急救性血管內氣球阻斷術(resuscitative endovascular balloon occlusion of the aorta, REBOA)是一種被用於血管內的治療方式，當病患腹部或骨盆以下遭受重創並導致危及性命的不可壓縮性出血時，可用REBOA氣球進行腹主動脈的暫時性止血以避免患者因出血性休克而死亡，使用REBOA可暫時恢復患者血壓值、生理機能、凝血機制與血量和止血。但若是使用較大的導管(大於12Fr, 4mm)進入患者股動脈(femoral artery)或髂動脈(iliac vessels)時會造成干涉，在結束治療時，導致移除導管的困難性，增加截肢的風險。此外使用REBOA對於重症患者進行治療時，若過度阻擋血流，可能因後負荷增加導致左心室擴張、肺動脈壓升高和心肌缺血，因此需定時將氣球放氣，使部分血流通過。
本研究之目的為設計一款REBOA可回收覆膜支架，希望利用鎳鈦支架的形狀記憶合金特性取代REBOA氣球，以縮小置入導管直徑，並且在置入後，可達提升患者血壓同時避免過度阻擋血流之功能。本研究因經費考量，在支架回收的實驗中，均使用光纖雷射切割的不鏽鋼支架作為實驗樣本。為了找到回收性能較佳的支架設計，在研究中提出了五款支架設計，並且針對各個不同Connector長度、錐度與弧度的設計進行回收測試和改良，從中選出最佳的支架設計。本研究利用3D列印機依據支架幾何外型製作PVA水解模具，以進行覆膜製程；接著利用自行設計的血壓模擬系統，依據文獻90 Hg mm作為壓力實驗標準值進行測試，驗證以本研究所設計的覆膜支架進行REBOA治療的可行性。

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a kind of treatment mean used in endovascular technique. When patients’s abodmen or pelvis have suffured severe injury and caused life-threatening, noncompressible hemorrhage, REBOA could be uesd and a REBOA balloon is inserted to the abdominal aorta, through patient’s femoral artery, for temporary occlusion and prevent them from death due to hemorrhagic shock and temporal restore blood pressure, correction of physiologic, coagulation, blood volume abnormalities and stops hemostasis in patients. However, if a normal 12Fr catheter is uesd for the operation, it could have serious interference in patient’s femoral artery and iliac vessels. At the end of operation, to remove the catheter could be difficult and increase the risk of amputation. In addition, if REBOA is used to the treatment of critically ill patients and blocks blood flow excessively, the left ventricular dilatation, pulmonary hypertension and myocardial ischemia may occur due to increase afterload, so intermittent deflation is required to allow partial blood flow.
The purpose of this study is to design a retrievable REBOA membrane stent. The stent uses the shape memory characteristic of the NiTi to replace REBOA balloon and reduces the diameter of the catheter. After placing the stent, it can raise the patient’s blood pressure and, at the same time, allow partial blood flow beyond the balloon to avoid over-blocking of the blood flow. Considering our limited budget, the stent samples for retrievable experiments stainless were cut from steel tubes by fiber laser in this study. In order to find the better retrivable stent design, in this study, five stent designs, with different connector length, taper and radian, were proposed and tested, and the experimental results were uesd to modify the design for optimal retrievable performance. The best one of these stent designs was selected as the geometry of PVA mold and it was built by a 3D printer. Then the PVA mold was used in the thin film process for achieving the stent’s membrane. Finally, a blood flow simulation system was used to test the developed membrane stent with the condition of 90 mmHg pressure. The result can verify the feasibility of our REBOA stent.

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