Lossef S V, Lutz R J, Mundorf J, Barth K H
Department of Radiology, Georgetown University Hospital, Washington, DC 20007.
J Vasc Interv Radiol. 1994 Mar-Apr;5(2):341-9. doi: 10.1016/s1051-0443(94)71499-8.
Elastic and plastic deformation properties of the Wallstent, Palmaz stent, and Strecker stent were evaluated quantitatively with an in vitro model simulating forces exerted by an eccentric lesion.
A miniaturized compression testing device was constructed. Stress-strain graphs were obtained for each stent, and the elastic moduli and yield points were calculated.
There is a 21-fold range in the elastic modulus among the Wallstent, Palmaz stent, and Strecker stents. The Palmaz stent was the only device to exhibit permanent plastic deformation. The 10-mm Palmaz stent will undergo 15% focal eccentric narrowing at 0.75 atm of pressure; the "standard braid" and "less shortening braid" 10-mm Wallstents at 0.55 and 0.25 atm, respectively; and the 10-mm tantalum Strecker stent at 0.08 atm. Overlapping of stents doubles the stiffness of the Wallstent and the Strecker stent and doubles the yield point of the Palmaz stent. The 4-9 mm Palmaz stent is 30% more resistant to deformation than the larger 8-12-mm version when expanded to identical 8-mm diameters.
The "standard braid" version of the 10-mm Wallstent provides 2.3-fold additional strength for resistant stenoses compared with the "less shortening braid." Overlapping or nesting of stents may permit full expansion should there be incomplete expansion or recoil of a single stent. The 4-9-mm Palmaz stent is preferable from the standpoint of allowing the use of a smaller (7-F instead of 9-F) introducer sheath and also for providing superior resistance to deformation. A purely elastic stent such as the Wallstent is preferable in locations where permanent plastic deformation may occur, such as the thoracic outlet.
使用模拟偏心病变施加力的体外模型,对Wallstent支架、Palmaz支架和Strecker支架的弹性和塑性变形特性进行定量评估。
构建了一个小型压缩测试装置。获取了每个支架的应力-应变图,并计算了弹性模量和屈服点。
Wallstent支架、Palmaz支架和Strecker支架的弹性模量范围为21倍。Palmaz支架是唯一表现出永久性塑性变形的装置。10毫米的Palmaz支架在0.75个大气压下会发生15%的局灶性偏心狭窄;10毫米的“标准编织”和“较少缩短编织”Wallstent支架分别在0.55和0.25个大气压下出现这种情况;10毫米的钽制Strecker支架在0.08个大气压下出现这种情况。支架重叠会使Wallstent支架和Strecker支架的刚度加倍,使Palmaz支架的屈服点加倍。当扩展到相同的8毫米直径时,4-9毫米的Palmaz支架比8-12毫米的大尺寸版本抗变形能力强30%。
与“较少缩短编织”的Wallstent支架相比,10毫米“标准编织”版本的Wallstent支架对耐药性狭窄提供了2.3倍的额外强度。如果单个支架出现不完全扩张或回缩,支架的重叠或嵌套可能允许完全扩张。从允许使用较小(7F而不是9F)的导入鞘以及提供更好的抗变形能力的角度来看,4-9毫米的Palmaz支架更可取。在可能发生永久性塑性变形的部位,如胸廓出口,像Wallstent这样的纯弹性支架更可取。