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冠状动脉支架的标准化台架试验评估:生物力学特性。

Standardized bench test evaluation of coronary stents: Biomechanical characteristics.

机构信息

Service de Cardiologie, CHU de Nantes-Nord Laennec, Saint-Herblain, France.

Laboratoire de Mécanique Physique, Talence, France.

出版信息

Catheter Cardiovasc Interv. 2018 Dec 1;92(7):E465-E470. doi: 10.1002/ccd.27912. Epub 2018 Sep 30.

Abstract

OBJECTIVES

The purpose of the study was to develop a standardized and global bench test protocol to evaluate the biomechanical characteristics of the most currently used drug-eluting coronary stents.

BACKGROUND

The use of coronary stents has contributed to the reduction of cardiovascular mortality but can be associated with specific complications. Improving the biomechanical matching between the stents and the coronary anatomy may reduce these complications.

METHODS

We assessed five commercially available drug-eluting stents: the Absorb, Orsiro, Resolute Onyx, Synergy, and Xience Alpine stents. Following stent deployment at nominal pressure in ambient air, radial elastic recoil and foreshortening were measured. Flexibility (crimped and deployed stents) and longitudinal and radial resistances were evaluated using a mechanical tester.

RESULTS

Biomechanical characteristics were significantly different for all tested devices (ANOVA, P < 0.01). The Synergy, Orsiro, and Xience Alpine stents presented the lowest elastic recoil. The Synergy and Resolute Onyx stents were the most flexible devices. The Xience Alpine and Absorb stents had the highest longitudinal and radial resistances.

CONCLUSIONS

Drug-eluting coronary stents used in current clinical practice have very different biomechanical characteristics, which should be taken into consideration to select the most appropriate device for each clinical situation.

摘要

目的

本研究旨在制定一个标准化的全球基准测试方案,以评估目前应用最广泛的药物洗脱冠状动脉支架的生物力学特性。

背景

冠状动脉支架的使用降低了心血管死亡率,但也可能与特定的并发症相关。改善支架与冠状动脉解剖结构之间的生物力学匹配,可能会降低这些并发症的发生风险。

方法

我们评估了五种市售的药物洗脱支架:Absorb、Orsiro、Resolute Onyx、Synergy 和 Xience Alpine 支架。在常温常压下以标称压力扩张支架后,测量其径向弹性回缩和缩短程度。使用机械测试器评估支架的柔韧性(卷曲和扩张状态)以及纵向和径向阻力。

结果

所有测试器械的生物力学特性均存在显著差异(方差分析,P<0.01)。Synergy、Orsiro 和 Xience Alpine 支架的弹性回缩最小。Synergy 和 Resolute Onyx 支架的柔韧性最佳。Xience Alpine 和 Absorb 支架的纵向和径向阻力最高。

结论

目前临床应用的药物洗脱冠状动脉支架具有非常不同的生物力学特性,在选择最适合特定临床情况的器械时应充分考虑这些特性。

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