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支架设计对弹性回缩减少的影响:通过定量血管内超声进行的比较

Effect of stent design on reduction of elastic recoil: a comparison via quantitative intravascular ultrasound.

作者信息

Yamamoto Y, Brown D L, Ischinger T A, Arbab-Zadeh A, Penny W F

机构信息

University of California, San Diego/VA Medical Center 92161, USA.

出版信息

Catheter Cardiovasc Interv. 1999 Jun;47(2):251-7. doi: 10.1002/(SICI)1522-726X(199906)47:2<251::AID-CCD26>3.0.CO;2-M.

Abstract

The increase in minimum lumen diameter achieved by coronary stent placement can be further enhanced by reducing the immediate recoil that occurs after stent deployment. The effect of various stent designs-flexible coils, slotted tubes, and a locking stent-on minimization of postdilation stent recoil was evaluated using an in vitro model of circumferential compression. The stents were expanded to 7 atm (3.82 +/- 0.02 mm); as pressure was reduced, lumen diameter and cross-sectional area (CSA) were determined by on-line intravascular ultrasound imaging (30 MHz) positioned inside the dilating balloon (n = 10-15 inflation-deflation cycles). Stent recoil was assessed by calculation of percent change in CSA from 7 atm to negative balloon pressure: -33.1 +/- 5.6% (GR-II) and -22.4 +/- 3.8% (Wiktor) in the coil stents; -20.0 +/- 4.2% (JJIS coronary), -8.4 +/- 2.6% (JJIS biliary), and -6.9 +/- 1.5% (Multilink) in the slotted tube stents; and -1.9 +/- 3.2% in the Navius ZR1 locking stent (P < 0.05 vs. Multilink, P < 0.0001 vs. others). A range of resistances to recoil is demonstrated by this model, with coil stent designs undergoing greater elastic recoil than slotted tube stent designs. The locking stent design demonstrated the greatest radial strength and the most reduction in elastic recoil.

摘要

通过减少冠状动脉支架置入后立即出现的回缩,可进一步提高支架置入所实现的最小管腔直径增加量。使用圆周压缩体外模型评估了各种支架设计(柔性线圈、开槽管和锁定支架)对扩张后支架回缩最小化的影响。将支架扩张至7个大气压(3.82±0.02毫米);随着压力降低,通过位于扩张球囊内的在线血管内超声成像(30兆赫)确定管腔直径和横截面积(CSA)(n = 10 - 15个充放气循环)。通过计算CSA从7个大气压到负球囊压力的变化百分比来评估支架回缩:线圈支架中为-33.1±5.6%(GR-II)和-22.4±3.8%(维克托);开槽管支架中为-20.0±4.2%(JJIS冠状动脉)、-8.4±2.6%(JJIS胆管)和-6.9±1.5%(多链);Navius ZR1锁定支架中为-1.9±3.2%(与多链相比P < 0.05,与其他相比P < 0.0001)。该模型显示了一系列不同的回缩阻力,线圈支架设计比开槽管支架设计经历更大的弹性回缩。锁定支架设计显示出最大的径向强度和弹性回缩减少最多。

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