PALMAZ-SCHATZ新血管支架有限元素法之力學分析

PALMAZ-SCHATZ ͕ҕგ͚ߛѣࢨ̮৵ڱ̝˧ጯ̶ژ

Ղ͛Ꮈ

઼ϲέΔࡊԫ̂ጯ፟ୠր

Ղธ໴

઼ϲέΔࡊԫ̂ጯ፟࿪ፋЪࡁտٙ

ౘܫР

خ݄ࡊԫѣࢨ̳Φ

ཧԈ˘

੺ઌࡔهᗁੰ͕᝙̰ࡊ

ၡ! ࢋ

ώࡁտ͹ࢋߏӀϡ Pro Engineer ᘱဦహវᘱᄦ Palmaz-Schatz Stent ͕᝙ҕ გ͚ߛ(stent)̝ 3D ၁វဦĂֹ֭ϡ ANSYS үࠎ˧ጯ̶ژహវĂଣ੅ྍ͕ҕგ

͚ߛٚצՠ஧ᕖૺᑅ˧ॡĂ͚ߛඕၹ˯Чშቢ̝̰ᑕ˧̶οଐԛĄ̶ژॡٙଣ

੅۞តᇴΒ߁ѣҕგ͚ߛۡशăቢᆵͽ̈́ᕖૺᑅ˧ඈĄPalmaz-Schatz ҕგ͚ߛ д࠹Тቢᆵ W=0.1mm ᄃԼត͚ߛۡश D ۞ଐԛ˭Ă୬д͚ߛቢ҈̰யϠ౵̂

۞ᑕ˧ 550N/mm

ॡĂࢍზ׎ٙᅮ۞͚ߛᎶණणฟᑅ˧Ăඕڍពϯۡश̈Ҍ 0.8 mm ॡ͚ߛ๪ԛშგ΍ன۞͎̇ड़ᑕྵࠎځពĂൾ຋߉̟ᕖૺᑅ˧ӈΞֹ଀ቢ

҈۞ᑕ˧ԣిᆧΐĄტ˯ٙࢗĂҕგ͚ߛૻޘ͹ࢋצזۡशᄃშԛඕၹ׌࣎Я ᇴٙᇆᜩĂۡश෸̈׎ૻޘ෸̂Ă࠹ͅ۞Ăშԛඕၹ݋ֹ଀ۡश෸̈۞ૻޘ෸

मĄ

ᙯᔣෟĈ͕ҕგ͚ߛăPro/EăANSYSăᑕ˧Ą

THE STRESS ANALYSES OF PALMAZ-SCHATZ CORONARY STENT WITH FINITE ELEMENTS METHOD

Wun-Hsing Lee

Department of Mechanical Engineering National Taipei University of Technology

Taipei, Taiwan 106, R.O.C.

Chun-Huang Lee

Institute of Mechtronic Integrated Engineering National Taipei University of Technology

Taipei, Taiwan 106, R.O.C.

Hsin-Chi Chen

Elite Crown Software & Consulting Co. Ltd Taipei, Taiwan 241, R.O.C.

Hung-I Yeh

Department of Cardiac Medicine and Medical Research Mackay Memorial Hospital

Taipei, Taiwan 104, R.O.C.

Key Words: coronary stent, Pro Engineer, ANSYS, stress.

ABSTRACT

Pro/engineering software was applied to draw a 3D model of a Palmaz-Schatz Coronary Stent in this study and the finite elements method, implemented by ANSYS software, was used to simulate the induced stress distribution of a coronary stent when it suffered from the pressure exerted by a balloon. The investigated parameters include stent diameter, strut width and expansion pressure. Using induced stress of 550 N/mm² in the Palmaz-Schatz stent structure at a fixed 0.1mm width and different stent diameters, the ANSYS results showed that size will be very critical when the stent diameter is smaller than 0.8mm. With a small increase of expansion pressure the stress in the stent structure was increased dramatically. As a conclusion, the strength of the stent was determined by two factors, stent diameter and structure. The smaller the diameter the greater the stent strength. On the other hand, the stent structure in this study will weaken the stent strength with a decrease in stent diameters.

˘ă݈! ֏

͕᝙͞ࢬ۞়ঽܕೀѐֽॲፂ኎Ϡཌ௚ࢍ۞ඕڍ൴ னĂ̏གྷ੼اԧ઼˩̂ѪЯ۞ௐαҜĂ݄҃ېજਔҕგ়

ঽ(coronary artery disease)˫ҫ˞͕᝙়ঽѪ˸ࣧЯ۞Ѻ̶

̝̣˩ͽ˯Ăזϫ݈ࠎͤঽּᇴᔘд֝ిᆧΐ (Җ߆ੰ኎

ϠཌĂ1998)Ąҋଂ༄̀ˠ Gruentzig д 1977 ѐฟֹؕϡ݄

ې જ ਔ ঈ ஧ ᕖ ૺ ఙ (percutaneous transluminal coronary angioplasty, PTCA)ޢĂ݄ېજਔঽাڼᒚ۞͞ڱĂੵ˞ѣ

̰ࡊᘽۏᒚڱ̈́γࡊ݄ېજਔᖒ྽͘ఙ(coronary artery bypass graft, CAGB)γĂ˫ѣ˞ௐˬ჌ѣड़۞ڼᒚ͞ڱĄѩ ڱड़ڍព඾Ăߏϫ݈ڼᒚ݄ېજਔҕგ়ঽ౵͹ࢋ۞͞

ڱĂҭ׎ 5%ᚑࢦࣤᗓ̈́ 10%ާّܡ๫׀൴াĂ׶Ηѐ̰

੼ٺ 30%Гব৫த(Serruys and Kutryk [5])ౌߏι۞͹ࢋ৿

ౝĄଂ 1986 ѐֽᓜԖྏរܮᙋځ݄ېજਔ̰ཉٸ͚ߛ(stent) Ξͽѣड़࿰֨׶ڼᒚ఺ֱ׀൴াĂֹ଀ј˼˯༱۞ঽˠ଀

ͽјΑ۞ତצ݄ېજਔҕგ়ঽ͚ߛڼᒚĂ׎̚ᓜԖֹϡ

˯ለ߷ߏͽ Wallstent ͚ߛ౵кĂ઼࡚҃݋ͽ Palmaz-Schatz

͚ߛࠎ͹Ąᔵ൒͚ߛѣЧ჌̙Т۞Մኳ׶ྻᏮր௚Ă൒҃

னд͕᝙૞छд݄ېજਔ̰ٸཉ͚ߛ۞јΑத̏੼྿

95%Ăͷ׎ΞҺੵฟ਒͘ఙ۞൭ࡴᄃПᐍĂЯѩ̂צᝌܓĄ ᄦү͚ߛ۞ϠᗁՄफ़(biomaterials)̚ΒӣధкܛᛳՄኳĄ ՙؠҕგ̰͚ߛ۞ᐹКĂ̂ొЊᄃཉˢܛᛳ۞পኳ࠹ᙯĂ ܛᛳՄफ़ੵ˞υื׍౯ϠᗁΑਕّ(biofunction)γĂ̙ਕѣ

ّ߲Ă̙ਕ࡭ᒛͷ͔൴౵͌۞௡ᖐͅᑕĂᑕ׍ѣ੼ᇾ໤̝

Ϡۏ࠹टّ(biocompatibility)Ą

Ϡۏ࠹टّ̝γĂ׍౯֖ૉ۞ΑਕّĂ඗၆ߏϠᗁ̮

І۞͹ࢋϫ۞Ă၆͕ҕგ͚ߛ҃֏Ăώ֗υื׍౯˘ؠ۞

შԛඕၹͽܮਕૉឰҕ߹఼࿅Ă͕᝙ྯજॡਕૉ੨Ъҕგ үᝈѡ׶ҩण(Sigwart [6])ĂЯѩᄦүॡυื׍ѣ֖ૉ۞ૻ

ޘĂٚצҕგќᒺ۞˧ณĂ̙ົயϠଡѡăΌౝăԶᕝ۞

ன෪(Rieu ඈˠ[4])ĂͷυืԆБ෭ܢдҕგጨ˯Ă֨ͤ༊

ҕგනૺॡдҕგ̰யϠ໣ொ۞ன෪Ă҃ͷშԛඕၹ౵р

׍ѣ౵̈۞ቢᆵ/ࢬ᎕ͧĂ఺ᇹ๋चგጨ۞፟ົ౵͌ĂტЪ ͽ˯Чี҂ᇋЯ৵ĂΞۢ၆ٺপؠ۞შԛඕၹనࢍĂࢍზ

׎ૻޘ׶ᑕ˧̶ژ၁ѣ׎υࢋّĄώࡁտЯѩᑕϡѣࢨ̮

৵ڱࢍზ͚ߛቢ҈ٙԛј۞ᑕ˧̶ҶဦĂͽଣ੅ྍ͚ߛშ ԛඕၹనࢍ˭͚ߛ۞ΞҖّĄ

˟ăࡁտ͞ڱᄃՎូ

ώࡁտՎូВ̶ˬีĂௐ˘ีࠎဦԛᘱᄦĂώࡁտߏ ͽ Pro Engineer హវ(Pro/E హវߏϤણᇴࡊԫ̳Φ PTC ٙ ࡁ൴Ԇј, 2001 ۍ)ֽᘱᄦ Palmaz-Schatz stent ҕგ͚ߛ̝

γ៍ೀңဦԛ(Palmaz-Schats stent made by Johnson and Johnson company, Warren, NJ, USA)Ăٙଣ੅۞ࡁտតᇴ͹

ࢋࠎҕგ͚ߛቢᆵᄃҕგ͚ߛۡशĂ֭૟ᘱᄦр̝ဦԛᖼ ј IGES (image general exchange system, ఼ϡဦԛᖼೱր

௚) ᇾ໤ဦᑫĄௐ˟ีࠎ S.S 316 L ̙ᛙ᐀(Chroma 17%, Nickel 12%, iron=residual)̝ٛҩ၁រĂͽ଀זྍՄफ़̝ᑕ

˧ – ᑕតপّѡቢĂᑕϡٺ ANSYS ඀ё̚ĄௐˬีՎូ

ࠎ ANSYS ̶ژ඀ё۞በᏭᄃ࿪ཝࢍზĄྎ௟̝ࡁտ߹඀

Pro Engineer IGES

316L

ANSYS

ANSYS

ဦ 1 ၁រ߹඀

ΞტЪтဦ 1 ٙϯĄ

1. ҕგ͚ߛγ៍ᘱᄦ

ώࡁտ͹ࢋߏॲፂ઼࡚ Johnson and Johnson Company

̳Φᄦౄ̝ Palmaz-Schatz ҕგ͚ߛ̝γ៍შԛߛၹࠎૄ

ᖂĂͽ Pro Engineer ᘱᄦ׎ဦԛĄ͚ߛ̝͎̇តᇴѣĈҕ გ͚ߛቢᆵ (width) Wăҕგ͚ߛቢՄݓޘ(thickness) Tă ҕგ͚ߛۡश (diameter) Dăҕგ͚ߛܜޘ (length) LĂώ ࡁտ૟͚ߛቢՄݓޘ׽ؠࠎ 0.1mmĂ͚ߛܜޘ׽ؠࠎ 8mmĂ౺ዶ׌តᇴ---͚ߛቢᆵ W ᄃ͚ߛۡश D Г੨Ъ͚

ߛᎶණ̝ᕖणᑅ˧ PĂВࢍˬ࣎ࡁտតᇴćͽ͚ߛቢᆵ W ࠎௐ˘ཏ௡̝តᇴĂ׽ؠ͚ߛۡश D ࠎ 1.0mmĂតᇴ̶Ҿ ߏ W = 0.06 mmă0.08mmă0.10mmă0.12mm ̈́ 0.14mm

̣჌̙Тᇴፂćௐ˟ཏ௡̝តᇴࠎ͚ߛۡश DĂ׽ؠ͚ߛ ቢᆵ W ࠎ 0.1mmĂតᇴ D ̶Ҿߏ 0.8 mmă1.0mmă1.5mmă 2.0mmă2.5mmă3.0mmă3.5mm ᄃ 4.0mmĂ൒҃఺׌௡˩

фϹ˽ࢦኑ̝ᇴፂࠎ D=1.0mmăW=0.10mmĂϺΞෛࠎྍ

௡ᇴፂᓂШ൴ण΍ௐ˘ཏ௡̝តᇴĂ҃ፖШण΍ௐ˟ཏ௡

̝ᇴፂĂޞͽᘱᄦԆјޢ̝ೀңဦԛĂГ૟Ч࣎ Pro/E ᑫ ९ᖼјઘᑫЩࠎ IGES ̝ᇾ໤ဦᑫĄ

2. ̙ᛙ᐀ 316 L ٛҩ၁រ

ௐ˟ี၁រՎូࠎ 316 L ̙ᛙ᐀̝ٛҩ၁រĂͽ଀ז

ྍՄफ़̝ᑕ˧ – ᑕតপّѡቢဦ׶ྍՄफ़۞໅ܼͩᇴĄٛ

ҩྏរߏͽ༱ਕԩٛྏរ፟ UTS (universal testing system)

ֽซҖĂྏͯఢॾ݋ॲፂ ASTM-A370 ᄦүĂീྏٙ଀̝

ᑕ˧-ᑕតဦĂ׎̚๬ّѡቢ߱۞ѡቢࠎѩѨ၁រ۞౵̂ϫ

۞ĂЯࠎྍ๬ّ߱ᄃҕგ͚ߛ͟ޢдങˢˠវॡ۞ᇅّа

ဦ 2 ѣࢨ̮৵ڱ ANSYS ̶ژ߹඀

ᖬ˧(recoil force)ѣ඾ໂ̂۞ᇆᜩĂࡶಏ৷ෛࠎቢّ۞ 316 LĂ҃Ϊϡ˘ਠ໅ܼͩᇴֽүѣࢨ̮৵̶ژ۞ྖĂ଀ז۞

ᑕ˧̶Ҷဦ૟జ࿅Њ۞ٸ̂Ăֹ଀౵ޢඕڍεৌĄ

ˬăҕგ͚ߛѣࢨ̮৵ᑕ˧̶ژ

ፋវѣࢨ̮৵ሀݭଳϡ ANSYS ̚ Solid 45 ࠎˬჯ၁ វඕၹ̮৵ĂϤˣ࣎༼ᕇ௡јĂՏ࣎༼ᕇጾѣˬ࣎ҋϤޘĂ

̶Ҿࠎ XăYăZ ͞ШĄ̶ژॡ̝ᙝࠧ୧ІĂፋវሀݭΪٺ

̚δפ˘༼ᕇٲՁค۞ҋϤޘĂͽΝੵࣣវྻજன෪Ąѩ γĂϤٺଳϡ 1/8 ၆ჍሀݭĂ߇ٺ၆Ⴭࢬ˯۞ٲՁ၆Ⴭࢬ ڱШҋϤޘĄ࢑ྶొ̶ĂϤٺሀᑢ̶ژঈ஧ᇣฟҕგ̝࿅

඀Ăٙͽ૟ঈ஧ঈᑅ߉ΐٺҕგ͚ߛሀݭ̰ጨܑࢬĄϤٺ

͚ߛ̝ೀңሀݭ̈́׎צ˧׶ࢨטౌӔค၆Ⴭ۞ሀёĂᑕϡ ѣࢨ̶ژహវॡĂԧࣇΪࢋͽค၆Ⴭ۞ొ̶үშॾ̶౷̈́

̶ژӈΞĂͽ༼࠷హវࢍზ۞ॡมĂѣࢨ̮৵შॾޙϲޢĂ ତ඾ؠཌྷҕგ͚ߛ۞ᙝࠧ୧І֭Ꮾˢԩٛ၁រٙ଀ז۞̙

㝮᐀Մफ़ᇴፂĂ൒ޢϤ ANSYS హវેҖᑕ˧̶ژ(ANSYS హវߏϤ ANSYS Inc,̳Φٙฟ൴ 5.7 ۍ)Ą̶ژ߹඀ဦϯٺ ဦ 2ĄϤٺ ANSYS ׍౯Ξણᇴ̼൴ण̝ᄬ֏(APDL)Ăٙ

ͽӍˠΞ࿰А૟̶ژ̝ᏮˢᑫፋநĂ૟পؠតᇴ̟ͽણᇴ

̼Ăтүϡ˧ᇴࣃඈĂϏֽ༊Ӎˠ୬̶ژ̙Түϡ˧̂̈

̝९ּॡĂΪࢋበᏭ࣒ԼࣧᏮˢᑫ̚үϡ˧ᇴࣃણᇴĂٺ ANSYS ̚᝝ˢѩᏮˢᑫӈΞ̶ژĂ࠷ੵࢦޙሀݭඈ׽ؠ̍

үĄ

(a)

(b)

ဦ 3 (a) Ӏ ϡ Pro-engineering హ វ ᘱ ᄦ ̙ Т ۡ श ̝

Palmaz-Schats ͚ߛ̝πࢬणฟဦć(b)Ӏϡ Pro- Engineering హវᘱᄦ̙Тۡश̝ Palmaz-Schats ͚

αăඕڍᄃ੅ኢ

1. Pro-engineering హវᘱᄦ Palmaz-Schats ͚ߛဦԛ

Ӏϡ Pro-engineering హវᘱᄦ̙Тۡश̝ Palmaz- Schats ͚ߛ̝πࢬणฟဦᄃ 3D ϲវဦԛĂ׎ඕڍϯٺဦ 3(a)ᄃ 3(b)ĄӀϡྍహវᘱဦඕڍពϯ Pro/E ၆ᘱᄦϲវ stent ဦ࠹༊၁ϡĂଂဦԛត̼Ξͽ࠻΍كѩม۞࠹၆̂

̈Ă̙Т͚ߛۡशΞዋϡд̙Т̝ˠវ̰გशĄࣧώϤ Pro Engineer ᖼˢ ANSYS ۞ IGES ဦᑫ۞ࣧؕ̂̈ĂགྷϤ ANSYS ޽΄۞በᏭޢĂЯࠎ͕ҕგ͚ߛώ֗۞၆ჍّĂ߇ Ϊࢋ̶ژ׎ֽࣧ̂̈۞ˣ̶̝˘ӈΞĂ͚ߛणฟ݈ޢ̝ѣ ࢨ̮৵შॾဦϯٺဦ 4(a)ᄃ 4(b)Ą

2. 316 L ̙ᛙ᐀̝ٛҩ၁រ̈́׎ SEM ព຋௡ᖐ

316 L ̙ᛙ᐀གྷٛҩ၁រޢĂٙ଀ז̝ᑕ˧–ᑕតপّ

ѡቢဦĂϯٺဦ 5Ăࢍზඕڍ׎ࢫЄૻޘ(yielding strength, Y.S) Y.S =234Ș/mm

Ăԩٛૻޘ(tensile strength, T.S) T.S = 863.3Ș/mm

Ăᕝෘૻޘ(freacture strength, F.S) F.S = 746.9 Ș/mm

ĂГϤဦՐ଀ྍՄफ़۞໅ܼͩᇴࠎ 20000 Ș/mm

Ą

̙ᛙ᐀ 316L ྏͯགྷԩٛ၁រޢ׎৔ᕝࢬ̝ବೡё࿪̄ព

຋ᙡ SEM ព຋௡ᖐဦĂϯٺဦ 6Ăд׎৔ᕝࢬ˯Ξͽޝځ ព۞࠻זᇧෘې۞ͷ׍Όౝ۞ព຋௡ᖐ(dimples)Ă҃఺ֱ

Όౝ̂̈ࡗࠎ 10 µmĂϤѩᇧෘې௡ᖐΞҿᕝ̙ᛙ᐀ 316L ߏ˘჌ؼणّᄃิّ࠰࠹༊։р۞ܛᛳՄफ़Ă༊׎צז࿅

̂۞ᑕ˧үϡॡĂΞᖣϤ๬Җតԛΐͽӛќ࿅к۞үϡ

(a)

(b)

ဦ 4 (a)Palmaz-Schatz

Stent ͕ҕგ͚ߛᎶණणฟ݈̝

შॾඕၹć(b) Palmaz-Schatz Stent ͕ҕგ͚ߛᎶ ණणฟޢ̝შॾඕၹ

52.2

43.5

34.8

26.1

17.4

8.7

0

0 41 82 123

(%) (kgf/mm2 )

164 246

20429007-01

205

ဦ

5 316 L ̙ᛙ᐀གྷٛҩ၁រޢĂٙ଀ז̝ᑕ˧–ᑕតপ

ّѡቢဦ

ਕณĂΩγϤ˘ֱ၁រྤफ़ពϯ S.S 316L ̙㝮᐀Մ׍౯੼

ᅝ̝ԩᄞّ(Oliver ඈˠ[3])Ăͽ̈́෹ᇅّ(Barragan ඈˠ[1])

̝পّĂՀপҾ۞ߏѩ჌̙㝮᐀۞ X ЍᏬडពனّ̙᏾Ă ᗁϠซҖ͘ఙॡޝटٽᖣϤ X Ѝ፟៍၅ז͚ߛ۞ٸཉҜཉ ߏӎϒቁĂٙͽߏϫ઼݈γ͕ҕგ͚ߛ۞͹ࢋᄦౄՄफ़Ą

༊ҕგ͚ߛצזՠ஧ᕖૺᑅ˧үϡॡĂ͚ߛणฟ۞ॡ

࣏ົֹ͚ߛშԛඕၹЧቢ҈யϠ˘ؠ۞̰ᑕ˧ĂॲፂА݈

ဦ 6 ̙ᛙ᐀ 316L ྏͯགྷԩٛ၁រޢ׎৔ᕝࢬ̝ବೡё

࿪̄ព຋ᙡ SEM ព຋௡ᖐဦ

600 550 500 450

4000 0.5 1 1.5 2 2.5 3 3.5 4 4.5

D (mm) (N/mm2 )

ဦ 7 ̙Т۞͚ߛۡश D ٚצ 0.235 N/mm²̝ᑅ˧ଐԛ

˭Ă׎ ANSYS நኢࢍზ΍ֽ۞౵̂ቢ҈ᑕ˧

۞ԩٛ၁រඕڍĂᏴפϫ݈ྵ૱ֹϡ۞׏ݭ͚ߛۡश D = 1.0 mmĂቢᆵ W = 0.1 mm ༊׎ቢՄצז౵̂ᑕ˧ S = 550 N/mm

ॡ(ѩࣃ̬ٺ Y.S ᄃ T.S ̝ม)Ăѩॡٙᅮࢋ۞Ꮆණ णฟᑅ˧ࠎ 0.235 N/mm

ĂቢՄ఍ٺщБ۞߉˧ቑಛ̰Ă Palmaz-Schatz ҕგ͚ߛд࠹Тቢᆵ W = 0.1mm ͽ̈́࠹ТᎶ ණणฟᑅ˧(employed pressure) 0.235 N/mm

үϡ˭Ăд̙

Т۞͚ߛۡश D ଐԛ˭Ă׎ ANSYS நኢࢍზඕڍϯٺဦ 7Ą༊ۡशд 2 mm ͽ˭ॡĂ͚ߛ̰ቢՄᑕ˧ᐌ͚ߛۡश D

̝ᆧΐ҃ഴ͌Ăͷ༊͚ߛۡश̂̈ӱརд 1.0 mm ̈́ 0.8 mm ॡĂ׎͚ߛ̰ቢՄᑕ˧࠹༊ତܕՄफ़ώ֗፟ୠّኳ T.SĂ

ܑϯშԛඕၹ۞ҕგ͚ߛۡशдனѣ۞Մफ़ᄃᑅ˧నؠ

˭Ăۡश෸̈၆צזणฟᑅ˧۞ୂຏޘ෸̂ć൒҃༊ۡश

͎̇̂ٺ 2 mm ͽ˯ॡĂ͚ߛቢ҈̰ᑕ˧ᐌ͚ߛۡश D ̝ ᆧΐ҃ቤၙᆧΐĂࡶࢋᄦઇՀ̂ۡश͎̇Ăᔘߏѣޝ̂۞

൴ण۩มćტЪᄲֽĂ͚ߛۡश D ٺ 0.8 mm Ҍ 4.0 mm ᄃ

׽ؠቢᆵ W = 0.1mm ௡Ъ˭Ăٚצ 0.235 N/mm

׽ؠणฟ ᑅ˧ॡĂயϠ౵̂ᑕ˧࠰̂ٺ Y.S. ( 234 N/mm

)Ăநኢ˯

࠰Ξ૟͚ߛणฟĄΩγٺ׽ؠणฟᑅ˧˭Ă͚ߛۡशᆧΐ ณᐌ͚ߛۡश D ̝ᆧΐ҃ᆧΐĂтဦ 8 ٙϯĄ༊ۡशࠎ 3.5mm ॡ౵̂ۡशᆧΐณΞҌ 3.7 mmĂјࠎ 7.2 mmĄ͚

ߛ͎̇ D= 0.8 mm ᄃ W = 0.1 mmĂٚצ 0.235 Ș/mm

Ꮆ ණणฟᑅ˧ॡٙயϠᑕ˧̈́តԛဦϯٺဦ 9ĄϤྍဦ̚Ξ

࠻΍౵̂ᑕ˧͹ࢋౌะ̚д͚ߛቢ҈ϹତҜཉĂྫྷԧࣇ˘

3 2.7 2.4 2.1 1.8 1.5

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 D (mm)

(mm)

ဦ 8 ٺ׽ؠणฟᑅ˧˭Ă͚ߛۡशᆧΐณᐌ͚ߛۡश D

̝ᆧΐ҃ᆧΐ۞ଐԛ

ဦ 9 ͚ߛ͎̇ D = 0.8 mm ᄃ W = 0.1 mmĂٚצ 0.235

N/mm

ਠ۞፟ୠ̮Іٙଯീ۞˘ᇹᔘߏ൴Ϡдᑕ˧ะ̚఍Ăٕߏ ԛېྵኑᗔ׍ѣࣆ֎۞ҜཉĂд͚ߛቢ҈ۡቢ߱۞ቁயϠ

ྵ̝̰̈ᑕ˧Ą

4. ߉ΐ׽ؠᑅ˧ٺ̙Т͚ߛቢᆵ۞˧ጯ̶ژ

Palmaz-Schatz ҕგ͚ߛд࠹Тۡश D = 1.0 mm ̈́࠹

ТᎶණणฟᑅ˧(employed pressure) 0.235 N/mm

үϡ˭Ă Լត͚ߛቢᆵ W ॡĂநኢࢍზඕڍពϯĂ͚ߛ̰ቢՄᑕ˧

ᄃۡशᆧΐณ࠰ᐌ͚ߛቢᆵ W ̝ᆧΐ҃ഴ͌Ăҭߏ༊ቢᆵ ᒺ̈Ҍ 0.06 mm ॡĂЯ࿅௟۞͎̇నࢍ҃யϠܧቢّ۞ᑕ

˧ࣃĂពϯቢᆵд෸ֽ෸௟ॡĂྍഠ͚ߛ۞ᑕ˧ࣃ˵෸ֽ

෸̙ᘦؠĂтဦ 10 ٙϯĄܑϯྍ͚ߛშԛඕၹቢᆵдனѣ

۞Մफ़͎̇ᄃᑅ˧నؠ˭Ăࢋԯቢᆵ͎̇ઇјՀ̈۞ྖĂ

૟ົѣ˘ؠ۞ࢨטć൒҃ቢᆵ෸̂ٙயϠ۞ۡशᆧΐณ˵

ಶ෸̈Ăтဦ 11 ٙϯĂࡶࢋ૟ྵ̂ቢᆵᇣฟז˘ؠ̂̈۞

ᎶණणฟۡशĂ࠹၆ٙᅮᏮˢ۞ᑅ˧˵ಶࢋՀ̂Ăѩᄃ૱

ᙊ˯׍ྵ௖ቢ҈ᑕྍ׍ѣྵૻ۞ૻޘ࠹ӚЪĄΩγࡶࢋᄦ ઇՀ̂۞͚ߛቢᆵ͎̇ĂΪࢋд̙ᇆᜩϠۏ௡ᖐ࠹टّ۞

݈೩˭Ăᔘߏѣ׎൴ण۩มĄ

5. Palmaz-Schatz ҕგ͚ߛٺ׽ؠቢᆵ 0.10 mm ᄃۡ

श 1.0mm ̝ᑕ˧̶ژ

ͽ͚ߛۡश D = 1.0 mmă͚ߛᆵޘ W = 0.1 mm ซҖ

630 580 530 480 430 380

0.04 0.06 0.08 0.1 0.12 0.14 W (mm)

(N/mm2 )

ဦ 10 ҕგ͚ߛд࠹Тۡश D = 1.0mm ̈́࠹ТᎶණणฟ ᑅ˧(employed pressure) 0.235 N/mm²үϡ˭Ă Լត͚ߛቢᆵ W ॡĂ͚ߛ̰ቢՄᑕ˧ᄃۡशᆧΐ ณ࠰ᐌ͚ߛቢᆵ W ̝ᆧΐ҃ഴ͌۞ଐԛ

3.5 3 2.5 2 1.5 1 0.5

0.04 0.06 0.08 0.1 0.12 0.14 W (mm)

(mm)

ဦ 11 ҕგ͚ߛд࠹Тۡश D = 1.0mm ̈́࠹ТᎶණणฟ ᑅ˧(employed pressure) 0.235 N/mm²үϡ˭Ă Լត͚ߛቢᆵ W ॡĂቢᆵ෸̂ٙயϠ۞ۡशᆧΐ ณ˵ಶ෸̈

1000 800 600 400 200

00 0.2 0.4 0.6 0.8 (N/mm2 )

(atm)

1 1.2 1.4

ဦ 12 ٺ͚ߛۡश D=1.0 mmă͚ߛᆵޘ W=0.1 mmĂ͚

ߛצז̙Тՠ஧ᕖૺᑅ˧ॡ͚ߛ̰ቢ҈ᑕ˧ᆧΐ

۞ଐԛ

͚ߛצז̙Тՠ஧ᕖૺᑅ˧ॡ̝˧ጯ̶ژĄࡁտඕڍពϯ Palmaz-Schatz ҕგ͚ߛົᐌ׎צזᕖૺᑅ˧۞ᆧΐ҃֝

ిणฟ(ྍᙷҬ̝၁ү၁រ̏གྷдซҖ̚)Ă༊ P ࣃז྿ 0.5

̂ঈᑅνΠॡĂ͚ߛ̝̰ᑕϲӈ̏ܧ૱ତܕ 316L ̙㝮᐀

̝ԩٛૻޘĂͷֹ͚ߛ̏གྷणฟҌ౵̂Ξਕۡश̶ϯٺဦ 12 ᄃဦ 13Ăԧࣇ൴ன͚ߛ̰̝ᑕ˧֭՟ѣ෹࿅Մफ़۞ T.S.

҃צז৔ᗼĄPalmaz-Schatz ͚ߛٺᏮˢ̙Т P ࣃޢĂტЪ ANSYS ٙ଀ז۞ᑕ˧ᄃᑕតᔌ๕̶ҶဦĂរᙋᗁर͘ఙॡ Ꮾˢ 7 ̂ঈᑅ۞щБّᄃϒቁّ(Hausleiter ඈˠ[2])Ą

5 4 3 2 1

00 0.2 0.4 0.6 0.8

(mm)

(atm)

1 1.2 1.4

ဦ 13 ٺ͚ߛۡश D=1.0 mmă͚ߛᆵޘ W=0.1 mmĂ͚

ߛצז̙Тՠ஧ᕖૺᑅ˧ॡ͚ߛۡशᆧΐณഴ͌

۞ଐԛ

0.4 0.35 0.3 0.25 0.2 0.15

0.5 1 1.5 2 2.5 3 3.5 4 4.5 (N/mm2 )

D (mm)

ဦ 14 Palmaz-Schatz ҕგ͚ߛд࠹Тቢᆵ W=0.1mm ᄃ Լត͚ߛۡश D ۞ଐԛ˭Ă୬д͚ߛቢ҈̰யϠ౵

̂۞ᑕ˧ 550 N/mm²ॡĂ׎ٙᅮ۞͚ߛᎶණणฟ ᑅ˧ဦ

4 3.5 3 2.5 2 1.5

0.5 1 1.5 2 2.5 3 3.5 4 4.5

(mm)

D (mm)

ဦ 15 யϠ౵̂ᑕ˧ 550 N/mm²ॡ͚ߛٙᅮ۞Ꮆණणฟ ᑅ˧ᄃۡशᆧΐณ࠰ᐌ͚ߛۡश D ̝ᆧΐ҃ᆧΐ

۞ଐԛ

6. யϠ౵̂ᑕ˧ 550 N/mm²ॡ͚ߛ̝˧ጯ̶ژ

Palmaz-Schatz ҕგ͚ߛд࠹Тቢᆵ W = 0.1 mm ᄃԼ ត͚ߛۡश D ۞ଐԛ˭Ă୬д͚ߛቢ҈̰யϠ౵̂۞ᑕ˧

550 Ș/mm

ॡĂࢍზ׎ٙᅮ۞͚ߛᎶණणฟᑅ˧Ăඕڍт ဦ 14Ăۡश 2 mm ٙᅮᎶණणฟᑅ˧౵̂Ăܑϯྍშԛඕ ၹдۡशࠎ 2 mm ۞ॡ࣏Ă͚ߛ׍ѣ౵̈ૻޘĄ༊ۡश 2 mm

̈ٺͽ˭ॡĂ͚ߛٙᅮ۞Ꮆණणฟᑅ˧ᄃۡशᆧΐณ࠰ᐌ

͚ߛۡश D ̝ᆧΐ҃ᆧΐ(ϯٺဦ 15)Ăពϯۡश͉̈ॡ͚

ߛ๪ԛშგົ΍னٙᏜ۞͎̇ड़ᑕྵࠎځពĂൾ຋߉̟ᕖ

ૺᑅ˧ӈΞֹ଀ቢ҈۞̰ᑕ˧ԣిᆧΐĂ̂ٺ 2 mm ̝ޢ

ٙᅮ۞Ꮆණणฟᑅ˧ᄃۡशᆧΐณĂు႙ᔌٺπቤ҃຋಼

˭ࢫĄϤѩΞۢĂྍඕၹ۞ҕგ͚ߛ̰ొᑕ˧͹ࢋצז׌

࣎ЯᇴٙᇆᜩĂௐ˘Ă఼૱ۡश෸̈۞๪გ׎ૻޘົ෸ֽ

෸̂Ăௐ˟Ă๪გ۞ૻޘ˵צזშԛඕၹٙՙؠĂЯѩĂ дߙ͚ߛۡशॡĂ͚ߛૻޘົЯѩ׌Я৵үϡ҃΍ன˘ᓜ

ࠧࣃĂೱήྖᄲ෸̈۞๪გۡश๪გૻޘ෸੼Ăშԛඕၹ

݋ֹ଀ྵ̈ۡश۞ૻޘ˭ࢫĂ׌۰࠹̢үϡĂдۡशࠎ 2 mm ۞ॡ࣏΍னѩᓜࠧࣃĄ

Ҍٺд࠹Тۡश D = 1.0mm Լត͚ߛቢᆵ W ۞ଐԛ

˭Ăਕֹ Palmaz-Schatz ҕგ͚ߛயϠ͚ߛቢ҈̰ᑕ˧ 550 Ș/mm

ॡĂࢍზඕڍពϯĂٙᅮᎶණणฟᑅ˧Ăᐌ͚ߛቢ ᆵ W ̝ᆧΐ҃ᆧΐĂҭߏ͚ߛۡशᆧΐณᐌ͚ߛቢᆵ W

̝ᆧΐ҃ഴ͌Ă͚ߛۡशᆧΐณᐌ͚ߛቢᆵ W ̝ᆧΐ҃ഴ

͌ĄϤѩΞۢЯࠎϏԼតშგۡशĂώࢍზ৷ოតј˞შ ԛૄώݭၗ̙តĂΪߏቢ҈ᆵޘдүត̼ĂЯѩΞۢ෸ᆵ

۞ቢ҈෸ᅮྵ̂۞͚ߛणฟᑅ˧Ă෸ᆵ۞ቢ҈ЯࠎΞͽᆧ

ૻ͚ߛૻޘĂЯѩᇣฟ۞ۡशតԛณྵ̈ĂҌᛳЪநĄ

̣ăඕ ኢ

1. ᑕϡ Pro Engineer ᘱဦహវĂΞϒቁг૟͕ҕგ͚ߛ۞

3D ၁វሀݭޙϲ੓ֽĂͽӀѣࢨ̮৵ڱ̝˧ጯ̶ژͽ

̈́ޢᜈ۞ΐ̍ᄦౄĄ

2. நኢ˯ᙋځᑕϡ 316L ̙ᛙ᐀Մफ़ซҖ͕ҕგ͚ߛᄦ

ౄĂЯࠎ׎෹ᇅّ۞፟ୠّኳĂ༊͚ߛצזᎶණᑅ˧ᇣ ฟॡĂ͚ߛ̙ົயϠᕝෘ۞ன෪Ą

3. ᑕϡ ANSYSĂΞͽ໤ቁ۞ࢍზ΍͚ߛצᎶණᑅ˧णฟ ޢ̝ᑕ˧̶ҶĄ

4. ҕგ͚ߛд࠹Тቢᆵ W=0.1mm ͽ̈́࠹ТᎶණᑅ˧˭Ă д̙Т۞͚ߛۡश D ઇត̼ॡĂநኢࢍზඕڍពϯĂ

͚ߛ̰ቢՄᑕ˧ᐌ͚ߛۡश D ̝ᆧΐ҃ഴ͌Ăۡशᆧ ΐณᐌ͚ߛۡश D ̝ᆧΐ҃ᆧΐĄ

5. ҕგ͚ߛд࠹Тۡश D=1.0 mm ͽ̈́࠹ТᎶණᑅ˧˭Ă д̙Т۞͚ߛቢᆵ W ઇត̼ॡĂநኢࢍზඕڍពϯĂ

͚ߛ̰ቢՄᑕ˧ᄃۡशᆧΐณ࠰ᐌ͚ߛቢᆵ W ̝ᆧΐ

҃ഴ͌Ą

6. ͚ߛд࠹Тۡश D = 1.0mm ᄃቢᆵ W = 0.1mm ۞௡Ъ ଐڶ˭Ă͚ߛົᐌ׎צז̰ᑕ˧۞ᆧΐ҃֝ిणฟĂ༊

P ࣃז྿ 0.5 ̂ঈᑅνΠĂӈΞֹ͚ߛणฟҌ౵̂ۡ

शĂͷ͚ߛ̰̝ᑕ˧֭՟ѣ෹࿅׎Մफ़۞ T.S.҃צז৔

ᗼĄ

7. ҕგ͚ߛд࠹Тቢᆵ W = 0.1 mm ᄃ̙Т۞͚ߛۡश D ઇត̼ॡĂϤ׎Ꮆණणฟᑅ˧ٙ଀۞ࢍზඕڍពϯĂ͚

ߛ̰ቢՄᑕ˧ᄃۡशᆧΐณ࠰ᐌ͚ߛۡश D ̝ᆧΐ҃

ഴ͌Ą

8. ҕგ͚ߛд࠹Тۡश D=1.0mm ᄃ̙Т۞͚ߛቢᆵ W ઇ ត̼ॡĂ༊߉ΐ׎Ꮆණणฟᑅ˧ซҖ̶ژॡĂ͚ߛ̰ቢ

Մᑕ˧ᄃۡशᆧΐณ࠰ᐌ͚ߛቢᆵ W ̝ᆧΐ҃ᆧΐĄ 9. ώඕၹ۞ҕგ͚ߛ̰ొᑕ˧͹ࢋצז׌࣎Яᇴٙᇆ

ᜩĂௐ˘Ăۡश෸̈۞๪გ׎ૻޘົ෸ֽ෸̂ćௐ˟Ă

๪გ۞ૻޘצזშԛඕၹٙՙؠĄЯѩĂдߙ͚ߛۡश ॡĂ͚ߛૻޘົЯѩ׌Я৵үϡ҃΍ன˘ᓜࠧࣃĄ

ᄫ ᔁ

ܧ૱ຏᔁ઼ࡊົώѐޘ఼࿅͕ҕგ̝ᄦүᄃϠۏᑕ ϡࡁտ૞ᗟࡁտࢍထ९Ăឰԧࣇੵ˞дநኢଣ੅γ˵ਕซ Җ၁ચࡁտ̍үĄຏᔁ፟ୠրषϒົି଱ăᏥځธି଱ă ҋજ̼ٙӓٙܜځ̌ᄃᄦౄࡊԫࡁտٙౘ߆ึି଱д Pro/E ׶Ч͞ࢬ۞םӄĄຏᔁ઼ࡊົ૞ᗟࢍထበཱི NSC 91-2213-E-027-009 ೩ֻགྷ෱Ăֹώ͛଀ͽԆјĄ

ણ҂͛ᚥ

1. Barragan, P., Rieu, R., Garitery, V., Roquebert, P., Sainsous, J., Silvestri, M., and Bayet, G., “Elastic Recoil of Coronary Stents : a Comparative Analysis,” Catheter

2. Hausleiter, J., Schuhlen, H., Elezi, S., Walter, M., Hdamitzky, M, Dirschinger, J., and Schomig, A., “Impact of High Inflation Pressures on Six-Month Angiographic Follow-Up After Coronary Stent Placement,” Journal of

369A (1997).

3. Bertrand, O. F., Sipehia, R., Mongrain, R., Rodes, J., Tardif, J. C., Bilodeau, L., Cote, G., and Bourassa, M. G.,

“Biocompatibility Aspects of New Stent Technology,”

Stent Biocompatibility. JACC, Vol. 32, No. 3 pp. 562-571

(1998).

4. Rieu, R., Barragan, R. J., Masson, C., Fuseri, J., Garitey, V., Silvestri, M., Roquebert, P., and Sainsous, J., “Radial Force of Coronary Stents: a Comparative Analysis,”

Catheter and Cardiovascular Intervention, Vol. 46, pp.

380-391 (1999).

5. Serruys, P. W., and Kutryk, M. J. B., Handbook of Coronary Stent, 2

Edition., Martin Dunitz Ltd., London, UK (1998).

6. Sigwart, U., “A Mechanical Solution for a Biological Problem,” European Heart Journal, Vol. 18, pp. 1068- 1072 (1997).

2002 ѐ 10 ͡ 11 ͟! ќቇ 2003 ѐ 03 ͡ 12 ͟! ܐᆶ 2003 ѐ 06 ͡ 11 ͟! ኑᆶ 2003 ѐ 06 ͡ 24 ͟! ତצ