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基于形状记忆聚合物的血管内装置:设计标准与未来展望。

Shape Memory Polymer-Based Endovascular Devices: Design Criteria and Future Perspective.

作者信息

Pineda-Castillo Sergio A, Stiles Aryn M, Bohnstedt Bradley N, Lee Hyowon, Liu Yingtao, Lee Chung-Hao

机构信息

Biomechanics and Biomaterials Design Laboratory (BBDL), The University of Oklahoma, Norman, OK 73019, USA.

Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, OK 73019, USA.

出版信息

Polymers (Basel). 2022 Jun 21;14(13):2526. doi: 10.3390/polym14132526.

Abstract

Devices for the endovascular embolization of intracranial aneurysms (ICAs) face limitations related to suboptimal rates of lasting complete occlusion. Incomplete occlusion frequently leads to residual flow within the aneurysm sac, which subsequently causes aneurysm recurrence needing surgical re-operation. An emerging method for improving the rates of complete occlusion both immediately after implant and in the longer run can be the fabrication of patient-specific materials for ICA embolization. Shape memory polymers (SMPs) are materials with great potential for this application, owing to their versatile and tunable shape memory properties that can be tailored to a patient's aneurysm geometry and flow condition. In this review, we first present the state-of-the-art endovascular devices and their limitations in providing long-term complete occlusion. Then, we present methods for the fabrication of SMPs, the most prominent actuation methods for their shape recovery, and the potential of SMPs as endovascular devices for ICA embolization. Although SMPs are a promising alternative for the patient-specific treatment of ICAs, there are still limitations that need to be addressed for their application as an effective coil-free endovascular therapy.

摘要

用于颅内动脉瘤(ICA)血管内栓塞的装置面临着与持久完全闭塞率不理想相关的局限性。不完全闭塞常常导致动脉瘤腔内残留血流,进而引发动脉瘤复发,需要再次进行手术。一种在植入后即刻及长期均能提高完全闭塞率的新兴方法可能是制造针对ICA栓塞的个性化材料。形状记忆聚合物(SMP)因其具有多功能且可调节的形状记忆特性,能够根据患者动脉瘤的几何形状和血流状况进行定制,故而在该应用中具有巨大潜力。在本综述中,我们首先介绍了最先进的血管内装置及其在提供长期完全闭塞方面的局限性。然后,我们阐述了SMP的制造方法、其形状恢复的最显著驱动方法,以及SMP作为ICA栓塞血管内装置的潜力。尽管SMP是针对ICA进行个性化治疗的一种有前景的替代方案,但作为一种有效的无线圈血管内治疗方法应用时,仍存在一些需要解决的局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51be/9269599/d8529652ebce/polymers-14-02526-g001.jpg

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