脑血管支架及其材料学研究现状

Endovascular stent and its material science

背景:血管内支架置入技术作为治疗动脉狭窄的有效手段,在临床应用中发展迅猛,但也存在着较高风险性,潜在危险因素较多。目的:分析不同脑血管支架材料的特点及发展状况。方法:由第一作者检索PubMed数据库及维普数据库2001/2010有关各种脑血管支架材料置入治疗脑血管狭窄的效果研究。结果与结论:球囊扩张性支架具有较好的顺应性,支撑力强等特点,但受外力作用后容易变形;新型球囊扩张性支架可降低再狭窄率,但价格较昂贵;自膨胀支架具有良好的支撑力,顺应性好,可适应成角病变,贴壁性佳,不容易形成死腔,支架释放后无缩短现象,但后扩后有连续点断裂的危险;编织支架柔韧性好,支架未完全释放时可回收,网孔直径小,释放后会出现不同程度缩短现象,很难精确定位,贴壁欠佳。相信随着支架工艺的不断改进,新型材料的研制和核心技术的普及,支架置入治疗技术已经成为神经外科、神经内科治疗脑血管病的重要手段,对于缺血性脑卒中的预防将是一种最为有效的方法。

BACKGROUND：As an effective approach for arterial stenosis,endovascular stent has rapidly developed in clinic.However,there are high and potential risks.OBJECTIVE：To analyze features and developing condition of different endovascular stent materials.METHODS：A computer-based online search of PubMed and VIP databases was performed for articles related effects of various endovascular stent materials on arterial stenosis published between 2001 and 2010.RESULTS AND CONCLUSION：Balloon-expanding stent has compliance and strong supporting force.However,it is deformable following external force.Novel balloon-expanding stent can reduce rate of restenosis,but it is not cost-effective.Self-expandable stent has strong supporting force and compliance,and good adherence,which prevents dead space formation;the stent is not shortened following release,but there are risks for breakage during expanding.Braided stent exhibits good flexibility and can be retrieved when the stent is not completely released.However,it is shortened following release,so the position of stent is difficult to identify.In addition,its adherence is poor.With developing stent technology and popularization of novel materials,stent implantation has become important approach for departments of neurosurgery and neurology to treat cerebrovascular disease.It also functions as an effective method for prevention of ischemic stroke.