液压支架快速撤除技术研究应用

新汶矿业集团经过探索和实践,研究运用了差异互补式全掩护支护技术、掩护支架自牵引联动装置工艺、矿车运输、滑移运输多用轨道、自动找正装车平台、液控调整装置等新技术、新工艺,做到了液压支架综合流程快速回撤,实现了高效化、连贯化安全回撤,取得了良好的经济效益。     

低温等离子体对血管内金属支架的表面改性

生物材料用于人体必须要具备生物相容性。尤其是与血液相接触的材料如血管内支架必须要具备血液相容性。材料的表面特性直接影响血液系统中是否会出现血栓。本文针对金属血管内支架的表面特性、与血液的界面反应以及用于提高血液相容性的低温等离子表面改性进行了简要综述     

Rapid Prototyping and Tooling of Custom-Made Tracheobronchial Stents

Rapid prototyping (RP) and rapid tooling (RT) techniques can be applied to the field of medicine primarily because of their ability to produce customised profiles and geometries in relatively short lead times. In this paper, the process by which these techniques can be applied for the production of customised tracheobronchial stents for the purpose of maintaining patency in an occluded respiratory tract is described. A comparison of RP systems was carried out to establish the preferred RP method to produce the master model. The vacuum casting RT process was then used to produce the stent.     

Rapid prediction method for nonlinear expansion process of medical vascular stent

A neural network model with high nonlinear recognition capability was constructed to describe the relationship between the deformation impact factors and the deformation results of vascular stent.Then,using the weighted correction method with the attached momentum term,the network training algorithm was optimized by introducing learning factor η and momentum factor ψ,so the speed of the network training and the system robustness were enhanced.The network was trained by some practi-cal cases,and the statisti...     

可降解镁合金表面载药涂层的制备和性能

在可降解AZ31B镁合金心血管支架表面成功制备了携带雷帕霉素的聚乳酸-聚三亚甲基碳酸酯(PLA-PTMC)共聚物涂层,评价了涂层的表面形貌、降解性能、血液相容性和药物释放性能.结果表明,PLA-PTMC共聚物作为载药涂层具有良好的柔韧性,表面均匀、光滑,降解周期超过1个月,血液相容性良好.涂层具有缓释雷帕霉素的功能,释药周期超过1个月,可在内膜增生期内有效抑制支架植入后再狭窄的发生,满足冠脉支架表面载药层的使用要求.     

Nickel-free stainless steel avoids neointima formation following coronary stent implantation

Abstract

SUS316L stainless steel and cobalt–chromium and platinum–chromium alloys are widely used platforms for coronary stents. These alloys also contain nickel (Ni), which reportedly induces allergic reactions in some subjects and is known to have various cellular effects. The effects of Ni on neointima formation after stent implantation remain unknown, however. We developed coronary stents made of Ni-free high-nitrogen austenitic stainless steel prepared using a N₂-gas pressurized electroslag remelting (P-ESR) process. Neointima formation and inflammatory responses following stent implantation in porcine coronary arteries were then compared between the Ni-free and SUS316L stainless steel stents. We found significantly less neointima formation and inflammation in arteries implanted with Ni-free stents, as compared to SUS316L stents. Notably, Ni²⁺ was eluted into the medium from SUS316L but not from Ni-free stainless steel. Mechanistically, Ni²⁺ increased levels of hypoxia inducible factor protein-1α (HIF-1α) and its target genes in cultured smooth muscle cells. HIF-1α and their target gene levels were also increased in the vascular wall at SUS316L stent sites but not at Ni-free stent sites. The Ni-free stainless steel coronary stent reduces neointima formation, in part by avoiding activation of inflammatory processes via the Ni-HIF pathway. The Ni-free-stainless steel stent is a promising new coronary stent platform.     

Macro- and microscale variables regulate stent haemodynamics,fibrin deposition and thrombomodulin expression

Drug eluting stents are associated with late stent thrombosis (LST), delayed healing and prolonged exposure of stent struts to blood flow. Using macroscale disturbed and undisturbed fluid flow waveforms, we numerically and experimentally determined the effects of microscale model strut geometries upon the generation of prothrombotic conditions that are mediated by flow perturbations. Rectangular cross-sectional stent strut geometries of varying heights and corresponding streamlined versions were studied in the presence of disturbed and undisturbed bulk fluid flow. Numerical simulations and particle flow visualization experiments demonstrated that the interaction of bulk fluid flow and stent struts regulated the generation, size and dynamics of the peristrut flow recirculation zones. In the absence of endothelial cells, deposition of thrombin-generated fibrin occurred primarily in the recirculation zones. When endothelium was present, peristrut expression of anticoagulant thrombomodulin (TM) was dependent on strut height and geometry. Thinner and streamlined strut geometries reduced peristrut flow recirculation zones decreasing prothrombotic fibrin deposition and increasing endothelial anticoagulant TM expression. The studies define physical and functional consequences of macro- and microscale variables that relate to thrombogenicity associated with the most current stent designs, and particularly to LST.     

Influence of high-porosity mesh stent on hemodynamics of intracranial aneu- rysm： A computational study

This paper studies the influence of a High-Porosity Mesh （HPM） stent on the hemodynamic characteristics in the intracranial aneurysm based on the Computational Fluid Dynamics （CFD）. An idealized basilar tip aneurysm model and a HPM stent model are built. The pulsating blood flow in a cardiac cycle is computationally simulated for non-stented and stented models, to provide a wealth of information of the spatio-temporally varying blood flow field. The influence of the stent placement on the hemodynamic characteristics is analyzed in terms of distributions of velocity, pressure, Wall Shear Stress （WSS） and Energy Loss （EL）, which are believed to play an important role in the development and rupture of the aneurysm. The numerical results clearly show that the velocity, pressure, WSS and EL of the blood flow in the aneurysm are reduced by 30%-40% when the HPM stent is implanted. These computational results may provide valuable hemodynamic information for clinical neurosurgeon.     

制备方法对高分子载药涂层结构和体外释放动力学的影响

分别采用浸涂法和喷涂法在316L不锈钢基体表面制备含雷帕霉素的丙烯酸树脂缓释涂层,并使用FTIR、SEM及DSC对涂层中雷帕霉素的物化状态进行了测试和分析,测试了上述两种方法制备的药物洗脱支架的体外药物释放动力学曲线,并分析了两种制备方法之间的差异.结果表明上述两种方法制备的含药涂层药物分布状态存在一定差异,药物释放速率有所不同,以浸涂法制备的含药涂层释放速率更快.     

Numerical modeling of a human stented trachea under different stent designs

Endotracheal stenting is a common treatment for tracheal disorders as stenosis, cronic cough or dispnoea episodes. However, medical treatment and surgery are still challenging due to the difficulties in overcoming potential prosthesis complications. In this work we analyze the response of the tracheal wall during breathing and coughing conditions under different stent implantations. A finite element model of a human trachea was developed and used to analyze tracheal deformability after prosthesis implantation under normal breathing and coughing using a fluid-structure interaction approach (FSI). The geometry of the trachea is obtained from computed tomography (CT) images of a healthy patient. A structured hexahedral-based grid for the tracheal wall and an unstructured tetrahedral-based mesh with coincident nodes for the fluid were used to perform the simulations with a finite element-based commercial software code. Tracheal wall is modeled as a fiber reinforced hyperelastic solid material in which the anisotropy due to the orientation of the fibers is taken into account. Deformations of the tracheal cartilage rings and of the muscle membrane, as well as the maximum principal stresses in the wall, are analyzed and compared with those of the healthy trachea in absence of prosthesis. The results showed that, the presence of the stent prevents tracheal muscle deflections especially during coughing. In addition, we proposed a methodology to evaluate, through numerical simulations, the predisposition of the stent to migrate.