一种新型支架回收器:设计、优化和实验验证。

IF 2.7 3区 医学 Q2 BIOPHYSICS
Shuo Wu, Francesca Berti, Xianming Wang, Bo Wang, Yimin Luo, Tianxiao Zhang, Shengnan Lyu
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引用次数: 0

摘要

急性缺血性中风仍然是全球致残和死亡的主要原因。虽然机械取栓支架通过快速再灌注改善了结果,但主要的限制是在弯曲和分叉的动脉中缺乏一致性,从而降低了在复杂血管解剖结构中血栓保留的效果。本研究介绍了一种新型的自膨胀支架回收器的设计,其特点是具有桥接元件的分段闭孔结构,旨在增强径向力和柔韧性。有限元分析评估了不同载荷配置下的力学性能,旨在评估几个关键的生物力学参数,如最大主应变和径向力。然后,进行多目标优化,在保持低应变的同时增加器件径向力。与商用支架相比,优化后的支架弯矩降低了18.2%,并且在变形情况下更有效地保持了截面几何形状,这表明在弯曲血管中航行时灵活性和形状保持能力得到了提高。体外血栓切除术的初步概念验证实验表明,在不同的现实情况下,如狭窄和弯曲的血管模型中,机械硬化血栓的有效参与。虽然在分叉模型中检索仍然存在一些挑战,但结果表明,所提出的设计在灵活性和径向强度之间提供了有希望的平衡,可能改善复杂血管环境中的血栓切除术结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Toward a novel stent retriever: design, optimization and experimental validation.

Acute ischemic stroke remains a leading cause of global disability and mortality. While mechanical thrombectomy with stent retrievers has improved outcomes through rapid reperfusion, the main limitation is the lack of conformability in tortuous and bifurcated arteries, thus reducing the thrombus retention efficacy in such complex vascular anatomies. This study introduces a novel self-expandable stent retriever design featuring a segmented closed-cell structure with bridging elements, designed to enhance both radial force and flexibility. Finite element analysis evaluated mechanical performance under different loading configurations, aiming at assessing a few key biomechanical parameters such as maximum principal strain and radial force. Then, a multi-objective optimization was performed to increase the device radial force while maintaining low strains. Compared to commercial devices, the optimized stent demonstrated a 18.2% lower bending moment and maintained cross-sectional geometry more effectively under deformation, indicating improved flexibility and shape preservation during navigation in tortuous vessels. Preliminary proof-of-concept in vitro thrombectomy experiments demonstrated effective engagement with mechanically stiff thrombi in different realistic scenarios, such as in stenotic and curved vessel models. While retrieval in bifurcated models still presents some challenges, the results suggest that the proposed design offers a promising balance between flexibility and radial strength, potentially improving thrombectomy outcomes in complex vascular environments.

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来源期刊
Biomechanics and Modeling in Mechanobiology
Biomechanics and Modeling in Mechanobiology 工程技术-工程:生物医学
CiteScore
7.10
自引率
8.60%
发文量
119
审稿时长
6 months
期刊介绍: Mechanics regulates biological processes at the molecular, cellular, tissue, organ, and organism levels. A goal of this journal is to promote basic and applied research that integrates the expanding knowledge-bases in the allied fields of biomechanics and mechanobiology. Approaches may be experimental, theoretical, or computational; they may address phenomena at the nano, micro, or macrolevels. Of particular interest are investigations that (1) quantify the mechanical environment in which cells and matrix function in health, disease, or injury, (2) identify and quantify mechanosensitive responses and their mechanisms, (3) detail inter-relations between mechanics and biological processes such as growth, remodeling, adaptation, and repair, and (4) report discoveries that advance therapeutic and diagnostic procedures. Especially encouraged are analytical and computational models based on solid mechanics, fluid mechanics, or thermomechanics, and their interactions; also encouraged are reports of new experimental methods that expand measurement capabilities and new mathematical methods that facilitate analysis.
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