Korpela A, Aarnio P, Sariola H, Törmälä P, Harjula A
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Chest. 1999 Feb;115(2):490-5. doi: 10.1378/chest.115.2.490.
The aim of the present study was to compare, in rabbits, the biocompatibility and suitability of a bioabsorbable spiral stent made of self-reinforced poly-L-lactide (SR-PLLA) in the management of experimental tracheal stenosis with stents made of metal and silicone. Tracheobronchial stenosis, and its management, is still problematic because stenoses are not always amenable to surgical resection and reconstruction, especially concerning anastomotic problems and stenosis after lung transplantation. Stenosis can be handled with stenting, although the ideal stent has yet to be developed; all the stents available have their disadvantages. Because stenting of the airways can be only temporary, stents made of bioabsorbable materials, theoretically, offer benefits. Tracheal stenosis was created in rabbits by the extramucosal resection of cartilaginous arches of the cervical trachea. After a few weeks, the animals were operated on again, and those stenoses that had developed were dilated with a balloon. Stents then were implanted in the area of stenosis to keep the dilated trachea open. All the animals in the group with silicone stents had to be killed because of respiratory difficulties: their stents had a tendency to occlude because of internal encrustation, and they developed a hyperplastic polyp at the ends of the stents. The SR-PLLA and metallic stents were tolerated well, and after follow-up ended the animals were put to death. This experimental study showed that silicone stents had a tendency to occlude and that stents made of metal and of SR-PLLA were well tolerated and can be used in the management of airway stenosis.
本研究的目的是在兔体内比较由自增强聚-L-丙交酯（SR-PLLA）制成的生物可吸收螺旋支架与金属和硅胶支架在治疗实验性气管狭窄方面的生物相容性和适用性。气管支气管狭窄及其治疗仍然存在问题，因为狭窄并不总是适合手术切除和重建，尤其是在肺移植后的吻合问题和狭窄方面。虽然理想的支架尚未开发出来，但狭窄可以通过支架置入来处理；所有现有的支架都有其缺点。由于气道支架置入只能是临时性的，理论上，由生物可吸收材料制成的支架具有优势。通过颈段气管软骨弓的黏膜外切除在兔体内造成气管狭窄。几周后，再次对动物进行手术，对已形成的狭窄用球囊进行扩张。然后在狭窄部位植入支架以保持扩张后的气管通畅。所有植入硅胶支架组的动物因呼吸困难而不得不处死：它们的支架因内部结痂有堵塞的倾向，并且在支架末端出现了增生性息肉。SR-PLLA支架和金属支架耐受性良好，随访结束后将动物处死。这项实验研究表明，硅胶支架有堵塞的倾向，而金属和SR-PLLA制成的支架耐受性良好，可用于气道狭窄的治疗。
