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一种基于镍钛诺框架内形状记忆聚合物泡沫的实验性犬动脉导管未闭封堵装置。

An experimental canine patent ductus arteriosus occlusion device based on shape memory polymer foam in a nitinol cage.

作者信息

Wierzbicki Mark A, Raines Sarah B, Gordon Sonya G, Criscione John C, Saunders Ashley B, Birch Scott, Due Bradley, Keller Brandis, Nash Landon D, Miller Matthew W, Maitland Duncan J

机构信息

Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA.

Department of Electrical Engineering, Texas A&M University, USA.

出版信息

J Mech Behav Biomed Mater. 2017 Nov;75:279-292. doi: 10.1016/j.jmbbm.2017.07.033. Epub 2017 Jul 25.

Abstract

Patent ductus arteriosus (PDA) is a congenital cardiovascular defect in which a fetal connection between the aorta and pulmonary artery does not spontaneously close shortly after birth. If left uncorrected serious complications and even death can occur. Surgical ligation is the traditional treatment method; however, it is an invasive procedure, that motivates development of a minimally invasive option. Shape memory polymer (SMP) foams are unique materials that hold promise in the field of minimally invasive occlusion devices. In this work, a prototype nitinol foam cage (NFC) incorporating SMP foams has been designed and evaluated in multiple mechanical and in vitro verification tests. The NFC demonstrated acceptable fatigue resistance in a preliminary strut integrity test, withstanding one million cycles without complete strut fracture. Radial force analysis of both thick- and thin-walled prototype variations generated less vessel distension and wall tension in a vessel mimic compared to a commercial device. The NFCs exhibited negligible in vitro migration, comparable to that of a commercial device, using simplified, ideal models of PDA. Deployment characteristics of the prototypes were evaluated and compared to that of a commercial device when delivered into physiological models of PDA. During mock deployments, a veterinary cardiologist noted that, while deliverable, the thin-walled NFC prototype exhibited poor deployment characteristics, however the thick-walled NFC had deployment characteristics comparable to that of a commercial device. The promising results of this study warrant further investigation of the NFC device for canine PDA closure.

摘要

动脉导管未闭(PDA)是一种先天性心血管缺陷,即胎儿期主动脉和肺动脉之间的连接在出生后不久不会自然闭合。如果不进行纠正,可能会发生严重并发症甚至死亡。手术结扎是传统的治疗方法;然而,这是一种侵入性手术,促使人们开发微创治疗方案。形状记忆聚合物(SMP)泡沫是一种独特的材料,在微创封堵装置领域具有应用前景。在这项工作中,设计了一种包含SMP泡沫的镍钛诺泡沫笼(NFC)原型,并在多项机械和体外验证测试中进行了评估。在初步的支柱完整性测试中,NFC表现出可接受的抗疲劳性,承受了100万次循环而没有完全支柱断裂。与商业装置相比,对厚壁和薄壁原型变体的径向力分析在模拟血管中产生的血管扩张和壁张力较小。使用简化的、理想的PDA模型,NFC在体外的迁移可忽略不计,与商业装置相当。当将原型输送到PDA的生理模型中时,评估了其展开特性并与商业装置进行了比较。在模拟展开过程中,一位兽医心脏病专家指出,虽然薄壁NFC原型可以输送,但展开特性较差,而厚壁NFC的展开特性与商业装置相当。这项研究的良好结果值得进一步研究NFC装置用于犬类PDA封堵。

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