Development of intra-aortic stent inserted percutaneously for aeute dissection

经皮置入主动脉内支架治疗急性夹层动脉瘤的研制

• 批准号: 09671377
• 负责人: NAKAMURA Tatsuo
• 金额: $ 1.92万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671377/
• 关键词: Aortic dissection; Stent Graft; Cylindrical balloon

Development of intra-aortic stent for acute dissection in the descending aorta, which is designed to be percutaneously inserted and to promote the thrombus formation in the pseudolumen, is the goal of this project.At the start, we tried to make novel animal model of aortic dissection at the descending aorta. In conventional animal models, aortic dissection has a tendency of high spontaneous recovery due to its embolic obstruction, because it has only an entry of the dissection. Then, in the present experiment, we made both entry and re-entry on the aortic dissection and observed the long term course of this model more than 2 years. The result was remarkable : the patency of the pseudo-lumen on new method was 100% in the aorta.On this animal model, we implanted an intravascular stent percutaneously. In order to prevent graft migration, however, a stent must be press the aortic wall strongly. With such strong pressure, the weak aortic is easy to rupture. .This is a contradicing dilemma.In order to solve this dilemma, we develop an new cylindrical balloon to obstruct temporally the pseudo lumen. We applied new cylindrical balloon in the aortic dissection model of the descending aorta. When we inflate the balloon, the entry of the pseudo-lumen close. The evaluation of the blood flow of the true lumen and the false-lumen was carried out with a ultrasonic echograph. The present result indicated that when we obstruct the entry with our new balloon at least 6 hours, the false lumen collapse completely with the thrombus. Thus this method is promising for the treatment of the acute dissection of descending aorta, as a epoch-making clinical treatment method. Accordingly we continue to study in an attempt to clinical application.

本项目的目标是研制用于急性降主动脉夹层的主动脉内支架，这种支架可以经皮植入并促进假腔内血栓的形成。在传统的动物模型中，由于主动脉夹层只有夹层的入口，因此由于其栓塞性阻塞，主动脉夹层有很高的自发恢复率。然后，在本实验中，我们在主动脉夹层上同时进行了进入和重新进入，并观察了该模型2年多的长期病程。结果是显著的：新方法的假腔通畅率为100%。在该动物模型上，我们经皮植入了血管内支架。然而，为了防止移植物迁移，支架必须用力压迫主动脉壁。在如此强大的压力下，脆弱的主动脉很容易破裂。这是一个矛盾的困境。为了解决这个困境，我们开发了一种新的柱状气球来暂时阻塞假腔。在降主动脉夹层模型中应用新型圆柱形球囊。当我们给气球充气时，假腔的入口关闭。用超声回声仪对真腔和假腔的血流进行评价。目前的结果表明，当我们用我们的新球囊堵塞入口至少6小时时，假腔完全塌陷，并伴有血栓。因此，该方法是治疗急性降主动脉夹层的一种划时代的临床治疗方法。据此，我们继续研究，试图将其应用于临床。