Fatigue Performance of Fabrics of Stent-Grafts Supported with Z-Stents vs. Ringed Stents

Stent-grafts were commercialized rapidly and gained a broad clinical acceptance over the past two decades. However,relatively more recent recognition of particular stent-graft design shortcomings have been identified which need to be addressed. It appears that various stent-graft designs may be more or less resistant to metal fatigue and /or fabric abrasions which can lead to type III and type IV endoleaks over the long term. Therefore,it is necessary to investigate the fatigue performance of the most common stentgraft designs: Z-stents and ringed stents,in a long-term in vitro fatigue simulation environment. This paper aimed to analyze nondestructively( gross observations) and destructively( fabric characteristics,mechanical and chemical properties) in order to put forward suggestions to improve the fabric and stent characteristics that may prevent type III and IV endoleaks. The fabric supported with ringed stent-grafts remained nearly completely intact after 168h. However, the fabric supported with Z-stents demonstrated significant damage. Fabric characteristics and tensile strength of the fibers did not present a significant difference between the control and fatigue simulated specimens. The crystallinity declined for both specimens. The fatigue performance of fabrics supported with ringed stents appears to be superior to that supported with Z-stents. The potential for a dynamic and destructive interaction between the apices of Z-stents which can lead to fraying and /or tearing of the graft fabric must be addressed in future designs.     

两种机织覆膜结构的腔内隔绝术用人工血管疲劳性能的比较

腔内隔绝术用人工血管(stent-graft,SG)长期植入人体后会出现不同程度疲劳损坏而导致内漏.针对这一问题设计制备了两种不同机织覆膜组织结构的SG试样,采用体外扭转弯折疲劳模拟装置对其进行体外仿真疲劳模拟,并对疲劳后试样进行非破坏性(总体观察)和破坏性(织物结构、物理特性)测试研究.结果表明:随着实验时间的延长,SG疲劳现象加剧;覆膜、支架及缝合线都出现了不同程度的老化破损;覆膜结晶度下降;覆膜组织结构为平纹的SG比3/1斜纹的SG更容易产生疲劳破损,但其结构更加稳定.