Makoyeva Alina, Darsaut Tim E, Salazkin Igor, Raymond Jean
Department of Radiology, University of Montreal, CHUM Notre-Dame Hospital; Montreal, Quebec, Canada -
Interv Neuroradiol. 2013 Dec;19(4):455-60. doi: 10.1177/159101991301900408. Epub 2013 Dec 18.
Y-stent placement to treat bifurcation aneurysms requires the second device to cross the confines of the first stent, with concerns regarding the formation of stenosis of the second device at the site of crossing. Various braided stents and flow diverters (FDs) were deployed to cross through a high porosity braided stent, in a Y configuration, with the ends of the devices inserted in plastic tubes of various diameters, leaving the mid-portion free to expand. The ensuing constructs were photographed, paying attention to the degree of stenosis, if any, created where the second device crosses the first stent. Experiments were repeated selecting different zones of the first stent as the site of crossing for the second device, different tube diameters, and changing the angle of the bifurcation. Crossing the first stent did not cause the second stent to become significantly stenosed in any case. Crossing through the transition or expansion zone of the first device had no influence on results. Different bifurcation angles had no influence on the occurrence of stenosis. Y-stent placement to treat arterial bifurcations using braided self-expanding stents and FDs does not lead to significant stenosis in bench-top studies.
使用Y型支架治疗分叉动脉瘤需要第二个装置穿过第一个支架的边界，这引发了人们对第二个装置在穿过部位形成狭窄的担忧。将各种编织支架和血流导向装置（FDs）以Y形配置部署，使其穿过高孔隙率编织支架，装置的两端插入不同直径的塑料管中，让中间部分自由扩张。对随后形成的结构进行拍照，注意第二个装置穿过第一个支架时是否产生狭窄以及狭窄程度。重复进行实验，选择第一个支架的不同区域作为第二个装置的穿过部位、改变管径并改变分叉角度。在任何情况下，穿过第一个支架都不会使第二个支架出现明显狭窄。穿过第一个装置的过渡区或扩张区对结果没有影响。不同的分叉角度对狭窄的发生没有影响。在台架研究中，使用编织自膨式支架和血流导向装置进行Y型支架置入治疗动脉分叉不会导致明显狭窄。
