A novel ex vivo tracheobronchomalacia model for airway stent testing and in vivo model refinement.
A novel ex vivo tracheobronchomalacia model for airway stent testing and in vivo model refinement.
复制标题
一种新颖的离体气管支气管软化症模型，用于气道支架测试和体内模型细化。
DOI：
10.1016/j.jtcvs.2023.04.010
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Dupont,PierreE
中科院分区：
文献类型：
--
作者：
Mondal,Abhijit;Visner,GaryA;Kaza,AdityaK;Dupont,PierreE
目的：我们试图建立一种能够产生轻度、中度和重度气管支气管软化的离体气管模型，以优化气道支架设计。我们还旨在确定软骨切除所需的量，以实现不同的气管支气管软化等级，可用于动物model.MethodsWe开发了一种体外气管测试系统，使视频为基础的测量内部横截面积的intrichelheal压力周期性变化的峰值负压为20至80厘米水柱。通过单一中前切口（n = 4）、中前圆周软骨切除25%（n = 4）和沿着约3 cm长度的每个软骨环切除50%（n = 4）诱导新鲜绵羊气管伴气管支气管软化。完整气管（n = 4）用作对照。安装所有实验气管并进行实验评价。此外，在25%（n = 3）和50%（n = 3）切除软骨环的气管中测试了2种不同螺距（6 mm和12 mm）和金属丝直径（0.52mm和0.6mm）的螺旋支架。从记录的视频轮廓为each experiment. ResultsEx-vivo气管受损的单切口和25%和50%的圆周软骨切除产生气管塌陷的气管横截面积的百分比计算相应的轻度，中度和重度气管支气管软化症的临床等级，分别。单一的前软骨切口产生刀鞘型气管支气管软化，而25%和50%的环形软骨切除产生环形气管支气管软化。支架试验使支架设计参数的选择，使气道塌陷与中度和重度气管支气管软化症可以减少到符合，但不超过，完整的气管（12毫米间距，0.6毫米线直径）。ConclusionsThe离体气管模型是一个强大的平台，使系统的研究和治疗不同等级和形态的气道塌陷和气管支气管软化症。这是一种在推进到体内动物模型之前优化支架设计的新工具。
ObjectivesWe sought to develop an ex vivo trachea model capable of producing mild, moderate, and severe tracheobronchomalacia for optimizing airway stent design. We also aimed to determine the amount of cartilage resection required for achieving different tracheobronchomalacia grades that can be used in animal models.MethodsWe developed an ex vivo trachea test system that enabled video-based measurement of internal cross-sectional area as intratracheal pressure was cyclically varied for peak negative pressures of 20 to 80 cm H2O. Fresh ovine tracheas were induced with tracheobronchomalacia by single mid-anterior incision (n = 4), mid-anterior circumferential cartilage resection of 25% (n = 4), and 50% per cartilage ring (n = 4) along an approximately 3-cm length. Intact tracheas (n = 4) were used as control. All experimental tracheas were mounted and experimentally evaluated. In addition, helical stents of 2 different pitches (6 mm and 12 mm) and wire diameters (0.52 mm and 0.6 mm) were tested in tracheas with 25% (n = 3) and 50% (n = 3) circumferentially resected cartilage rings. The percentage collapse in tracheal cross-sectional area was calculated from the recorded video contours for each experiment.ResultsEx vivo tracheas compromised by single incision and 25% and 50% circumferential cartilage resection produce tracheal collapse corresponding to clinical grades of mild, moderate, and severe tracheobronchomalacia, respectively. A single anterior cartilage incision produces saber-sheath type tracheobronchomalacia, whereas 25% and 50% circumferential cartilage resection produce circumferential tracheobronchomalacia. Stent testing enabled the selection of stent design parameters such that airway collapse associated with moderate and severe tracheobronchomalacia could be reduced to conform to, but not exceed, that of intact tracheas (12-mm pitch, 0.6-mm wire diameter).ConclusionsThe ex vivo trachea model is a robust platform that enables systematic study and treatment of different grades and morphologies of airway collapse and tracheobronchomalacia. It is a novel tool for optimization of stent design before advancing to in vivo animal models.