利用微计算机断层扫描分析灌注固定人类心脏内先前植入支架的设备-组织界面

A. DeVos, P. Iaizzo
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摘要

冠状动脉疾病可由部分或全部冠状动脉闭塞引起,导致心脏缺血。今天,经皮支架植入是最常见的治疗方法,以打开这些阻塞,从而恢复对心肌的氧气输送。随着时间的推移,随后的支架钙化或再狭窄可能会阻碍这些支架的有效性。可见心脏®实验室收集了30个灌注固定的人类心脏,这些心脏在器官捐赠前总共进行了35次此类干预。微型计算机断层扫描(Micro computer tomography, Micro CT)可用于研究植入支架后恢复前数十年的设备-组织界面。这些程序以大约40微米的分辨率进行扫描。生成计算模型,使钙化和再狭窄可以可视化和量化。在这个独特的数据集中,存在各种各样的支架长度、位置和钙化体积。虽然90%的病例在支架外存在不同程度的钙化,但只有11%的病例表现出一定程度的再狭窄。这是一个独特的研究机会,微CT扫描35例治疗性植入支架灌注固定标本。广泛的可视化和分析可以在生成的计算3D模型上进行,以便更好地理解治疗性植入支架的设备-组织界面的变化。
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ANALYSES OF THE DEVICE-TISSUE INTERFACES OF PREVIOUSLY IMPLANTED STENTS WITHIN PERFUSION-FIXED HUMAN HEARTS UTIILIZING MICRO COMPUTED TOMOGRAPHY
Coronary artery disease can be caused by partial or total occlusions of the coronaries, leading to cardiac ischemia. Today, the percutaneous implantation of stents is the most common treatment to open such blockages and thus restore oxygen delivery to the myocardium. Subsequent stent calcification or restenosis may hinder the effectiveness of these stents over time. The Visible Heart® Laboratories have a collection of 30 perfusion-fixed human hearts that had a total of 35 such intervention prior to organ donation. Micro computed tomography (micro CT) can be used to study the device-tissue interfaces of stents implanted up to decades prior to recovery. These procedures were scanned with approximately 40-micron resolution. Computational models were generated such that calcification and restenosis could be visualized and quantified. Within this unique data-set, there was a wide variety of stent length, location, and volume of calcification present. Although 90% of the cases had varying degree of calcification present outside the stent only 11% showed any degree of restenosis. This is a unique research opportunity to micro CT scan 35 cases of therapeutically implanted stents in perfusion-fixed specimens. Extensive visualizations and analyses can be performed on generated computational 3D models, so to provide for better understanding of the variations within the device-tissue interfaces of therapeutically implanted stents.
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