摘要
背景:国内外开展的急性脑栓塞机械取栓的病例较少,使用Penumbra取栓系统机械取栓的病例更少,该种取栓方法对于局部脑血管的影响认识尚不清楚。目的:通过数值模拟描述Penumbra机械取栓对1例脑栓塞患者局部脑血管的影响。方法:选取左侧大脑中动脉急性栓塞患者1例,女,77岁。在急诊DSA术中对其各种原始数据进行采集,并使用Penumbra成功机械取栓。术后对其原始数据进行处理,建成"由近及远吸栓法"和"由远及近吸栓法"两种取栓方法的三维数值模型,并进行有限元分析。结果与结论:成功地完成建模和有限元分析;结果提示:与"由近及远吸栓法"相比,"由远及近吸栓法"的模型有较小的吸栓导管内流速和血栓壁面切应力(P<0.01),有较大的血管壁壁面切应力、血管壁变形量(P<0.01)和血栓变形量(P<0.05)。结果可见Penumbra机械取栓的有限元分析有助于介入医师更加清楚认识自己的操作对患者脑血管的影响,作为一种研究方法值得今后继续探讨。
BACKGROUND：Few cases of acute cerebral embolism were treated by mechanical thrombectomy al over the world. However, there were few cases currently treated by mechanical thrombectomy using Penumbra system. It is an unclear understanding of effects on regional cerebral blood vessels using this kind of surgery. OBJECTIVE：To describe effects of numerical simulation on regional cerebral blood vessels of an acute cerebral embolism patient by mechanical embolectomy using Penumbra system. METHODS：A 77-year-old woman suffering from acute cerebral embolism of left middle cerebral artery was selected. Various raw data were col ected in emergency of digital subtraction angiography, then mechanical thrombectomy using Penumbra system was carried out successful y. After these raw data were processed into dimensional numerical models of two kinds of embolectomy methods （“suction bolt method from near to far”and“suction bolt method from far to near”）, and then finite element analysis was carried out. RESULTS AND CONCLUSION：Model establishment and finite element analysis were successful y conducted. Compared with“suction bolt method from near to far”,“suction bolt method from far to near”models had smal er velocity of flow in catheter and smal er wal shear stress of thrombus （P〈0.01）, and had larger wal shear stress of blood vessel wal , deformation of blood vessel wal （P〈0.01） and deformation of thrombus （P〈0.05）. Results suggested that finite element analysis of mechanical embolectomy using Penumbra system can help physicians to involve in a clear understanding of their impacts on cerebral blood vessels of patients. As a research method, it is worth to continue to explore in the future.
出处
《中国组织工程研究》
CAS
CSCD
2014年第27期4345-4354,共10页
Chinese Journal of Tissue Engineering Research
基金
重庆市永川区自然科学基金资助项目(Ycstc
2013nc8031)
重庆市卫生局资助项目(2010-2-250)
重庆市永川区软科学基金资助项目(Ycstc
2011BE5004)~~
作者简介
刘波，男，1978年生，四川省资阳市人，汉族，重庆医科大学在读博士，主治医师，主要从事脑血管介入、脑血管流体力学方面的研究。
李志伟，主任医师，教授，重庆医科大学附属永川医院神经内科，重庆市402160
