Yamazaki Daisuke, Hanaoka Yoshiki, Horiuchi Tetsuyoshi
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Neurosurgery, Ina Central Hospital, Ina, Japan.
Interv Neuroradiol. 2025 Sep 8:15910199251368705. doi: 10.1177/15910199251368705.
BackgroundA stable guiding system is essential for successful carotid artery stenting (CAS), particularly when navigating tortuous aortic or supra-aortic anatomy. However, data on the mechanical behavior of stent delivery systems remain scarce.ObjectiveTo assess and compare the bending stiffness and trackability of five commercially available carotid stent delivery systems using bench-top experiments.MethodsFive stent systems-CASPER RX, PRECISE PRO RX, PROTÉGÉ RX, PROTÉGÉ RX Tapered, and Carotid WALLSTENT-were evaluated. Bending stiffness was measured via a three-point bending test along a 20 cm length from the distal tip. Trackability was assessed by measuring resistance force during simulated advancement through a 6F guiding sheath within a 90° angulated vessel model.ResultsCASPER RX demonstrated the lowest bending stiffness in the stent-mounted segment (85-118 cN), whereas the Carotid WALLSTENT had the lowest stiffness in the delivery-shaft segment (120-180 cN). Systems with higher bending stiffness exhibited increased resistance during trackability testing. A correlation between increased bending stiffness and higher advancement resistance was observed across all platforms.ConclusionsCarotid stent delivery systems exhibit diverse mechanical behaviors that impact navigability through tortuous anatomy. Awareness of these mechanical properties can inform device selection and technique optimization during transradial or anatomically challenging CAS procedures.
背景
稳定的引导系统对于成功进行颈动脉支架置入术（CAS）至关重要，尤其是在处理迂曲的主动脉或主动脉弓以上解剖结构时。然而，关于支架输送系统力学行为的数据仍然匮乏。
目的
通过台式实验评估和比较五种市售颈动脉支架输送系统的弯曲刚度和可跟踪性。
方法
评估了五种支架系统——CASPER RX、PRECISE PRO RX、PROTÉGÉ RX、PROTÉGÉ RX Tapered和Carotid WALLSTENT。通过从远端尖端沿20厘米长度进行的三点弯曲试验测量弯曲刚度。通过在90°成角血管模型中模拟通过6F引导鞘推进过程中测量阻力来评估可跟踪性。
结果
CASPER RX在支架安装段表现出最低的弯曲刚度（85 - 118 cN），而Carotid WALLSTENT在输送轴段具有最低的刚度（120 - 180 cN）。弯曲刚度较高的系统在可跟踪性测试中表现出更大的阻力。在所有平台上均观察到弯曲刚度增加与推进阻力增加之间存在相关性。
结论
颈动脉支架输送系统表现出多样的力学行为，这些行为会影响在迂曲解剖结构中的导航能力。了解这些力学特性可为经桡动脉或解剖结构复杂的CAS手术中的器械选择和技术优化提供参考。
