Mazzaccaro Daniela, Berti Francesca, Antonini Luca, Pennati Giancarlo, Petrini Lorenza, Migliavacca Francesco, Nano Giovanni
Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy.
Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials, and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
Med Hypotheses. 2020 Sep;142:109771. doi: 10.1016/j.mehy.2020.109771. Epub 2020 May 4.
To suggest an in silico modelling approach to estimate the fatigue failure on peripheral Nitinol stents implanted in the superficial femoral artery (SFA) and interpret the clinically observed stent fractures of a retrospective series of patients.
Preoperative data of 27 patients who underwent SFA Nitinol stenting were retrospectively analyzed. Data about preoperative features of the SFA and the lesion were collected. Follow-up data were also collected about the occurrence of restenosis/occlusion and stent fracture.
After a lengthening of the entire vessel, the occluded region was slightly stretched due to its high stiffness, whereas the healthy regions accommodated the artery length variation. The stent fatigue was predicted to be higher in the regions of low stiffness and higher shortening. In 7 out of 27 patients a stent fracture was clinically recorded. The model resulted to be accurate in 90% of the cases.
The clinical outcomes in terms of biomechanical fatigue behavior of peripheral Nitinol stents of the SFA could be interpreted by our new approach.
提出一种计算机模拟方法，以估计植入股浅动脉（SFA）的外周镍钛诺支架的疲劳失效，并解释回顾性系列患者临床观察到的支架骨折情况。
回顾性分析27例行SFA镍钛诺支架置入术患者的术前数据。收集有关SFA和病变术前特征的数据。还收集了关于再狭窄/闭塞和支架骨折发生情况的随访数据。
在整个血管延长后，闭塞区域由于其高刚度而略有拉伸，而健康区域则适应了动脉长度的变化。预计在低刚度和高缩短区域支架疲劳程度更高。27例患者中有7例临床记录到支架骨折。该模型在90%的病例中结果准确。
我们的新方法可以解释SFA外周镍钛诺支架在生物力学疲劳行为方面的临床结果。
