Yoshimura M, Tsugawa C, Tsubota N
Department of General Thoracic Surgery, Hyogo Medical Center for Adults, Akashi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Nov;42(11):2054-9.
To develop a new prosthesis for treating tracheal stenosis and tracheobronchomalacia, we examined the usefulness of an intratracheal stent made of shape memory alloy (SMA), a titanium-nickel alloy composed of 50% of each metal. At its recovery temperature (37 degrees C), the SMA stent was designed to recall the memorized shape of a coil with a diameter of 5 or 6 mm and a length of 10 mm. For the present experiment, it was transformed to a smaller coil 3 mm in diameter at a low temperature (-50 degrees C) and then loaded into the prosthesis introducer tube. An experimental model of potentially fatal tracheomalacia was made surgically by cutting and fracturing the tracheal cartilages of rabbits and tracheal collapse was confirmed by rigid bronchoscope. The introducer tube with the SMA stent was inserted and then the prosthesis was advanced into the collapsed segment of the trachea using the stent pusher. The SMA stent warmed bo body temperature and recovered its memorized shape after 1-2 min. In 3 out of 8 rabbits, follow-up bronchoscopy performed at 6, 8, and 10 months after implantation revealed satisfactory patency of the SMA stent and the trachea. After follow-up, 3 animals were sacrificed for histological observation, which showed little proliferation of granulation tissue and no dislocation of the SMA stent from the malacic portion. The remaining 5 rabbits have been followed for 18-24 months and are doing well. We conclude that the SMA stent maintains good tracheal patency, causes little reaction in the tracheal wall, and is easy to handle. Thus, it shows the potential for clinical application.
为研发一种用于治疗气管狭窄和气管支气管软化症的新型假体,我们研究了由形状记忆合金(SMA)制成的气管内支架的实用性,SMA是一种钛镍合金,两种金属各占50%。在其恢复温度(37摄氏度)下,SMA支架被设计成可恢复为直径5或6毫米、长度10毫米的记忆螺旋形状。在本实验中,它在低温(-50摄氏度)下被转变为直径3毫米的较小螺旋,然后装入假体导入管。通过切割和折断兔气管软骨,手术构建了一个具有潜在致命性气管软化的实验模型,并通过硬支气管镜确认气管塌陷。插入带有SMA支架的导入管,然后使用支架推送器将假体推进气管塌陷段。SMA支架升温至体温后,1 - 2分钟内恢复其记忆形状。在8只兔子中的3只里,植入后6、8和10个月进行的随访支气管镜检查显示,SMA支架和气管的通畅情况令人满意。随访后,处死3只动物进行组织学观察,结果显示肉芽组织增殖极少,SMA支架未从软化部分移位。其余5只兔子已随访18 - 24个月,情况良好。我们得出结论,SMA支架能保持良好的气管通畅,在气管壁引起的反应极小,且易于操作。因此,它显示出临床应用的潜力。