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使用平板探测器计算机断层扫描(DynaCT)研究新型leo plus支架与弯曲血管模型的贴合性。

Study of conformability of the new leo plus stent to a curved vascular model using flat-panel detector computed tomography (DynaCT).

作者信息

Valdivia y Alvarado Miguel, Ebrahimi Nilou, Benndorf Goetz

机构信息

Department of Radiology, Methodist Hospital Research Institute, Houston, Texas, USA.

出版信息

Neurosurgery. 2009 Mar;64(3 Suppl):ons130-4; discussion ons134. doi: 10.1227/01.NEU.0000336304.26756.21.

Abstract

OBJECTIVE

In a previous study, we assessed the conformability limitations of self-expandable stents to a curved vascular model. The LEO stent (Balt Extrusion, Montmorency, France), one of the current self-expandable models available for intracranial aneurysm stenting, displayed 2 adverse mechanics: flattening of the stent midsection and inward crimping of the proximal and distal ends. We present a follow-up study in which we evaluate the conformability to curved vessels of a second-generation stent, LEO PLUS.

METHODS

A 3.5-x 25-mm LEO PLUS stent was deployed inside a 3-mm x 10-cm polytetrafluoroethylene tube (vascular model) with a simulated 5-mm aneurysm neck at its midsection. The polytetrafluoroethylene tube was then placed in a polystyrene block (styrofoam; Dow Chemical Co., Midland, MI) and bent at different angles ranging from 0 to 150 degrees. For each angle, a rotational radiogram was performed using a C-arm angiographic system with a 30-x 43-cm CsI/amorphous silicon flat detector operated with 23-second rotations, 0.80-degree increments, 166 projections, and a 2480 x 1920 matrix (2K matrix).

RESULTS

The LEO PLUS stent showed symmetric deployment at all tested degrees of curvature, without flattening or kinking. The stent retained its round cylindrical shape at all curvatures without inward crimping of its proximal and distal ends.

CONCLUSION

The previously documented adverse mechanics of the LEO stent were not observed with the new LEO PLUS stent. This suggests better conformability to curved or tortuous vasculature owing to design improvements.

摘要

目的

在之前的一项研究中,我们评估了自膨式支架对弯曲血管模型的顺应性限制。LEO支架(法国蒙特莫朗西的巴尔特种挤压公司)是目前可用于颅内动脉瘤支架置入的自膨式模型之一,显示出两种不良力学特性:支架中部变平以及近端和远端向内卷曲。我们进行了一项后续研究,评估第二代支架LEO PLUS对弯曲血管的顺应性。

方法

将一个3.5×25毫米的LEO PLUS支架部署在一根3毫米×10厘米的聚四氟乙烯管(血管模型)内,该管中部有一个模拟的5毫米动脉瘤颈。然后将聚四氟乙烯管放置在聚苯乙烯块(泡沫塑料;陶氏化学公司,密歇根州米德兰)中,并弯曲成从0到150度的不同角度。对于每个角度,使用C形臂血管造影系统进行旋转放射成像,该系统配备一个30×43厘米的碘化铯/非晶硅平板探测器,以23秒的旋转时间、0.80度的增量、166个投影和2480×1920矩阵(2K矩阵)运行。

结果

LEO PLUS支架在所有测试的曲率角度下均显示出对称展开,没有变平或扭结。支架在所有曲率下都保持其圆柱形形状,其近端和远端没有向内卷曲。

结论

新的LEO PLUS支架未观察到LEO支架先前记录的不良力学特性。这表明由于设计改进,其对弯曲或迂曲血管系统具有更好的顺应性。

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