Dabir Darius, Feisst Andreas, Thomas Daniel, Luetkens Julian A, Meyer Carsten, Kardulovic Ana, Menne Matthias, Steinseifer Ulrich, Schild Hans H, Kuetting Daniel L R
Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Institute of Applied Medical Engineering, Helmholtz Institute of RWTH Aachen University and Hospital, Pauwelsstr. 20, 52074, Aachen, Germany.
Cardiovasc Intervent Radiol. 2018 Jun;41(6):942-950. doi: 10.1007/s00270-018-1916-1. Epub 2018 Feb 28.
Iliocaval obstruction is a substantial contributor to chronic venous insufficiency and is increasingly being treated endovascularly with angioplasty and stent placement. Utilization of an appropriate stent for treatment is pivotal; however, until today, mechanical properties of venous stents remain unknown.
We analyzed the radial resistive force, the chronic outward force, as well as the crush resistance of seven stent models [Zilver Vena (Cook, Bjaeverskov, Denmark), Sinus Venous, Sinus Obliquus and Sinus XL Flex (Optimed, Ettlingen, Germany), Vici (Veniti; St. Louis, USA), Wallstent (Boston Scientific, Marlborough, USA), and Venovo (Bard, Tempe, USA)] in vitro using a radial force testing machine (RX-650, Machine Solutions Inc., Flagstaff, AZ, USA) and a hardness testing machine (zwickiLine, Zwick Roell, Ulm, Germany).
The Sinus Obliquus revealed the highest radial resistive force (19.41 N/cm) and the highest chronic outward force at 50 and 30% nominal diameter (7.93 N/cm at 50%, 16.97 N/cm at 30%) while the Venovo revealed the highest chronic outward force at 90 and 80% nominal diameter (4.83 N/cm at 90%, 5.37 N/cm at 80%). The radial resistive force and the chronic outward force of the Wallstent greatly depended on whether the stent ends were fixated. The Wallstent revealed the highest crush resistance at nominal diameters of 90% (0.46 N/cm) to 60% (1.16 N/cm). The Sinus Obliquus revealed the highest crush resistance at a nominal diameter of 50% (1.41 N/cm).
Venous stents greatly differ regarding their mechanical properties. These results should be considered when choosing an appropriate stent for the treatment of venous obstruction.
髂股静脉阻塞是导致慢性静脉功能不全的一个重要因素，目前越来越多地通过血管成形术和支架置入术进行血管内治疗。使用合适的支架进行治疗至关重要；然而，直到现在，静脉支架的力学性能仍不清楚。
我们使用径向力试验机（RX - 650，美国亚利桑那州弗拉格斯塔夫市机器解决方案公司）和硬度试验机（zwickiLine，德国乌尔姆市兹维克·罗尔公司），在体外分析了七种支架模型[Zilver Vena（丹麦比耶沃斯科夫市库克公司）、Sinus Venous、Sinus Obliquus和Sinus XL Flex（德国埃特林根市奥普蒂姆德公司）、Vici（美国圣路易斯市韦尼蒂公司）、Wallstent（美国马萨诸塞州马尔伯勒市波士顿科学公司）和Venovo（美国亚利桑那州坦佩市巴德公司）]的径向阻力、慢性向外力以及抗压性。
Sinus Obliquus显示出最高的径向阻力（19.41牛/厘米），在标称直径的50%和30%时慢性向外力最高（50%时为7.93牛/厘米，30%时为16.97牛/厘米），而Venovo在标称直径的90%和80%时慢性向外力最高（90%时为4.83牛/厘米，80%时为5.37牛/厘米）。Wallstent的径向阻力和慢性向外力在很大程度上取决于支架两端是否固定。Wallstent在标称直径90%（0.46牛/厘米）至60%（1.16牛/厘米）时显示出最高的抗压性。Sinus Obliquus在标称直径50%（1.41牛/厘米）时显示出最高的抗压性。
静脉支架的力学性能差异很大。在选择合适的支架治疗静脉阻塞时应考虑这些结果。
