作者:申祥，王磊，孙鹏，王炎，田润
Authors:SHEN Xiang,WANG Lei,SUN Peng,WANG Yan,TIAN Run摘要:自膨式 NiTi 合金支架逐渐被广泛用于治疗人体的外周动脉狭窄,但由于外周动脉复杂的生理环境与高频次的弯曲变形,传统结构的支架在植入后的治疗效果仍不理想,并且伴随着较高的疲劳断裂风险 。因此本文设计了一种新型的具有多元结构的柔性支架 ,基于有限元计算分析了新型支架在多重狭窄型外周血管环境中 ,斑 块偏心率对支架柔顺性、扩张均匀性、外周血管管腔通畅率和血管及斑块应力的影响 。结果表明:在相同的外周血管模型中,新型柔性支架的柔顺性、扩张均匀性和血管管腔通畅率均优于常规支架;在多重狭窄型血管中 ,斑块的偏心率越大,新型支架柔顺性能越好,在偏心率为25% 的斑块模型中,支架扩张均匀性最差,管腔通畅率最大,斑块上的应力峰值最小 。本文的研究结果可以为面向多重狭窄的外周支架的优化设计和临床上支架的选择提供理论基础和科学依据。
Abstract:Self-expandable NiTi alloy stents are gradually widely used to treat peripheral artery stenosis in humans, but due to the complex physiological environment of peripheral arteries and high-frequency bending deformation, the therapeutic effect of traditional structure stents after implantation is still unsatisfactory, accompanied by a high risk of fatigue fracture. Therefore, a new type of flexible stent with multi-element structure is designed in this paper. Based on finite element calculation, the effects of plaque eccentricity on stent flexibility, expansion uniformity, peripheral vascular lumen patency rate and vascular and plaque stresses in the multi-stenosis peripheral vascular environment are analyzed. The results showed that the flexibility, expansion uniformity and lumen patency rate of the new flexible stent were superior to those of the conventional stent in the same peripheral vascular model; in the multiple stenotic vessels, the greater the eccentricity of the plaque, the better the flexibility of the new stent, and in the plaque model with an eccentricity of 25% , the stent expansion uniformity was the worst, the lumen patency rate was the largest, and the peak stress on the plaque was the smallest. The results of this study can provide a theoretical basis and scientific basis for the optimal design of peripheral stents oriented to multiple stenoses and the selection of stents in clinical practice.

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