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颈内动脉Y形分叉处双支架并联取栓术的有限元模拟

Finite Element Simulation of Double-Stent Parallel Thrombectomy at Y-Shaped Bifurcation of Internal Carotid Artery

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【作者】 赵可佳蔡云寒颜文涛王盛章

【Author】 ZHAO Kejia;CAI Yunhan;YAN Wentao;WANG Shengzhang;Institute of Biomedical Engineering Technology, Academy of Engineering and Technology, Fudan University;Department of Aeronautics and Astronautics, Institute of Biomechanics, Fudan University;Shanghai Testing and Inspection Institute for Medical Device;Yiwu Research Institute, Fudan University;

【通讯作者】 王盛章;

【机构】 复旦大学工程与应用技术研究院生物医学工程技术研究所复旦大学航空航天系生物力学研究所上海市医疗器械检验研究院复旦大学义乌研究院

【摘要】 目的 利用有限元方法模拟单、双支架在理想颈内动脉Y形分叉处血管取栓过程,依据仿真结果分析取栓过程中支架-血栓-血管相互作用,为改善分叉处支架取栓效果提供指导。方法 利用CAD软件建立模型,利用有限元分析软件模拟单、双支架取栓过程。结果 单支架模型取栓失败,双支架模型取栓成功,并且取栓过程中血栓的最大应力是单支架的2倍,最大应变是单支架的1.12倍,血管壁表面的最大接触压强大约是单支架的2倍。结论 Solitaire双支架能够有效防止分叉处血栓移位并且成功取出血栓,但血栓中段应力水平较高存在断裂风险;取栓过程中前动脉侧血管接触压强更大,血管壁损伤风险更大。因此,有必要优化取栓支架的设计以提高其柔顺性。

【Abstract】 Objective To study the process of single stent and double-stent thrombectomy at Y-shaped bifurcation of the ideal internal carotid artery by finite element simulation, analyze the stent-thrombus-vessel interaction during thrombectomy process based on the simulation results, and provide guidance for improving the effect of stent thrombectomy at the bifurcation. Methods The CAD software was used to build the model and the finite element analysis software was used to simulate the process of single stent and double-stent thrombectomy. Results Thrombectomy was unsuccessful in single stent model and successful in double-stent model, and the maximum stress of thrombus during embolus retrieval was twice that of single stent, the maximum strain was 1.12 times that of single stent, and the maximum contact pressure on the vessel surface was approximately twice that of single stent. Conclusions Solitaire double-stent can effectively prevent thrombus displacement at the bifurcation and successfully retrieve the thrombus, but there is a risk of fracture due to the high stress level in middle section of the thrombus. The contact pressure of the vessel on anterior artery side is higher during thrombectomy, and the risk of vessel damage is greater. Therefore, it is necessary to optimize the design of stent retriever to improve its flexibility.

【基金】 国家自然科学基金项目(11872152)
  • 【文献出处】 医用生物力学 ,Journal of Medical Biomechanics , 编辑部邮箱 ,2023年03期
  • 【分类号】R651.12;R318.01
  • 【下载频次】23
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