Luffy Sarah A, Chou Da-Tren, Waterman Jenora, Wearden Peter D, Kumta Prashant N, Gilbert Thomas W
Department of Surgery, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Biomed Mater Res A. 2014 Mar;102(3):611-20. doi: 10.1002/jbm.a.34731. Epub 2013 May 2.
Tracheomalacia is a relatively rare problem, but can be challenging to treat, particularly in pediatric patients. Due to the presence of mechanically deficient cartilage, the trachea is unable to resist collapse under physiologic pressures of respiration, which can lead to acute death if left untreated. However, if treated, the outcome for patients with congenital tracheomalacia is quite good because the cartilage tends to spontaneously mature over a period of 12 to 18 months. The present study investigated the potential for the use of degradable magnesium-3% yttrium alloy (W3) to serve as an extraluminal tracheal stent in a canine model. The host response to the scaffold included the formation of a thin, vascularized capsule consisting of collagenous tissue and primarily mononuclear cells. The adjacent cartilage structure was not adversely affected as observed by bronchoscopic, gross, histologic, and mechanical analysis. The W3 stents showed reproducible spatial and temporal fracture patterns, but otherwise tended to corrode quite slowly, with a mix of Ca and P rich corrosion product formed on the surface and observed focal regions of pitting. The study showed that the approach to use degradable magnesium alloys as an extraluminal tracheal stent is promising, although further development of the alloys is required to improve the resistance to stress corrosion cracking and improve the ductility.
气管软化是一个相对罕见的问题,但治疗起来可能具有挑战性,尤其是在儿科患者中。由于存在机械性能不足的软骨,气管在呼吸的生理压力下无法抵抗塌陷,如果不治疗可能导致急性死亡。然而,如果进行治疗,先天性气管软化患者的预后相当好,因为软骨往往会在12至18个月的时间内自然成熟。本研究在犬模型中研究了使用可降解镁-3%钇合金(W3)作为腔内气管支架的潜力。宿主对支架的反应包括形成一个由胶原组织和主要为单核细胞组成的薄的、血管化的囊。通过支气管镜、大体、组织学和力学分析观察到,相邻的软骨结构未受到不利影响。W3支架显示出可重复的空间和时间断裂模式,但除此之外,其腐蚀往往相当缓慢,表面形成富含钙和磷的混合腐蚀产物,并观察到点蚀的局部区域。该研究表明,使用可降解镁合金作为腔内气管支架的方法是有前景的,尽管需要进一步开发这些合金以提高抗应力腐蚀开裂性能并改善延展性。