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FeMnN合金生物可吸收血流导向支架在兔腹主动脉中的评估。

Evaluation of FeMnN alloy bioresorbable flow diverting stents in the rabbit abdominal aorta.

作者信息

Oliver Alexander A, Bilgin Cem, Connon Mitchell L, Vercnocke Andrew J, Bayraktar Esref A, Cortese Jonathan, Dai Daying, Ding Yong Hong, Erdahl Sarah A, Pederson John, Carlson Kent D, Griebel Adam J, Schaffer Jeremy E, Dragomir-Daescu Dan, Kadirvel Ramanathan, Guillory Roger J, Kallmes David F

机构信息

Biomedical Engineering and Physiology, Mayo Clinic Graduate School of Biomedical Sciences, 200 1st St SW, Rochester, MN, 55905, USA.

Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.

出版信息

Bioact Mater. 2025 Feb 12;48:18-28. doi: 10.1016/j.bioactmat.2025.01.039. eCollection 2025 Jun.

DOI:10.1016/j.bioactmat.2025.01.039
PMID:40303967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12038441/
Abstract

Flow diverting stents are braided, metallic endoluminal devices widely used to treat intracranial aneurysms. Bioresorbable flow diverters (BRFDs) are gaining traction as the next generation of flow diverter technology. BRFDs aim to occlude and heal the aneurysm before safely dissolving into the body, mitigating or eliminating complications associated with the permanent presence of conventional flow diverters such as thromboembolism and stenosis. Additional putative advantages of a BRFD include a reduction in metal induced medical imaging artifacts, a restoration of physiological vasoreactivity, and allowing physicians to re-access the aneurysm if an additional procedure is required. In this current study, iron-manganese-nitrogen (FeMnN) alloy BRFDs and permanent control FDs composed of an industry standard Cobalt-Nickel-Chromium alloy were deployed in the rabbit aorta. MicroCT and SEM corrosion analysis determined the FeMnN wire volumes and cross-sectional areas had reduced approximately 85 % and 95 % after 3- and 6-months implantation duration, respectively. Histological analysis demonstrated the BRFDs exhibited suitable biocompatibility, with no cases of in-stent thrombosis, clinically significant stenosis, or adverse tissue responses observed. Immunohistochemistry revealed the neointimas surrounding the BRFDs featured a confluent endothelium covering several layers of smooth muscle cells, with macrophages adjacent to the device wires. The macrophages were able to penetrate the corrosion product and were observed transporting corrosion products away from the implant site. This current work provides primary corrosion and biocompatibility data to the field for FeMn alloys, which we feel will stimulate and inform the design of next-generation bioresorbable endovascular devices.

摘要

血流导向支架是一种编织的金属腔内装置,广泛用于治疗颅内动脉瘤。可生物吸收的血流导向装置(BRFDs)作为下一代血流导向技术正越来越受到关注。BRFDs旨在在安全溶解于体内之前闭塞并治愈动脉瘤,减轻或消除与传统血流导向装置永久存在相关的并发症,如血栓栓塞和狭窄。BRFDs的其他假定优势包括减少金属诱导的医学成像伪影、恢复生理血管反应性,以及在需要额外手术时允许医生再次进入动脉瘤部位。在本研究中,将铁锰氮(FeMnN)合金BRFDs和由行业标准钴镍铬合金制成的永久性对照FDs植入兔主动脉。MicroCT和SEM腐蚀分析确定,植入3个月和6个月后,FeMnN金属丝的体积和横截面积分别减少了约85%和95%。组织学分析表明,BRFDs具有良好的生物相容性,未观察到支架内血栓形成、临床显著狭窄或不良组织反应的病例。免疫组织化学显示,BRFDs周围的新生内膜有一层汇合的内皮覆盖着几层平滑肌细胞,巨噬细胞与装置金属丝相邻。巨噬细胞能够穿透腐蚀产物,并观察到它们将腐蚀产物从植入部位运走。这项工作为铁锰合金领域提供了初步的腐蚀和生物相容性数据,我们认为这将刺激并为下一代可生物吸收血管内装置的设计提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/e984f93d06f0/gr8.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/90793cb93c91/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/4242fc7b327e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/c3181b7830b7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/8e1b2857778d/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/4c6b94c1f273/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/51b454413f34/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/3f5bbb0f5821/gr6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f026/12038441/e984f93d06f0/gr8.jpg

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本文引用的文献

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Curr Opin Biomed Eng. 2022 Dec;24. doi: 10.1016/j.cobme.2022.100411. Epub 2022 Sep 8.
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Absorbable metal stents for vascular use in pediatric cardiology: progress and outlook.用于小儿心脏病学血管的可吸收金属支架:进展与展望。
Front Cardiovasc Med. 2024 Jul 26;11:1410305. doi: 10.3389/fcvm.2024.1410305. eCollection 2024.
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Radiopaque FeMnN-Mo composite drawn filled tubing wires for braided absorbable neurovascular devices.
用于编织可吸收神经血管装置的不透射线的铁锰氮-钼复合拉制填充管丝
Bioact Mater. 2024 Jun 7;40:74-87. doi: 10.1016/j.bioactmat.2024.06.002. eCollection 2024 Oct.
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Evaluation of flow diverters for cerebral aneurysm therapy: recommendations for imaging analyses in clinical studies, endorsed by ESMINT, ESNR, OCIN, SILAN, SNIS, and WFITN.脑动脉瘤治疗中血流导向装置的评估:临床研究影像分析建议,由欧洲介入和治疗神经放射学会(ESMINT)、欧洲神经放射学会(ESNR)、介入神经放射学会(OCIN)、拉丁美洲神经介入学会(SILAN)、神经介入学会(SNIS)和世界介入神经放射学联合会(WFITN)认可。
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