du Mesnil de Rochemont R, Yan B, Zanella F E, Rüfenacht D A, Berkefeld J
Institute of Neuroradiology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
AJNR Am J Neuroradiol. 2006 Feb;27(2):324-6.
Endovascular placement of coronary balloon-expandable stents in patients with recurrent cerebral ischemia has emerged as a treatment option for intracranial arterial occlusive disease. We have developed an in vitro model matching the tortuous curve of the carotid siphon that allows the assessment of apposition of stents to a curved vessel wall.
Six types of balloon-expandable coronary stents were implanted in a silicone model of the carotid siphon. Digital radiographs and 3D rotational angiograms were obtained. Stent morphology was evaluated and the degree of apposition between stent and wall of the model was measured on a digital workstation.
All 6 stents showed lack of apposition between stent and the wall at the convexity of the anterior segment of the carotid siphon and the wall at the concavity at both extremities of the stent. In and around the curve, the modules of the stents did not expand completely to their nominal diameter and were distorted to an oval shape.
The tested coronary balloon-expandable stents did not completely conform to the vessel wall of the model of the carotid siphon and further development is needed to approach the goal of an "ideal intracranial stent."
对于复发性脑缺血患者,冠状动脉球囊扩张支架的血管内植入已成为颅内动脉闭塞性疾病的一种治疗选择。我们开发了一种体外模型,其与颈动脉虹吸部的迂曲曲线相匹配,可用于评估支架与弯曲血管壁的贴合情况。
将六种类型的球囊扩张冠状动脉支架植入颈动脉虹吸部的硅胶模型中。获取数字X线片和三维旋转血管造影图像。在数字工作站上评估支架形态,并测量支架与模型壁之间的贴合程度。
所有6种支架在颈动脉虹吸部前段凸面处的支架与壁之间以及支架两端凹面处的壁之间均显示出贴合不佳。在曲线处及其周围,支架组件未完全扩张至其标称直径,而是扭曲成椭圆形。
所测试的冠状动脉球囊扩张支架不能完全贴合颈动脉虹吸部模型的血管壁,需要进一步研发以实现“理想颅内支架”的目标。