渐变直径取栓支架体外实验的效果分析

Effect of in vitro experiment of tapered diameter thrombectomy stent

目的分析渐变直径支架在体外实验中的取栓效果。方法制作脑血管循环模型固定在试验台上,通过微型水泵向其内注入0.9%氯化钠溶液使之循环,将血栓制品放在目标位置,用目前常用的取栓装置Solitaire支架为对照组和本次研制的渐变直径取栓支架为实验组共两组取栓做对比,采用简单分组及随机分组,每组中将含红细胞不同体积的血栓各取5次,共40次;分别记录和观察每种支架取不同血栓的首次取栓后再通率(FPR)情况;用χ^(2)检验和单因素方差分析血栓和支架类型对取栓结果的影响。结果随着血栓所含红细胞体积的不同和血栓所处位置的不同,血栓在目前常用取栓支架和渐变直径支架上的移位、嵌合程度均不相同;含红细胞体积越低的血栓与支架的嵌合程度越差(血管迂曲处最为显著)、在支架上的移位越明显、出现血栓逃逸的风险越大;在每组取栓过程中,含红细胞体积0%的血栓取栓效果最差,含红细胞体积80%的血栓取栓效果最好。实验组的首次取栓后再通率(FPR)100%相同于对照组,差异无统计学意义(P>0.05);实验组在红细胞体积为0%血栓中重度移位相同于对照组,在红细胞体积为5%血栓中中度移位相同于对照组,在红细胞体积为40%和80%血栓中轻度移位相同于对照组,不同血栓类型与血栓移位程度是差异有统计学意义(χ^(2)=80.000,P<0.001),并且我们发现含有较高红细胞体积(40%、80%)的血栓发生血栓移位的程度要比含较低红细胞体积(0%、5%)发生血栓移位的程度要低很多;而不同支架类型与血栓移位程度差异无统计学意义(χ^(2)=0.000,P>0.05),实验组发生血栓移位程度的数据也与对照组发生血栓移位程度的数据一致。不排除实验取栓设置过于简单所致的可能。结论渐变直径支架与目前常用取栓支架在体外实验中取栓效果相同,且有很大提升空间。

Objective To analyze the thrombectomy effect of varying diameter stent in vitro.Methods A cerebrovascular circulation model was made and fixed on the test table,and 0.9%sodium chloride solution was injected into it through a miniature water pump to circulate it.Thrombus products were placed in the target position.The currently commonly used thrombectomy device SOLITAIRE stent was used as the control group and the gradually changed diameter thrombectomy stent developed in this study was used as the experimental group for thrombectomy comparison.Blood clots containing different volumes of red blood cells were taken 5 times in each group,a total of 40 times.Statistical software SPSS 19.0 was used to record and observe the first-pass recanalization rate(FPR)of each stent for different thrombus.Chi-square test and one-way variance analysis were used to analyze the effects of thrombus and stent type on thrombectomy results.P<0.05 was considered statistically significant.Results The displacement and chimerism degree of thrombus on the currently commonly used thrombectomy stent and the taper-diameter stent were different with the different volume of red blood cells in the thrombus and the different location of the thrombus.The less the volume of the thrombus containing red blood cells,the worse the chimerism degree with the stent(vessel tortuosity is the most significant),the more obvious the displacement on the stent,and the greater the risk of thrombus escape.In the process of thrombectomy in each group,thrombectomy with 0%erythrocyte volume was the worst,while thrombectomy with 80%erythrocyte volume was the best.The FPR in the experimental group was 100%the same as that of the control group,with no statistical difference(P>0.05).The experimental group had the same severe displacement in 0%RBC volume thrombus as the control group,the same moderate displacement in 5%RBC volume thrombus as the control group,and the same mild displacement in 40%and 80%RBC volume thrombus as the control group,there was statistical difference between different types of thrombus and the degree of thrombus displacement(Chi-square=80.000,P<0.001),and we found that the degree of thrombus displacement was significantly lower in the thrombus with higher RBC volume(40%,80%)than in the thrombus with lower RBC volume(0%,5%).There was no statistical difference between different stent types and the degree of thrombus displacement(Chi-square=0.000,P>0.05),and the data of the degree of thrombus displacement in the experimental group was consistent with that in the control group.The possibility that the experimental thrombectomy is too simple cannot be ruled out.Conclusion Tapered diameter stent has the same effect as current common thrombectomy stent in vitro experiment,and has great room for improvement.