Kwak Youngseok, Son Wonsoo, Kim Byoung-Joon, Kim Myungsoo, Yoon Sang-Youl, Park Jaechan, Lim Jongkyeong, Kim Joonwon, Kang Dong-Hun
Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, South Korea.
Department of Mechanical Engineering, Gachon University, Seongnam-si, South Korea.
Front Neurol. 2022 Aug 24;13:964354. doi: 10.3389/fneur.2022.964354. eCollection 2022.
To date, no vascular model to analyze frictional forces between stent retriever devices and vessel walls has been designed to be similar to the real human vasculature. We developed a novel intracranial cerebrovascular model and analyzed frictional forces of three stent retriever devices.
A vascular mold was created based on digital subtraction angiography of a patient's cerebral vessels. The vascular model was constructed using polydimethylsiloxane (PDMS, Dow Corning, Inc.) as a silicone elastomer. The vascular model was coated on its inner surface with a lubricating layer to create a low coefficient of friction (~0.037) to closely approximate the intima. A pulsatile blood pump was used to produce blood flow inside the model to approximate real vascular conditions. The frictional forces of Trevo XP, Solitaire 2, and Eric 4 were analyzed for initial and maximal friction retrieval forces using this vascular model. The total pulling energy generated during the 3 cm movement was also obtained.
Results for initial retrieval force were as follows: Trevo, 0.09 ± 0.04 N; Solitaire, 0.25 ± 0.07 N; and Eric, 0.33 ± 0.21 N. Results for maximal retrieval force were as follows: Trevo, 0.36 ± 0.07 N; Solitaire, 0.54 ± 0.06 N; and Eric, 0.80 ± 0.13 N. Total pulling energy (N·cm) was 0.40 ± 0.10 in Trevo, 0.65 ± 0.10 in Solitaire, and 0.87 ± 0.14 in Eric, respectively.
Using a realistic vascular model, different stent retriever devices were shown to have statistically different frictional forces. Future studies using a realistic vascular model are warranted to assess SRT devices.
迄今为止,尚未设计出一种血管模型来分析取栓支架装置与血管壁之间的摩擦力,使其与真实的人体血管系统相似。我们开发了一种新型的颅内脑血管模型,并分析了三种取栓支架装置的摩擦力。
基于患者脑血管的数字减影血管造影创建血管模具。使用聚二甲基硅氧烷(PDMS,道康宁公司)作为硅橡胶弹性体制备血管模型。血管模型的内表面涂有润滑层,以产生低摩擦系数(约0.037),使其紧密近似内膜。使用脉动血泵在模型内产生血流,以模拟真实的血管状况。使用该血管模型分析了Trevo XP、Solitaire 2和Eric 4的初始和最大取栓摩擦力。还获得了在3厘米移动过程中产生的总牵引能量。
初始取栓力的结果如下:Trevo为0.09±0.04 N;Solitaire为0.25±0.07 N;Eric为0.33±0.21 N。最大取栓力的结果如下:Trevo为0.36±0.07 N;Solitaire为0.54±0.06 N;Eric为0.80±0.13 N。Trevo、Solitaire和Eric的总牵引能量(N·cm)分别为0.40±0.10、0.65±0.10和0.87±0.14。
使用逼真的血管模型,不同的取栓支架装置显示出具有统计学差异的摩擦力。有必要开展使用逼真血管模型的进一步研究来评估取栓支架装置。