
作者：
Feins EN;Lee Y;O'Cearbhaill ED;Vasilyev NV;Shimada S;Friehs I;Perrin D;Hammer PE;Yamauchi H;Marx G;Gosline A;Arabagi V;Karp JM;Del Nido PJ
固定尺寸的医疗植入物不能适应儿童正常组织的生长，最终往往需要更换，有时需要移除，导致反复干预，并发症发生率增加，结果更差。能够矫正解剖畸形和适应组织生长的植入物仍然是一个未满足的需求。在这里，我们报告了一种用于儿科应用的生长调节装置的设计和使用，该装置由可生物降解的核心和管状编织套管组成，套管长度和直径成反比。可生物降解的芯限制了套筒的直径，植入后逐渐降解的芯使套筒和整个装置伸长，以适应组织生长。通过使用数学建模和使用收获的猪心脏的离体实验，我们证明了该设备对疾病和患者特定需求的行为的可预测性和可调性。我们还使用大鼠胫骨和仔猪心脏瓣膜作为组织生长的两个模型，以证明聚合物降解可以使装置在体内膨胀和生长调节。
Medical implants of fixed size cannot accommodate normal tissue growth in children, and often require eventual replacement or in some cases removal, leading to repeated interventions, increased complication rates and worse outcomes. Implants that can correct anatomic deformities and accommodate tissue growth remain an unmet need. Here, we report the design and use of a growth-accommodating device for paediatric applications that consists of a biodegradable core and a tubular braided sleeve, with inversely related sleeve length and diameter. The biodegradable core constrains the diameter of the sleeve, and gradual core degradation following implantation enables sleeve and overall device elongation in order to accommodate tissue growth. By using mathematical modeling and ex vivo experiments using harvested swine hearts, we demonstrate the predictability and tunability of the behavior of the device for disease- and patient-specific needs. We also used the rat tibia and the piglet heart valve as two models of tissue growth to demonstrate that polymer degradation enables device expansion and growth accommodation in vivo.
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