中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (3): 517-524.doi: 10.3969/j.issn.2095-4344.2013.03.022

• 生物材料综述 biomaterial review • 上一篇    下一篇

自膨胀式支架在脑血管介入中的应用

陈尼卡,蒋晓江,李训军,郎 莹,马国重,刘雅贞   

  1. 中国人民解放军第三军医大学大坪医院野战外科研究所神经内科,重庆市 400042
  • 收稿日期:2012-06-18 修回日期:2012-08-27 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 蒋晓江,博士,主任医师,博士生导师,中国人民解放军第三军医大学大坪医院野战外科研究所,神经内科三病区主任,重庆市 400042 jiangxiaojiang@hotmail.com
  • 作者简介:陈尼卡★,男,1979年生,湖南省邵阳市人,汉族,2002年南华大学毕业,中国人民解放军第三军医大学硕士,主治医师,主要从事脑血管病研究。 zinica@126.com

Application of self-expanding stents in the cerebrovascular intervention

Chen Ni-ka, Jiang Xiao-hong, Li Xun-jun, Lang Ying, Ma Guo-zhong, Liu Ya-zhen   

  1. Department of Neurology, Institute of Field Surgery, Daping Hospital, Third Military Medical University of Chinese PLA, Chongqing 400042, China
  • Received:2012-06-18 Revised:2012-08-27 Online:2013-01-15 Published:2013-01-15
  • Contact: Jiang Xiao-jiang, Doctor, Chief physician, Doctoral supervisor, Department of Neurology, Institute of Field Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China jiangxiaojiang@hotmail.com
  • About author:Chen Ni-ka★, Studying for master’s degree, Attending physician, Department of Neurology, Institute of Field Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China zinica@126.com

摘要:

背景:随着冠脉血管支架和外周血管支架置入技术的成熟,如今自膨胀式支架正成为国内外医疗器械厂商致力于开发的重点和热点产品,由于脑血管相当迂曲和细小,以及置入风险比其他部位血管高很多,因此自膨胀式支架的开发要难度很大。首要任务就是选用合适的生物医用材料,如何提高脑血管病支架材料的安全性、减少并发症是该项技术的要点和难点。
目的:分析不同自膨胀式支架材料在脑血管介入中的应用的相关文献,比较自膨胀式支架置入与传统的脑血管病治疗方法的优势,以及安全性和相关并发症等问题。
方法:收集不同自膨胀式支架治疗不同脑血管病的相关文献,就临床开始使用以及正在研究开发的各类自膨胀式支架材料的物理性能、化学性能和生物相容性进行对比分析,比较不同治疗方法的优缺点。
结果与结论:关于血管内治疗的方案,仍然缺乏统一的标准。不同治疗方法都存在一定的弊端,各种治疗方案的安全性及有效性尚需要大规模、前瞻性、随即对照试验予以证实。随着自膨胀式支架材料的更新与发展,自膨胀式支架的应用可成为脑血管病的重要治疗方法。

关键词: 生物材料, 生物材料综述, 自膨胀式支架, 支架置入, 脑血管, 颅内动脉疾病, 颅内动脉瘤, 颈动脉狭窄, 镍钛合金, 形状记忆效应, 并发症, 再狭窄

Abstract:

BACKGROUND: With the development of coronary vascular stents and peripheral vascular stent implantation technology, the coronary vascular stents and peripheral vascular stent technology, the self-expanding stent is becoming the key and hot product dedicated to the development by the domestic and international medical equipment manufacturers. As the brain vessel is quite tortuous and small, and the risk of placement is much higher than other parts, the development of self-expanding stent is very difficult.The primary task is the appropriate choice of biomedical materials, while, how to improve the security of cerebrovascular disease scaffold materials and reduce the complications is the main point and difficulty.
OBJECTIVE: To analyze the literatures on the application of different self-expanding stents in cerebrovascular intervention, and to compare the advantages of self-expanding stent implantation and traditional treatment methods of cerebrovascular diseases, as well as to analyze the security and complications.
METHODS: The literatures on the treatment of different cerebrovascular diseases with different self-expanding stents were collected. The physical properties, chemical properties and biocompatibility of various types of self-expanding stents were comparatively analyzed which were clinically used and in development. The disadvantages and advantages of different treatment methods were compared.
RESULTS AND CONCLUSION: There still lacks of a unified standard of endovascular treatment program. Each treatment method has their own advantages and disadvantages, the safety and efficacy of various treatment programs still require large-scale, prospective, randomized controlled trials to be confirmed. With the update and development of self-expanding stent materials, the application of self-expanding stent has become the important treatment method for cerebrovascular diseases.

Key words: biomaterials, biomaterial review, self-expanding stents, stent implantation, intracranial arterial diseases, intracranial aneurysms, carotid stenosis, nickel-titanium alloy, shape memory effect, complications, restenosis

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