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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 蕭浩明(Hao-Ming Hsiao) | |
dc.contributor.author | Tzu-Yun Chou | en |
dc.contributor.author | 周子芸 | zh_TW |
dc.date.accessioned | 2021-07-10T22:10:48Z | - |
dc.date.available | 2021-07-10T22:10:48Z | - |
dc.date.copyright | 2018-08-14 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-07-30 | |
dc.identifier.citation | [1] E. F. Goljan, 'Rapid review pathology,' Mosby/Elsevier, Philadelphia, 2010.
[2] E. S. Jr. Connolly, A. A. Rabinstein, J. R. Carhuapoma, et al, 'Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association,' Stroke, vol. 43, pp. 1711-1737, 2012. [3] J. C. Richardson and H. H. Hyland, 'A clinical and pathological study of subarachnoid and intracerebral haemorrhage caused berry aneurysms,' Medicine, vol. 20, pp. 1-84, 1941. [4] D. Krex, H. Schackert, and G. Schackert, 'Genesis of cerebral aneurysms–an update,' Acta neurochirurgica, vol. 143, pp. 429-449, 2001. [5] G. J. Rinkel, M. Djibuti, A. Algra, et al, 'Prevalence and risk of rupture of intracranial aneurysms a systematic review,' Stroke, vol. 29, pp. 251-256, 1998. [6] Pinehurst Neurology. Cerebral Aneurysms. Available: http://www.pinehurstneurology.com/single-post/2017/09/04/Cerebral-Aneurysms (accessed on 30 April 2018). [7] Open-i Biomedical Image Search Engine. Open-i. Available: https://openi.nlm.nih.gov/imgs/512/267/3563954/PMC3563954_40258_2012_5_Fig1_HTML.png (accessed on 30 April 2018). [8] Aneurysm Measurements. Peripheral Brain. Available: https://pbrainmd.wordpress.com/2015/10/04/aneurysm-measurements/(accessed on 30 April 2018). [9] C. Drake, 'Progress in cerebrovascular disease. Management of cerebral aneurysm,' Stroke, vol. 12, pp. 273-283, 1981. [10] C. Vega, J. V. Kwoon, and S. D. Lavine, 'Intracranial aneurysms: current evidence and clinical practice,' American family physician, vol. 66, pp. 601-610, 2002. [11] The Magnetic Resonance Angiography in Relatives of Patients with Subarachnoid Hemorrhage Study Group, 'Risks and benefits of screening for intracranial aneurysms in first-degree relatives of patients with sporadic subarachnoid hemorrhage,' N Engl J Med, vol.341, pp. 1344-1350, 1999. [12] A. Ronkainen, J. Hernesniemi, M. Puranen, et al, 'Familial intracranial aneurysms,' Lancet, vol.349, pp.380-384, 1997. [13] T. W. Raaymakers, G. J. Rinkel, and L. M. Ramos, 'Initial and follow-up screening for aneurysms in families with familial subarachnoid hemorrhage,' Neurology, vol.51, pp.1125-1130, 1998. [14] A. M. Lozano and R. Leblanc, 'Familial intracranial aneurysms,' Journal of neurosurgery, vol. 66, pp. 522-528, 1987. [15] H. Ujiie, K. Sato, H. Onda, et al., 'Clinical analysis of incidentally discovered unruptured aneurysms,' Stroke, vol. 24, pp. 1850-1856, 1993. [16] J. M. Barrett, J. E. Van Hooydonk, and F. H. Boehm, 'Pregnancy-related rupture of arterial aneurysms,' Obstetrical & gynecological survey, vol. 37, pp. 557-566, 1982. [17] J. L. Brisman, J. K. Song, and D. W. Newell, 'Cerebral aneurysms,' New England Journal of Medicine, vol. 355, pp. 928-939, 2006. [18] A. P. Lozier, E. S. Connolly, S. D. Lavine, et al, 'Guglielmi detachable coil embolization of posterior circulation aneurysms: a systematic review of the literature,' Stroke, vol. 33, pp. 2509-2518, 2002. [19] V. L. Roger, A. S. Go, D. M. Lloyd-Jones, et al, 'Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association,' Circulation, vol. 125, pp. 188-197, 2012. [20] J. Wardlaw and P. White, 'The detection and management of unruptured intracranial aneurysms,' Brain, vol. 123, pp. 205-221, 2000. [21] J. W. Hop, G. J. Rinkel, A. Algra, et al, 'Case-fatality rates and functional outcome after subarachnoid hemorrhage: a systematic review,' Stroke, vol. 28, pp. 660-664, 1997. [22] S. C. Johnston, S. Selvin, and D. R. Gress, 'The burden, trends, and demographics of mortality from subarachnoid hemorrhage,' Neurology, vol. 50, pp. 1413-1418, 1998. [23] A. Hijdra, R. Braakman, J. van Gijn, et al, 'Aneurysmal subarachnoid hemorrhage. Complications and outcome in a hospital population,' Stroke, vol. 18, pp.1061-1067, 1987. [24] H. B. Locksley, 'Natural history of subarachnoidal hemorrhage, intracranial aneurysms, and arteriovenous malformations,' J Neurosurg, vol.25, pp. 321-368, 1966. [25] K. Kayembe, M. Sasahara, and F. Hazama, 'Cerebral aneurysms and variations in the circle of Willis,' Stroke, vol. 15, pp. 846-850, 1984. [26] R. A. Solomon, M. E. Fink, and J. Pile-Spellman, 'Surgical management of unruptured intracranial aneurysms,' Journal of neurosurgery, vol. 80, pp. 440-446, 1994. [27] J. Dubin. (2007). Craniotomy. Available: http://joeldubin.cgsociety.org/art/cinema-4d-photoshop-craniotomy-3d-520789/ (accessed on 30 April 2018). [28] The University of Chicago Medical Center. Cerebral Aneurysm. Available: http://healthlibrary.uchospitals.edu/Search/85,P08772 (accessed on 30 April 2018). [29] G. Guglielmi, F. Viñuela, J. Dion, et al, 'Electrothrombosis of saccular aneurysms via endovascular approach: part 2: preliminary clinical experience,' J Neurosurg, vol. 75, pp. 8-14, 1991. [30] G. Guglielmi, F. Vinuela, I. Sepetka, et al, 'Electrothrombosis of saccular aneurysms via endovascular approach. Part 1: electrochemical basis, technique, and experimental results,' J Neurosurg, vol.75, pp. 1-7, 1991. [31] F. Viñuela, G. Duckwiler, and M. Mawad, 'Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients,' Journal of neurosurgery, vol. 86, pp. 475-482, 1997. [32] A. F. Zubillaga, G. Guglielmi, F. Vinuela, et al, 'Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results,' American Journal of Neuroradiology, vol. 15, pp. 815-820, 1994. [33] H. Dinç, M. H. Öztürk, A. Sari, et al, 'Coil embolization in 481 ruptured intracranial aneurysms: angiographic and clinical results,' Diagnostic and interventional radiology, vol. 19, p. 165, 2013. [34] G. M. Debrun, V. A. Aletich, P. Kehrli, et al, 'Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience,' Neurosurgery, vol. 43, pp. 1281–1295, 1998. [35] G. M. Debrun, V. A. Aletich, P. Kehrli, et al, 'Aneurysm geometry: an important criterion in selecting patients for Guglielmi detachable coiling,' Neurol Med Chir (Tokyo), vol. 38, pp. 1–20, 1998. [36] Pinterest. Endovascular coiling; the treatment works by promoting blood clotting around the coils, eventually sealing the aneurysm and reducing pressure on it. Available: https://www.pinterest.com/pin/467670742531444693/ (accessed on 30 April 2018). [37] H. M. Hsiao, Y. P. Wang, Y. H. Cheng, et al, “A novel spherical stent concept for intracranial aneurysm” Sensors and Materials, Vol. 28, pp. 947-955, 2016. [38] I. S. Muskens, J. T. Senders, H. H. Dasenbrock, et al, 'The Woven Endobridge Device for Treatment of Intracranial Aneurysms: A Systematic Review,' World Neurosurg, vol. 98, pp. 809-817, 2017. [39] Y. H. Ding, D. A. Lewis, R. Kadirvel, et al, 'The Woven EndoBridge: a new aneurysm occlusion device,' AJNR Am J Neuroradiol, vol. 32, pp. 607-611, 2011. [40] National Skull Base Center. Flow diversion for aneurysm. Available: http://www.nsbcenter.org/neuro-intervention/flow-diversion-for-aneurysm/ (accessed on 30 April 2018). [41] P. K. Nelson, P. Lylyk, I. Szikora, et al, 'The pipeline embolization device for the intracranial treatment of aneurysms trial,' AJNR Am J Neuroradiol, vol. 32, pp. 34-40, 2011. [42] I. Szikora, Z. Berentei, Z. Kulcsar, et al, 'Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device,' AJNR Am J Neuroradiol, vol. 31, pp. 1139-1147, 2010. [43] M. Leonardi, L. Cirillo, F. Toni, et al, 'Treatment of intracranial aneurysms using flow-diverting silk stents (BALT): a single centre experience,' Interv Neuroradiol, vol. 17, pp. 306-315, 2011. [44] O. I. Tähtinen, H. I. Manninen, R. L. Vanninen, et al, 'The silk flow-diverting stent in the endovascular treatment of complex intracranial aneurysms: technical aspects and midterm results in 24 consecutive patients' Neurosurgery, vol. 70, pp. 617-623, 2012. [45] F. Drescher, W. Weber, A. Berlis, et al, 'Treatment of Intra- and Extracranial Aneurysms Using the Flow-Redirection Endoluminal Device: Multicenter Experience and Follow-Up Results,' AJNR Am J Neuroradiol, vol. 38, pp. 105-112, 2017. [46] N. Kocer, C. Islak, O. Kizilkilic, et al, 'Flow Re-direction Endoluminal Device in treatment of cerebral aneurysms: initial experience with short-term follow-up results' J Neurosurg, vol. 120, pp. 1158-1171, 2014. [47] D. Fiorella, F. C. Albuquerque, V. R. Deshmukh, et al, 'Usefulness of the Neuroform stent for the treatment of cerebral aneurysms: results at initial (3–6 mo) follow-up,' Neurosurgery, vol. 56, pp. 1191–1201, 2005. [48] D. Fiorella, P. Lylyk, I. Szikora, et al, 'Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms,' J Neurointervent Surg, vol. 1, pp. 56–65, 2009. [49] J. V. Byrne, R. Beltechi, J. A. Yarnold, et al,'Early Experience in the Treament of Intracranial Aneurysms by Endovascular Flow Diversion: a Multicentre Prospective Study,' PLoS One, vol. 5, pp.1-8, 2010. [50] B. Lubicz, L. Collignon, G. Raphaeli, et al, 'Flow-Diverter Stent for the Endovascular Treatment of Intracranial Aneurysmes. A Prospective Study in 29 patients with 34 aneurysms,' Stroke, vol. 41, pp. 2247-2253, 2010. [51] E. J. Mattsson, T. R. Kohler, S. M. Vergel, et al, 'Increased blood flow induces regression of intimal hyperplasia,' Arterioscler Thromb Vasc Biol, vol. 17, pp. 2245-2249, 1997. [52] A. M. Malek, S. L. Alper, and S. Izumo, 'Hemodynamic shear stress and its role in atherosclerosis,' JAMA, vol. 282, pp. 2035-2042, 1999. [53] O. Traub, and B. C. Berk, 'Laminar shear stress: mechanisms by which endothelial cells transduce an atheroprotective force,' Arterioscler Thromb Vasc Biol, vol. 18, pp. 677-685, 1998. [54] L. W. Kraiss, R. L. Geary, E. J. Mattsson, et al, 'Acute reductions in blood flow and shear stress induce platelet-derived growth factor-A expression in baboon prosthetic grafts,' Circ Res, vol. 79, pp. 45-53, 1996. [55] D. C. Chappell, S. E. Varner, R. M. Nerem, et al, 'Oscillatory shear stress stimulates adhesion molecule expression in cultured human endothelium,' Circ Res, vol. 82, pp. 532-539, 1998. [56] T. Ziegler, K. Bouzourene, V. J. Harrison, et al, 'Influence of oscillatory and unidirectional flow environments on the expression of endothelin and nitric oxide synthase in cultured endothelial cells,' Arterioscler Thromb Vasc Biol, vol. 18, pp. 686-692, 1998. [57] D. N. Ku, 'Blood flow in arteries,' Annu Rev Fluid Mech, vol. 29, pp. 399-434, 1997. [58] D. N. Ku, C. K. Zarins, D. P. Giddens, et al, 'Pulsatile flow and atherosclerosis in the human carotid bifurcation: positive correlation between plaque localization and low and oscillating shear stress,' Arteriosclerosis, vol. 5, pp. 292-302, 1985. [59] K. Kataoka, M. Taneda, T. Asai, et al, 'Structural fragility and inflammatory response of ruptured cerebral aneurysms: a comparative study between ruptured and unruptured cerebral aneurysms,' Stroke, vol. 30, pp. 1396-1401, 1999. [60] R. Palumbo, C. Gaetano, G. Melillo, et al, 'Shear stress downregulation of platelet-derived growth factor receptor- beta and matrix metalloprotease-2 is associated with inhibition of smooth muscle cell invasion and migration,' Circulation, vol. 102, pp. 225-230, 2000. [61] H. Ueba, M. Kawakami, and T. Yaginuma, 'Shear stress as an inhibitor of vascular smooth muscle cell proliferation: role of transforming growth factor-beta 1 and tissue-type plasminogen activator,' Arterioscler Thromb Vasc Biol, vol. 17, pp. 1512-1516, 1997. [62] Y. Geng, G. K. Hansson, and E. Holme, 'Interferon-gamma and tumor necrosis factor synergize to induce nitric oxide production and inhibit mitochondrial respiration in vascular smooth muscle cells,' Circ Res, vol. 71, pp. 1268-1276, 1992. [63] U. C. Garg, and A. Hassid, 'Mechanisms of nitrosothiol-induced antimitogenesis in aortic smooth muscle cells,' Eur J Pharmacol, vol. 237, pp. 243-249, 1993. [64] F. C. Tanner, P. Meier, H. Greutert, et al, 'Nitric oxide modulates expression of cell cycle regulatory proteins: a cytostatic strategy for inhibition of human vascular smooth muscle cell proliferation,' Circulation, vol. 101, pp. 1982-1989, 2000. [65] H. M. Hsiao, Y. H. Chiu, K. H. Lee, et al, 'Computational modeling of effects of intravascular stent design on key mechanical and hemodynamic behavior,' Computer-Aided Design, vol. 44, pp. 757-765, 2012. [66] H. M. Hsiao, K. H. Lee, Y. C. Liao, et al, 'Cardiovascular stent design and wall shear stress distribution in coronary stented arteries,' Micro & Nano Letters, vol. 7, pp. 430-433, 2012. [67] U. F. a. D. Administration, 'Guidance for Industry and FDA Staff-Non-Clinical Engineering Tests and Recommended Labeling for Intravascular Stents and Associated Delivery Systems,' 2010. [68] T. Duerig, A. Pelton, and D. Stöckel, 'An overview of nitinol medical applications,' Materials Science and Engineering: A, vol. 273, pp. 149-160, 1999. [69] A. Pelton, V. Schroeder, M. Mitchell, et al, 'Fatigue and durability of Nitinol stents,' J Mech Behav Biomed Mater, vol. 1, pp. 153-164, 2008. [70] T. M. Pham, M. DeHerrera, and W. Sun, 'Analysis and Simulation of PTMA Device Deployment into the Coronary Sinus: Impact of Stent Strut Thickness,' Mech Biol Syst Mater, Vol. 2, pp. 1-10, 2011. [71] P. Adler, J. Allen, J. Lessar, et al, 'Martensite Transformations and Fatigue Behavior of Nitinol,' J ASTM Int, vol. 4, pp. 1-16, 2007. [72] T. Duerig, D. Tolomeo, and M. Wholey, 'An overview of superelastic stent design,' Minim Invasive Ther Allied Technol, vol. 9, pp. 235-246, 2000. [73] M. Grujicic, B. Pandurangan, A. Arakere, et al, 'Fatigue-life computational analysis for the self-expanding endovascular nitinol stents,' J Mater Eng Perform, vol. 21, pp. 2218-2230, 2012. [74] Z. Lin and A. Denison, 'Nitinol fatigue resistance—a strong function of surface quality,' Med Device Mater, Proc Mater Processes Med Devices Conf, Sanjay Shrivastave, pp. 205-208, 2003. [75] M. Sanchez, D. Ambard, V. Costalat, et al, 'Biomechanical assessment of the individual risk of rupture of cerebral aneurysms: a proof of concept,' Annals of biomedical engineering, vol. 41, pp. 28-40, 2013. [76] J. Xu, Z. Wu, Y. Yu, et al, 'Combined Effects of Flow Diverting Strategies and Parent Artery Curvature on Aneurysmal Hemodynamics: A CFD Study,' PLoS One, vol. 10, p. e0138648, 2015. [77] V. Costalat, M. Sanchez, D. Ambard, et al, 'Biomechanical wall properties of human intracranial aneurysms resected following surgical clipping (IRRAs Project),' Journal of biomechanics, vol. 44, pp. 2685-2691, 2011. [78] M. Sanchez, O. Ecker, D. Ambard, et al, 'Intracranial aneurysmal pulsatility as a new individual criterion for rupture risk evaluation: biomechanical and numeric approach (IRRAs Project),' AJNR Am J Neuroradiol, vol. 35, pp. 1765-1771, 2014. [79] A. Creane, E. Maher, S. Sultan, et al, 'Finite element modelling of diseased carotid bifurcations generated from in vivo computerised tomographic angiography,' Computers in Biology and Medicine, vol. 40, pp. 419-429, 2010. [80] J. D. Cutnell and K. W. Johnson, 'Physics. 4th Edi-tion,' ed: John Wiley & Sons Ltd., New York, 1998. [81] B. Joshua, J. M. Buick, and G. Simon, 'Analysis of the Casson and Carreau-Yasuda non-Newtonian blood models in steady and oscillatory flows using the lattice Boltzmann method,' Phys Fluids, vol. 19, pp. 093103, 2007. [82] S. Chien, S. Usami, H. M. Taylor, et al, 'Effects of hematocrit and plasma proteins on human blood rheology at low shear rates,' Journal of Applied Physiology, vol. 21, pp. 81-87, 1966. [83] T. Seo, L. G. Schachter, and A. I. Barakat, “Computational study of fluid mechanical disturbance induced by endovascular stents,” Ann Biomed Eng, vol.33, pp. 444-456, 2005. [84] J. R. Womersley, 'Method for the calculation of velocity, rate of flow and viscous drag in arteries when the pressure gradient is known,' The Journal of physiology, vol. 127, p. 553, 1955. [85] W. Fu, Z. Gu, X. Meng, et al, 'Numerical simulation of hemodynamics in stented internal carotid aneurysm based on patient-specific model,' Journal of Biomechanics, vol. 43, pp. 1337-1342, 2010. [86] L. D. Jou, and M. E. Mawad, 'Hemodynamic effect of neuroform stent on intimal hyperplasia and thrombus formation in a carotid aneurysm,' Medical engineering & physics, vol. 33, pp. 573-580, 2011. [87] P. K. Nelson, P. Lylyk, I. Szikora, et al, 'The pipeline embolization device for the intracranial treatment of aneurysms trial,' American Journal of Neuroradiology, vol. 32, pp. 34-40, 2011. [88] G. Janiga, C. Rössl, M. Skalej, and D. Thévenin, 'Realistic virtual intracranial stenting and computational fluid dynamics for treatment analysis,' Journal of biomechanics, vol. 46, pp. 7-12, 2013. [89] L. Boussel, V. Rayz, C. McCulloch, et al, 'Aneurysm growth occurs at region of low wall shear stress: patient-specic correlation of hemodynamics and growth in a longitudinal study,' Stroke, vol. 39, pp. 2997-3002, 2008. [90] V. L. Rayz, L. Boussel, M. T. Lawton, et al, 'Numerical modeling of the flow in intracranial aneurysms: prediction of regions prone to thrombus formation,' Ann Biomed Eng, vol. 36, pp. 1793-1804, 2008. [91] Y. Qian, H. Takao, K. Fukui, et al, 'Computational risk parameter analysis and geometric estimation for cerebral aneurysm growth and rupture,' Stroke, vol. 39, pp. 527-729, 2008. [92] M. Shojima, M. Oshima, K. Takagi, et al, 'Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms,' Stroke, vol. 35, pp. 2500-2505, 2004. [93] 柯俊誼, '鎳鈦合金於植入式醫療器材上的多種應用,' 2016. [94] C. L. Chu, R. M. Wang, T. Hu, et al, 'Surface structure and biomedical properties of chemically polished and electropolished NiTi shape memory alloys,' Materials Science and Engineering: C, vol. 28, pp. 1430-1434, 2008. [95] Á. Lengyel, P. Nagy, E. Bognár, et al, 'Development of Nitinol Stents: Electropolishing Experiments,' Materials Science Forum, vol. 729, pp. 436-441, 2012. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/77597 | - |
dc.description.abstract | 顱內動脈瘤為血管壁弱化導致局部病理性擴張的腦血管疾病,隨著動脈瘤擴大,其可能壓迫到鄰近組織,或破裂造成嚴重併發症甚至猝死。顱內動脈瘤治療的標準方法為開顱手術及白金線圈栓塞術,目的為阻擋血液進入動脈瘤以降低動脈瘤破裂的風險。近年來新的治療方法「血液分流器」漸漸普及,其部署於母血管以導引血流方向,將動脈瘤阻隔於血液循環外,但仍有許多臨床問題待解。本研究提出治療顱內動脈瘤的創新介入性裝置「Hybrid血液分流器」,此概念乃全球首創,使血液分流器擁有多種密度的網眼,其中密的網眼面向動脈瘤,確保阻斷進入動脈瘤的血流量,與母血管接觸的部分,則為較疏的網眼,避免阻塞母血管。本文著眼於創新性Hybrid血液分流器的開發,從設計最佳化到製程、部署過程的有限元素分析及部署前後的血液動力學分析,並實際製造出雛型品。參數化設計將網眼密度分配進行了最佳化的調整,接著以有限元素模型進行Hybrid血液分流器製造過程及部署至動脈瘤母血管的模擬,以分析Hybrid血液分流器的機械性質,並以Goodman疲勞安全係數分析來評估Hybrid血液分流器的抗疲勞強度。最後本研究建立了血液動力學模型分析Hybrid血液分流器的性能,模擬結果顯示部署Hybrid血液分流器能阻擋75%至95%流入動脈瘤的血液,動脈瘤囊的壁面剪應力大幅下降,動脈瘤內的平均滯留時間也提升為原本的12.47倍,延長淤滯可促進血栓形成,血液流場狀態更穩定,大幅降低動脈瘤破裂的風險;同時母血管的網眼較疏,低壁面剪應力面積也較少,可以避免血管狹窄。模擬結果符合預期後,本研究以鎳鈦合金無縫微管進行雷射切削加工,再進行熱處理定型、噴砂、電解拋光等處理,進行Hybrid血液分流器雛型品的製造,並將雛型品部署於血管模型作為概念展示。 | zh_TW |
dc.description.abstract | An intracranial aneurysm is a cerebrovascular disorder in which structural weakening of the wall media causes localized pathological dilation of the blood vessel. As an aneurysm grows, it puts pressure on adjacent structures and may eventually rupture, leading to severe complications or even sudden death. The standard treatments for intracranial aneurysms include traditional craniotomy and endovascular coiling. The purpose of these treatments is to stop the blood flow into the aneurysm to reduce the risk of rupture. In recent years, another new device, called “flow diverter”, has gained popularity. It is placed in the parent artery in order to divert the blood flow away from the weakened area, isolating aneurysms from normal circulation. Although flow diverter stents have great potential, there remains clinical issues to be resolved. In this research, a novel interventional device concept for treatments of intracranial aneurysm, called “hybrid flow diverter”, is proposed. The hybrid flow diverter concept is the first of its kind in the world. The hybrid flow diverter is designed to have variable metal densities, with the denser side facing the aneurysm to block the blood supply and the lighter side facing the parent artery to prevent in-stent stenosis. Development of hybrid flow diverter is proposed in this research, including optimal design, finite element analysis of manufacturing and deployment processes, hemodynamic analysis before and after deployment, and manufacturing processes. Parametric design methodology was used to achieve the optimal design. Finite element models were developed to analyze the mechanical behavior of the device during manufacturing and deployment processes. Goodman life analysis was used to evaluate the fatigue resistance of hybrid flow diverter. Hemodynamic models were established to evaluate the performance of hybrid flow diverter. Results show that hybrid flow diverter stops 75%-95% blood flow into the aneurysm. Wall shear stress in aneurysm sac drops significantly after deployment of hybrid flow diverter. Average residence time within the aneurysm is increased by 12.47 times, elongating the stasis and producing thrombogenic conditions. The blood flow field is more stable, significantly reducing the risk of aneurysm rupture. Low wall shear stress area in parent artery is reduced due to the lighter side of hybrid flow diverter, thus preventing in-stent thrombosis or stenosis. After expected results of computational modeling, a pulsed-fiber optic laser, expansions, heat treatments, and polishing technologies were used on nitinol seamless tube to make the first prototype of hybrid flow diverter. The hybrid flow diverter was then deployed in an aneurysm model for demonstration. | en |
dc.description.provenance | Made available in DSpace on 2021-07-10T22:10:48Z (GMT). No. of bitstreams: 1 ntu-107-R05522822-1.pdf: 5571717 bytes, checksum: d94f3060d1738e236acf4b8540545533 (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 口試委員審定書 ii
誌謝 iii 摘要 iv Abstract v 目錄 vii 圖目錄 ix 表目錄 xii 第一章 緒論 1 1.1. 前言 1 1.2. 顱內動脈瘤 1 1.3. 血液分流器(Flow Diverter) 8 1.4. 血管壁剪應力(Wall Shear Stress, WSS) 10 1.5. 研究目的與研究內容 11 第二章 Hybrid血液分流器設計 14 2.1. 血液分流器基本設計 14 2.2. Hybrid血液分流器設計概念 15 2.3. Hybrid血液分流器模型幾何 19 第三章 Hybrid血液分流器有限元素模型 21 3.1. Hybrid血液分流器製程有限元素模型 21 3.1.1. Hybrid血液分流器製程模型設定 21 3.1.2. Hybrid血液分流器製程模擬設定 26 3.1.3. 觀察指標 27 3.2. Hybrid血液分流器製程模擬結果 29 3.3. Hybrid血液分流器部署有限元素模型 32 3.3.1. Hybrid血液分流器部署方法 32 3.3.2. Hybrid血液分流器部署模型設定 34 3.3.3. Hybrid血液分流器部署模擬設定 38 3.4. Hybrid血液分流器部署模擬結果 40 第四章 Hybrid血液分流器血液動力學模型 43 4.1. 物理模型與統御方程式 43 4.1.1. 流體性質 43 4.1.2. 統御方程式 44 4.1.3. Womersley Flow 45 4.2. 血液動力學模型 47 4.2.1. 模型設定 47 4.2.2. 邊界條件 49 4.2.3. 網格劃分 51 4.2.4. 觀察指標 52 4.2.5. 模擬結果 55 第五章 Hybrid血液分流器雛型品製造 62 5.1. 雛型品製造 62 5.1.1. 雷射切削加工模組及參數設定 62 5.1.2. 熱處理加工模組及參數設定 63 5.1.3. 表面處理加工模組及參數設定 64 5.1.4. 雛型品展示 66 5.2. 顱內動脈瘤部署模型雛型品 68 第六章 結論與未來展望 70 參考文獻 73 | |
dc.language.iso | zh-TW | |
dc.title | 創新複合式血液分流器的設計與開發 | zh_TW |
dc.title | Design and Development of Novel Hybrid Flow Diverter | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 劉建豪(Chien-Hao Liu),楊士進(Shih-Chin Yang) | |
dc.subject.keyword | 有限元素法,血液動力學,鎳鈦合金,複合式血液分流器,顱內動脈瘤,壁面剪應力, | zh_TW |
dc.subject.keyword | Finite element analysis,Hemodynamics,Nitinol,Hybrid flow diverter,Intracranial aneurysm,Wall shear stress, | en |
dc.relation.page | 83 | |
dc.identifier.doi | 10.6342/NTU201802098 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2018-07-30 | |
dc.contributor.author-college | 工學院 | zh_TW |
dc.contributor.author-dept | 機械工程學研究所 | zh_TW |
顯示於系所單位: | 機械工程學系 |
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