In Vivo Molding of Airway Stents Optimized to Preserve Ciliary Function for Neonates and Infants
优化气道支架体内成型以保护新生儿和婴儿的纤毛功能
基本信息
- 批准号:9317819
- 负责人:
- 金额:$ 25.4万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-06-13 至 2019-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAirAnatomyBlood VesselsCaliberCardiovascular systemCathetersChildChronicComplexComputer SimulationCongenital AbnormalityCustomDevicesDistressEnsureEnvironmental air flowEvaluationExcisionFDA approvedFamily suidaeForeign-Body ReactionGasesGeometryGoalsGranulation TissueGrowthHumanImpairmentInfantInfectionLengthLiquid substanceMammalsMetalsModelingMoldsMonitorMotionMucous body substanceOperative Surgical ProceduresPatientsPatternPediatricsPneumoniaPolymersPopulationPositioning AttributeProceduresProcessReportingRespiratory distressRiskShapesSiliconesSolidSplint DeviceStentsStreamStructureSuctionSystemTarget PopulationsTechniquesTechnologyTestingThickTracheitisTracheobronchomalaciaTubeUltraviolet RaysValidationVariantVentilatorWorkalpha helixbasecartilaginouscostdesignendotrachealexperienceexperimental studyexpirationflexibilityin vivoinnovationmanmigrationneonateoptical fiberpressurepreventprototyperespiratory examinationtreatment durationtwo-dimensional
项目摘要
Project Summary
Tracheobronchomalacia is the most common congenital defect of the central airways and has been identified
in up to 15% of infants and 30% of young children undergoing bronchoscopic examination for respiratory
distress. Intrinsic weakness of the airway leads to collapse during expiration resulting in air trapping and poor
gas exchange. These neonates and infants are typically treated with positive pressure ventilation where the
positive pressure acts as a pneumatic stent. During the 3-9 month treatment period, the child remains
connected to the ventilator and close monitoring is required to provide regular suctioning of the endotracheal
tube. Even with suctioning, the inability to clear mucus increases the risk of airway infections, e.g., pneumonia.
Alternatively, stents can be used to prevent airway collapse, however, existing airway stents are sized for
adults. While some neonates have been treated with metal mesh vascular stents, these stents induce the
growth of granulation tissue through the mesh requiring a very invasive removal procedure. To avoid this issue,
solid silicone tubes have been developed for adults, but they too have shortcomings. They block mucociliary
function over the length of the stent resulting in mucous plugging and inspissated secretions that impede gas
exchange. They also have a high migration rate. The goal of this project is to create a stent technology for
neonates and infants that avoids the risks and costs of positive pressure ventilation while providing five
innovations. First, stent geometry will minimize impairment of the mucociliary function by providing an
unobstructed path along the stent length following observed mucus streaming patterns. Second, stent design
will also facilitate atraumatic removal. Third, reduction of stent migration will be addressed through design of
the contact geometry between the stent and airway. Fourth, stent geometry will be optimized to minimize the
amount of foreign material in contact with the airway while still providing support equivalent to ventilation. Fifth,
an in vivo molding process will be developed that can quickly and inexpensively produce a customized stent
inside a patient's airway. Personalized stents can be vital for neonates and infants given the variability in
airway anatomy associated with tracheobronchomalacia and the impact of adjacent cardiovascular structures.
Aim 1 addresses the first four innovations and will involve optimizing stent geometry and dimensions for two
design concepts using analytical models as well as FEM. To provide for rapid evaluation, the optimized
designs will be fabricated using standard techniques (silicone-coated NiTi) and tested through ex vivo and in
vivo experiments in a porcine model. Aim 2 will develop the fifth innovation of in vivo molding of customized
stents. The stent will be comprised of a flexible polymer shell filled with a liquid UV-curable polymer. It will be
delivered over a balloon catheter that is inflated to press the stent against the airway wall. UV light will be
transmitted through the balloon catheter to cure the liquid polymer to the shape of the airway. This technique
will be developed for one of the optimized designs from Aim 1 and tested in ex vivo and in vivo experiments.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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{{ truncateString('Pierre E Dupont', 18)}}的其他基金
Removable airway stents that preserve mucociliary function
保留粘膜纤毛功能的可拆卸气道支架
- 批准号:
10258203 - 财政年份:2021
- 资助金额:
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- 批准号:
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- 资助金额:
$ 25.4万 - 项目类别:
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