Chua Matthew, Chui Chee-Kong, Teo Constance, Lau David
1 Department of Mechanical Engineering, National University of Singapore, Singapore - Singapore.
Int J Artif Organs. 2015 Jan;38(1):31-8. doi: 10.5301/ijao.5000374. Epub 2015 Jan 23.
Surgical removal of the trachea is the current gold standard for treating severe airway carcinoma and stenosis. Resection of 6 cm or more of the trachea requires a replacement graft due to anastomotic tension. The high failure rates of current grafts are attributed to a mismatching of mechanical properties and slow epithelium formation on the inner lumen surface. There is also a current lack of tracheal prostheses that are closely tailored to the patient's anatomy.
We propose the development of a patient-specific, artificial trachea made of carbon nanotubes and poly-di-methyl-siloxane (CNT-PDMS) composite material. Computational simulations and finite element analysis were used to study the stress behavior of the designed implant in a patient-specific, tracheal model.
Finite element studies indicated that the patient-specific carbon nanocomposite prosthesis produced stress distributions that are closer to that of the natural trachea. In vitro studies conducted on the proposed material have demonstrated its biocompatibility and suitability for sustaining tracheal epithelial cell proliferation and differentiation. In vivo studies done in porcine models showed no adverse side effects or breathing difficulties, with complete regeneration of the epithelium in the prosthesis lumen within 2 weeks.
This paper highlights the potential of a patient-specific CNT-PDMS graft as a viable airway replacement in severe tracheal carcinoma.
手术切除气管是目前治疗严重气道癌和狭窄的金标准。由于吻合口张力,切除6厘米或更长的气管需要进行移植替代。目前移植的高失败率归因于机械性能不匹配以及内腔表面上皮形成缓慢。目前还缺乏与患者解剖结构紧密匹配的气管假体。
我们提议开发一种由碳纳米管和聚二甲基硅氧烷(CNT-PDMS)复合材料制成的定制人工气管。使用计算模拟和有限元分析来研究设计的植入物在定制气管模型中的应力行为。
有限元研究表明,定制的碳纳米复合假体产生的应力分布更接近天然气管。对所提议材料进行的体外研究表明其具有生物相容性,适合维持气管上皮细胞的增殖和分化。在猪模型中进行的体内研究未显示出不良副作用或呼吸困难,假体腔内的上皮在2周内完全再生。
本文强调了定制的CNT-PDMS移植物作为严重气管癌可行气道替代物的潜力。