Ratnovsky Anat, Regev Noa, Wald Shaily, Kramer Mordechai, Naftali Sara
Afeka, Tel-Aviv Academic College of Engineering, Medical Engineering Department, Tel Aviv 69107, Israel.
Afeka, Tel-Aviv Academic College of Engineering, Medical Engineering Department, Tel Aviv 69107, Israel.
Med Eng Phys. 2015 Apr;37(4):408-15. doi: 10.1016/j.medengphy.2015.02.008. Epub 2015 Mar 5.
Airway stents improve pulmonary function and quality of life in patients suffering from airway obstruction. The aim of this study was to compare main types of stents (silicone, balloon-dilated metal, self-expanding metal, and covered self-expanding metal) in terms of their mechanical properties and the radial forces they exert on the trachea. Mechanical measurements were carried out using a force gauge and specially designed adaptors fabricated in our lab. Numerical simulations were performed for eight different stent geometries, inserted into trachea models. The results show a clear correlation between stent diameter (oversizing) and the levels of stress it exerts on the trachea. Compared with uncovered metal stents, metal stents that are covered with less stiff material exert significantly less stress on the trachea while still maintaining strong contact with it. The use of such stents may reduce formation of mucosa necrosis and fistulas while still preventing stent migration. Silicone stents produce the lowest levels of stress, which may be due to weak contact between the stent and the trachea and can explain their propensity for migration. Unexpectedly, stents made of the same materials exerted different stresses due to differences in their structure. Stenosis significantly increases stress levels in all stents.
气道支架可改善气道阻塞患者的肺功能和生活质量。本研究的目的是比较主要类型的支架(硅胶支架、球囊扩张金属支架、自膨式金属支架和覆膜自膨式金属支架)的机械性能以及它们对气管施加的径向力。使用测力计和我们实验室特制的适配器进行力学测量。对插入气管模型的八种不同支架几何形状进行了数值模拟。结果表明,支架直径(尺寸过大)与其对气管施加的应力水平之间存在明显的相关性。与未覆膜金属支架相比,覆有较软材料的金属支架对气管施加的应力显著较小,同时仍能与气管保持紧密接触。使用此类支架可能会减少黏膜坏死和瘘管的形成,同时仍能防止支架移位。硅胶支架产生的应力水平最低,这可能是由于支架与气管之间的接触较弱,这可以解释其易于移位的倾向。出乎意料的是,由于结构不同,由相同材料制成的支架施加的应力也不同。狭窄会显著增加所有支架的应力水平。