Vinograd I, Klin B, Brosh T, Weinberg M, Flomenblit Y, Nevo Z
Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
J Thorac Cardiovasc Surg. 1994 May;107(5):1255-61.
Temporary or permanent tracheal splinting in pediatric patients may be indicated in tracheomalacia or bronchomalacia, repair of congenital tracheal stenosis, and after tracheal resection. This study presents the results of the development of a new intraluminal airway stent made from titanium alloy, a metal with "shape memory effect". At low temperatures (martensitic state) the titanium alloy stent can be fashioned into a specific shape; then when heated to a higher temperature (austenitic state) the stent alters its shape, only to regain its original shape when recooled to the lower temperature. The stent, connected to a small electric power supply, was introduced into 20 young rabbits with the use of a 2.5 cm rigid bronchoscope. After implantation in the martensitic state the stent was warmed to 40 degrees C, the austenitic state, by an electric current of 1.5 to 3 ampere for 1 to 2 seconds. After a period of 8 to 10 weeks the stent was removed (in its martensitic state) through the same-sized bronchoscope after being cooled with 3 to 4 ml of 80% alcohol solution at 6 degrees C. No signs of airway obstruction developed in any of the animals after implantation or extraction of the stent. The biomechanical properties of the trachea, as shown by strain measurements with the use of incremental forces, showed significant differences between the stented and unstented segments (p < 0.005). The titanium alloy intratracheal stent adequately fulfilled the requirements of a temporary intraluminal airway splint, and because of its unique feature of shape memory effect the stent could be inserted, fixed, and removed easily, even in very small airways.
小儿气管软化症或支气管软化症、先天性气管狭窄修复术后以及气管切除术后,可能需要进行临时性或永久性气管支架植入。本研究展示了一种新型腔内气道支架的研发成果,该支架由具有“形状记忆效应”的钛合金制成。在低温(马氏体状态)下,钛合金支架可被加工成特定形状;然后加热到较高温度(奥氏体状态)时,支架会改变形状,而当再次冷却到低温时又会恢复其原始形状。将连接着小型电源的支架,通过一根2.5厘米的硬质支气管镜,植入20只幼兔体内。在马氏体状态下植入后,通过1.5至3安培的电流持续1至2秒,将支架加热至40摄氏度(奥氏体状态)。8至10周后,在支架用3至4毫升6摄氏度的80%酒精溶液冷却后,通过相同尺寸的支气管镜将其取出(处于马氏体状态)。在植入或取出支架后,所有动物均未出现气道阻塞迹象。通过使用递增力进行应变测量显示,气管的生物力学特性在置入支架和未置入支架的节段之间存在显著差异(p < 0.005)。钛合金气管内支架充分满足了临时性腔内气道支架的要求,并且由于其独特的形状记忆效应,即使在非常小的气道中,该支架也能轻松插入、固定和取出。