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Study of the Behavior of a Bell-Shaped Colonic Self-Expandable NiTi Stent under Peristaltic Movements

机译:蠕动运动下钟形结肠自扩张NiTi支架的行为研究

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摘要

Managing bowel obstruction produced by colon cancer requires an emergency intervention to patients usually in poor conditions, and it requires creating an intestinal stoma in most cases. Regardless of that the tumor may be resectable, a two-stage surgery is mandatory. To avoid these disadvantages, endoscopic placement of self-expanding stents has been introduced more than 10 years ago, as an alternative to relieve colonic obstruction. It can be used as a bridge to elective single-stage surgery avoiding a stoma or as a definitive palliative solution in patients with irresectable tumor or poor estimated survival. Stents must be capable of exerting an adequate radial pressure on the stenosed wall, keeping in mind that stent must not move or be crushed, guaranteeing an adequate lumen when affected by peristaltic waves. A finite element simulation of bell-shaped nitinol stent functionality has been done. Catheter introduction, releasing at position, and the effect of peristaltic wave were simulated. To check the reliability of the simulation, a clinical experimentation with porcine specimens was carried out. The stent presented a good deployment and flexibility. Stent behavior was excellent, expanding from the very narrow lumen corresponding to the maximum peristaltic pressure to the complete recovery of operative lumen when the pressure disappears.
机译:处理由结肠癌引起的肠梗阻通常需要在状况较差的情况下对患者进行紧急干预,并且在大多数情况下需要创建肠造口。无论肿瘤是否可切除,都必须进行两阶段手术。为了避免这些不利因素,十多年来,人们开始采用内窥镜放置自膨式支架,以缓解结肠梗阻。它可以用作避免造口的选择性单阶段手术的桥梁,或作为无法切除的肿瘤或估计生存率较差的患者的最终姑息治疗方案。支架必须能够在狭窄的壁上施加足够的径向压力,同时请记住,支架不得移动或压碎,以确保在受到蠕动波影响时有足够的管腔。钟形镍钛合金支架功能的有限元模拟已经完成。模拟了导管的引入,就位释放以及蠕动波的影响。为了检查模拟的可靠性,对猪标本进行了临床实验。该支架具有良好的展开性和灵活性。支架行为非常好,从对应最大蠕动压力的非常狭窄的内腔扩展到当压力消失时可手术的内腔完全恢复。

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