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用于小儿动脉导管未闭血管内介入治疗的“S”形3D打印软质导丝

Toward "S"-Shaped 3D-Printed Soft Robotic Guidewires for Pediatric Patent Ductus Arteriosus Endovascular Interventions.

作者信息

Colton Adira, Fitzgerald Declan, Sarker Sunandita, Barnes Noah, Gandhi Dheeraj, Janowski Miroslaw, Brown Jeremy D, Kanter Joshua, Olivieri Laura, Fuge Mark, Krieger Axel, Sochol Ryan D

机构信息

Department of Mechanical Engineering, University of Maryland, College Park, MD, 20742, USA.

Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.

出版信息

IEEE Int Conf Soft Robot. 2024 Apr;2024:965-970. doi: 10.1109/robosoft60065.2024.10521960. Epub 2024 May 13.

Abstract

Patent Ductus Arteriosus (PDA) is a heart condition in which the ductus arteriosus-a blood vessel connecting the pulmonary artery to the aorta in a fetus-fails to undergo closure after birth. A PDA can be an important factor in neonates born with severe congenital heart disease (CHD) or born prematurely. With the advent of new intravascular stent technologies, treatments based on ductus arteriosus stenting can now be completed in many cases; however, difficulties remain in accessing the ductus arteriosus in small babies successfully using current guidewire-catheter systems. Recent developments for soft robotic endovascular instruments that leverage control schemes hold distinctive potential for addressing these access challenges, but such technologies are not yet at the sizes required for navigating neonatal vasculature safely and efficiently. In an effort to meet this clinical need, this work presents an approach for 3D printing 1.5 French (Fr) soft robotic guidewires that transition from straight to "S"-shaped configurations under the application of fluidic (., pneumatic or hydraulic) loading. Two distinct dual-opposing segmented soft actuators, including a symmetric and asymmetric system design (both with heights of 2.5 mm), were 3D printed onto 1.1 Fr capillaries in 35-60 minutes "Two-Photon Direct Laser Writing (DLW)". Experimental results revealed that both designs not only withstood pressures of up to 550 kPa, but also exhibited increased opposing bending deformations-corresponding to decreased radii of curvature-with increasing applied pressure. In combination, this study serves as a critical foundation for next-generation fluidically actuated soft robotic guidewire-catheter systems for PDA interventions.

摘要

动脉导管未闭(PDA)是一种心脏疾病,即胎儿期连接肺动脉和主动脉的血管——动脉导管在出生后未能闭合。PDA可能是患有严重先天性心脏病(CHD)或早产新生儿的一个重要因素。随着新型血管内支架技术的出现,现在许多情况下都可以完成基于动脉导管支架置入的治疗;然而,使用当前的导丝导管系统成功进入小婴儿的动脉导管仍存在困难。利用控制方案的软机器人血管内器械的最新进展在解决这些进入挑战方面具有独特的潜力,但此类技术的尺寸尚未达到安全、高效地在新生儿血管系统中导航所需的大小。为了满足这一临床需求,这项工作提出了一种3D打印1.5法国规格(Fr)软机器人导丝的方法,该导丝在流体(即气动或液压)加载作用下从直线构型转变为“S”形构型。两种不同的双对置分段软致动器,包括对称和不对称系统设计(高度均为2.5毫米),在35 - 60分钟内通过“双光子直接激光写入(DLW)”3D打印到1.1 Fr的毛细管上。实验结果表明,两种设计不仅能够承受高达550 kPa的压力,而且随着施加压力的增加,还表现出增加的反向弯曲变形——对应于减小的曲率半径。综合来看,这项研究为用于PDA干预的下一代流体驱动软机器人导丝导管系统奠定了关键基础。

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