학술논문

Pediatric Airway Stent Designed to Facilitate Mucus Transport and Atraumatic Removal
Document Type
Periodical
Source
IEEE Transactions on Biomedical Engineering IEEE Trans. Biomed. Eng. Biomedical Engineering, IEEE Transactions on. 67(1):177-184 Jan, 2020
Subject
Bioengineering
Computing and Processing
Components, Circuits, Devices and Systems
Communication, Networking and Broadcast Technologies
Wires
Force
Pediatrics
Ventilation
Atmospheric modeling
Surgery
Strain
Tracheobronchomalacia
airway stent
Language
ISSN
0018-9294
1558-2531
Abstract
Objective: The goal was to develop a pediatric airway stent for treating tracheobronchomalacia that could be used as an alternative to positive pressure ventilation. The design goals were for the stent to allow mucus flow and to resist migration inside the airways, while also enabling easy insertion and removal. Methods: A helical stent design, together with insertion and removal tools, is presented. A mechanics model of stent compression is derived to assist in selecting stent design parameters (pitch and wire diameter) that provide the desired amount of tracheal support, while introducing the minimal amount of foreign material into the airway. Worst-case airway area reduction with stent support is investigated experimentally using a pressurized tracheal phantom matched to porcine tracheal tissue properties. The stent design is then evaluated in a porcine in vivo experiment. Results: Phantom testing validated the mechanics model of stent compression. In vivo testing demonstrated that the stent was well tolerated by the animal. Since the helical design covers only a small portion of the epithelium, mucus transport through the stented region was minimally impeded. Furthermore, the screw-like stent resisted migration, while also providing for atraumatic removal through the use of an unscrewing motion during removal. Conclusion: The proposed stent design and tools represent a promising approach to prevent airway collapse in children with tracheobronchomalacia. Significance: The proposed technology overcomes the limitations of existing airway stents and may provide an alternative to maintaining children on a ventilator.