Uthamaraj Susheil, Tefft Brandon J, Jana Soumen, Hlinomaz Ota, Kalra Manju, Lerman Amir, Dragomir-Daescu Dan, Sandhu Gurpreet S
Division of Engineering, Mayo Clinic.
Department of Cardiovascular Diseases, Mayo Clinic.
J Vis Exp. 2016 Oct 26(116):54731. doi: 10.3791/54731.
Stent-grafts are widely used for the treatment of various conditions such as aortic lesions, aneurysms, emboli due to coronary intervention procedures and perforations in vasculature. Such stent-grafts are manufactured by covering a stent with a polymer membrane. An ideal stent-graft should have a biocompatible stent covered by a porous, thromboresistant, and biocompatible polymer membrane which mimics the extracellular matrix thereby promoting injury site healing. The goal of this protocol is to manufacture a small caliber stent-graft by encapsulating a balloon expandable stent within two layers of electrospun polyurethane nanofibers. Electrospinning of polyurethane has been shown to assist in healing by mimicking native extracellular matrix, thereby promoting endothelialization. Electrospinning polyurethane nanofibers on a slowly rotating mandrel enabled us to precisely control the thickness of the nanofibrous membrane, which is essential to achieve a small caliber balloon expandable stent-graft. Mechanical validation by crimping and expansion of the stent-graft has shown that the nanofibrous polyurethane membrane is sufficiently flexible to crimp and expand while staying patent without showing any signs of tearing or delamination. Furthermore, stent-grafts fabricated using the methods described here are capable of being implanted using a coronary intervention procedure using standard size guide catheters.
支架移植物广泛用于治疗各种病症,如主动脉病变、动脉瘤、冠状动脉介入手术引起的栓子以及脉管系统穿孔。此类支架移植物是通过用聚合物膜覆盖支架来制造的。理想的支架移植物应具有生物相容性支架,该支架由多孔、抗血栓且生物相容的聚合物膜覆盖,该聚合物膜模仿细胞外基质,从而促进损伤部位愈合。本方案的目标是通过将球囊可扩张支架封装在两层电纺聚氨酯纳米纤维中来制造小口径支架移植物。已证明电纺聚氨酯有助于通过模仿天然细胞外基质促进内皮化,从而促进愈合。在缓慢旋转的心轴上进行聚氨酯纳米纤维的电纺使我们能够精确控制纳米纤维膜的厚度,这对于实现小口径球囊可扩张支架移植物至关重要。通过对支架移植物进行卷曲和扩张进行的机械验证表明,纳米纤维聚氨酯膜具有足够的柔韧性以进行卷曲和扩张,同时保持通畅,没有任何撕裂或分层的迹象。此外,使用此处所述方法制造的支架移植物能够使用标准尺寸的引导导管通过冠状动脉介入手术进行植入。