不同形状血管中医用支架扩张力学行为的研究进展

血管支架介入术由于其微创性和高效性成为目前治疗由血管狭窄所引发的冠心病的主要治疗手段，但支架内再狭窄却是影响支架远期效果的最大障碍，严重制约了其实际疗效。首先从支架内再狭窄的形成机制出发，从固体力学的角度回顾了力学环境对再狭窄的影响，并主要阐述近年来支架在圆直、锥形、分叉、弯曲4种不同形状的血管内扩张的研究进展，特别是从支架扩张对血管应力及血管形状的改变与再狭窄间的相关关系方面进行综述。最后，针对不同的血管形状对支架扩张的影响，提出一个旨在提高支架扩张性能及减少再狭窄的血管支架多目标优化设计方法。
The implantation of an intravascular stent has become a widely used minimally invasive treatment for coronary heart disease due to its low invasiveness and high efficiency. But the long-term outcomes are often compromised by in-stent restenosis (ISR), which severely restricts its effectiveness in practical. In this paper, the formation mechanism of ISR was given, and the effects of mechanical environment on ISR were analyzed from the view of solid mechanics. The research progress of stent expansion in vessels with 4 different shapes, including straight vessel, tapered vessel, bifurcation vessel and curved vessel was reviewed. Moreover, the correlations between vessel stress and vessel shape change caused by stent expansion and ISR were reviewed. Finally, based on the influence of different vessel shapes on stent expansion, a multi-objective optimization design method was proposed to improve stent expansion performance and reduce the occurrence of ISR.