JP-7854741-B2 - Coronary artery motion simulator and vascular model

JP7854741B2JP 7854741 B2JP7854741 B2JP 7854741B2JP-7854741-B2

Inventors

岩▲崎▼ 清隆
陸洪澤
北場紀香
岡村誉之

Assignees

学校法人早稲田大学

Dates

Publication Date: 20260507
Application Date: 20220515

Claims (11)

A coronary artery motion simulator that simulates the movement of the coronary arteries in conjunction with the beating of the heart, The system comprises a vascular model that simulates a predetermined portion of the coronary artery, and a model support unit that supports the vascular model. The coronary artery motion simulator is characterized in that the model support unit holds the blood vessel model, which is positioned at an angle with respect to its installation surface, so that it can rotate along a predetermined plane, and by repeatedly performing this rotation in forward and reverse directions, it is possible to simulate the displacement of the blood vessel model associated with the pulsation.
The model support unit comprises an inclined platform installed on the mounting surface and a movable device having a mechanism for performing the rotational movement while holding the blood vessel model. The inclined base has an inclined surface portion that is positioned at a predetermined inclination angle with respect to the installation surface, The coronary artery motion simulator according to claim 1 , characterized in that the movable device is arranged at an inclination along the inclined surface.
The movable device comprises a support configured to enable the rotational movement and a drive device for operating the support. The coronary artery motion simulator according to claim 2 , characterized in that the drive device includes an actuator that applies an external force to the support, and by applying the external force, it simulates the displacement of the blood vessel model associated with the pulsation.
The support comprises a fixing part fixed to the inclined surface and an operating part connected to the fixing part so as to be rotatable relative to the surface of the fixing part. The coronary artery motion simulator according to claim 3, characterized in that the operating unit comprises a base having a structure that can rotate along the surface of the fixed unit by the drive of the drive device, and a model holding unit that is positioned upright relative to the base and can detachably hold the blood vessel model.
The model holding portion is positioned to hold the blood vessel model at a predetermined angle of inclination relative to a reference line within the base that is aligned with the inclination direction of the inclined surface portion, in a plan view. The coronary artery motion simulator according to claim 4 , characterized in that the operating unit has a structure that rotates relative to the fixed unit within a predetermined range of rotation angle and displacement.
The actuator applies an external force to the base while repeatedly performing a linear reciprocating motion in one direction. The coronary artery motion simulator according to claim 4, characterized in that the operating unit is configured to rotate in forward and reverse directions within a predetermined range of rotation angle and displacement relative to the fixed unit by the linear reciprocating motion of the actuator, thereby causing the blood vessel model to oscillate relative to the fixed unit.
The aforementioned vascular model has a three-dimensional shape that simulates the bifurcation of the left main coronary artery. The model holding portion is provided so as to be able to hold the blood vessel model at a predetermined inclination angle that is inclined vertically with respect to the base, The coronary artery motion simulator according to claim 5, characterized in that the respective inclination angles of the inclined table and the model holder, and the positioning angle of the model holder with respect to the reference line on the base, are set to angles that match the condition of the left main coronary artery bifurcation of a patient during actual surgery.
The drive device further comprises a control unit for controlling the drive of the actuator, The control unit drives the actuator in the forward direction for a period of time that is the sum of a drive time corresponding to the time from the diastole to the systole of the heart and a predetermined stop time, and repeatedly drives the actuator in a cycle that also includes driving in the reverse direction, as described in claim 6 .
The coronary artery motion simulator according to claim 6 , characterized in that the operating part of the actuator is connected via a universal joint to an end of the operating part that is far from the center of rotation of the operating part.
A vascular model used in the coronary artery motion simulator described in claim 1 , which simulates the bifurcation of the left main coronary artery, A vascular model characterized by comprising a main section corresponding to the main trunk of the left coronary artery and branch sections corresponding to the anterior descending branch and circumflex branch of the left coronary artery, wherein the branch sections are formed in a three-dimensional shape so as to branch into two relative to the main section in a plan view and bend at a predetermined angle relative to the main section in a side view.
The blood vessel model according to claim 10 , characterized in that the luminal cross-section is formed in an elliptical shape.

Description

This invention relates to a coronary artery motion simulator that simulates the movement of coronary arteries in conjunction with the beating of the heart, and a vascular model used therein. The coronary arteries are blood vessels that supply blood to the surface of the heart to power the heart muscle. They consist of the left and right coronary arteries, which branch off from the base of the aorta. The left coronary artery is a very important vessel, supplying oxygenated and nutrient-rich blood to power the left ventricular heart muscle, which plays a vital role in pumping blood throughout the body. This left coronary artery branches from the main trunk (LMT) that connects to the aorta into the left anterodescending coronary artery (LAD) and the circumflex coronary artery (LCx). The anterior descending artery (LAD) is mainly responsible for supplying blood to the anterior wall and intermyocardial septum of the left ventricle, while the circumflex artery (LCx) is responsible for supplying blood from the lateral wall to the posterior wall of the left ventricle. Ischemic heart disease, in which the heart does not receive enough blood due to narrowing or blockage of the coronary arteries, is primarily treated with drug therapy, coronary artery bypass surgery (which involves creating bypass vessels before and after the narrowing), and percutaneous coronary intervention (CPR) using a catheter. One type of CPR is stent-assisted coronary intervention. In this treatment, a metal mesh stent crimped onto a polymer thin-film balloon is inserted through a blood vessel in the groin or wrist using a catheter. The stent is then transported through the blood vessel to the narrowed area, and the balloon is expanded, causing the narrowed lesion to expand and compress within the blood vessel, thus ensuring blood flow. Among ischemic heart diseases, left main coronary artery bifurcation lesions are conditions in which stenosis or occlusion occurs in the blood vessels at the base of the anterior descending artery (LAD) and circumflex artery (LCx) that branch off from the main coronary artery (LMT), and can be directly life-threatening. Stent treatment for left main coronary artery bifurcation lesions presents challenges in terms of long-term outcomes compared to coronary artery bypass surgery, and many clinical technique improvements are being considered to improve treatment outcomes. Recently, advances in drug-eluting stents have improved treatment outcomes, and coronary intervention is now acceptable for relatively simple left main coronary artery bifurcation lesions that can be treated with a single stent. On the other hand, for complex left main coronary artery bifurcation lesions, a two-stent approach using two stents is necessary, but due to the high frequency of thrombosis and restenosis, coronary artery bypass surgery is recommended. In clinical practice, treatment of the left main coronary artery bifurcation is performed while the heart is beating, making it difficult to identify the structure of the stent within the coronary artery on the X-ray fluoroscopy screen. Furthermore, due to limitations in the mobility of the X-ray angiography equipment used in clinical treatment, the anterior descending artery (LAD) and circumflex artery (LCx) may appear to overlap. Additionally, because it is a fluoroscopic image, treatment is performed while observing from a surrogate viewpoint that shortens the length of the vessel. Therefore, to verify and evaluate which techniques can appropriately expand the lesion with two stents while suppressing stent protrusion into the vascular lumen, which can cause thrombosis, an experimental system that reflects real-world clinical practice is necessary. The inventors have previously conducted research and development on stent treatment methods and stent selection using an elastic vascular model that mimics the diameter and angle of a bifurcation vessel of the left main coronary artery, while the model is stationary (see Non-Patent Literature 1). Yutaka Hikichi, Kiyotaka Iwasaki et al., Reduction in incomplete stent apposition area caused by jailed struts after single stenting at left main bifurcation lesions: micro-CT analysis using a three-dimensional elastic bifurcated coronary artery model, Cardiovasc Interv and Ther, 2017 January, 32, P.12-17 This is a conceptual diagram of a side view of the coronary artery motion simulator according to this embodiment.This is a schematic front view of the simulated blood vessel unit.This is a schematic side view of a simulated blood vessel unit.This is a schematic plan view of the movable device.This is a schematic perspective view of the support structure.This is a schematic perspective view of the fixing part as seen from the top.This is a schematic front view of the fixed part.This is a schematic perspective view of the operating part as seen from the back.This is a schematic front view of the operating section.This is a schematic plan view of the mov