In Silico Assessment of the effects of Material on Stent Deployment

Coronary stents are expandable scaffolds that are used to widen occluded diseased arteries and restore blood flow. Because of the strain they are exposed to and forces they must resist as well as the importance of surface interactions, material properties are dominant. Indeed, a common differentiating factors amongst commercially available stents is their material. Several performance requirements relate to stent materials including radial strength for adequate arterial support post-deployment. This study investigated the effect of the stent material in three finite element models using different stents made of: (i) Cobalt-Chromium (CoCr), (ii) Stainless Steel (SS316L), and (iii) Platinum Chromium (PtCr). Deployment was investigated in a patient specific arterial geometry, created based on a fusion of angiographic data and intravascular ultrasound images. In silico results show that: (i) the maximum von Mises stress occurs for the CoCr, however the curved areas of the stent links present higher stresses compared to the straight stent segments for all stents, (ii) more areas of high inner arterial stress exist in the case of the CoCr stent deployment, (iii) there is no significant difference in the percentage of arterial stress volume distribution among all models.

[1]  S. Chua,et al.  Finite element simulation of slotted tube (stent) with the presence of plaque and artery by balloon expansion , 2004 .

[2]  Shijia Zhao,et al.  Effects of arterial strain and stress in the prediction of restenosis risk: Computer modeling of stent trials , 2012 .

[3]  Min Qi,et al.  An FEA method to study flexibility of expanded coronary stents , 2007 .

[4]  P. Shah,et al.  Apolipoprotein A-I/HDL infusion therapy for plaque stabilization-regression: a novel therapeutic approach. , 2007, Current pharmaceutical design.

[5]  Gerhard A Holzapfel,et al.  Changes in the mechanical environment of stenotic arteries during interaction with stents: computational assessment of parametric stent designs. , 2005, Journal of biomechanical engineering.

[6]  Junaid Zafar,et al.  Medical Stents : State of the Art and Future Directions Coronary Stent Materials and Coatings : A Technology and Performance Update , 2015 .

[7]  Fanis G Kalatzis,et al.  A new methodology for accurate 3-dimensional coronary artery reconstruction using routine intravascular ultrasound and angiographic data: implications for widespread assessment of endothelial shear stress in humans. , 2013, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[8]  Caitríona Lally,et al.  Simulation of a balloon expandable stent in a realistic coronary artery-Determination of the optimum modelling strategy. , 2010, Journal of biomechanics.

[9]  E. Sacco,et al.  Finite-element Analysis of a Stenotic Artery Revascularization Through a Stent Insertion , 2001 .

[10]  David Martin,et al.  Computational structural modelling of coronary stent deployment: a review , 2011, Computer methods in biomechanics and biomedical engineering.

[11]  P. J. Prendergast,et al.  Elastic Behavior of Porcine Coronary Artery Tissue Under Uniaxial and Equibiaxial Tension , 2004, Annals of Biomedical Engineering.

[12]  K. Bibbins-Domingo,et al.  Global Overview of the Epidemiology of Atherosclerotic Cardiovascular Disease. , 2015, Archives of medical research.

[13]  S. Chua,et al.  Effects of varying slotted tube (stent) geometry on its expansion behaviour using finite element method , 2004 .

[14]  Lorenza Petrini,et al.  A predictive study of the mechanical behaviour of coronary stents by computer modelling. , 2005, Medical engineering & physics.

[15]  Walter Maurel,et al.  Biomechanical Models for Soft Tissue Simulation , 2003, Esprit Basic Research Series.

[16]  Caitríona Lally,et al.  The influence of plaque composition on underlying arterial wall stress during stent expansion: the case for lesion-specific stents. , 2009, Medical engineering & physics.

[17]  Gerhard A. Holzapfel,et al.  A Numerical Model to Study the Interaction of Vascular Stents with Human Atherosclerotic Lesions , 2007, Annals of Biomedical Engineering.

[18]  S. Al-Hassani,et al.  A method for investigating the mechanical properties of intracoronary stents using finite element numerical simulation. , 2001, International journal of cardiology.

[19]  Silvia Schievano,et al.  Simulation of Stent Deployment in a Realistic Human Coronary Artery , 2008 .

[20]  Sanjay Pant,et al.  Geometry parameterization and multidisciplinary constrained optimization of coronary stents , 2011, Biomechanics and Modeling in Mechanobiology.

[21]  P. Ballyk,et al.  Intramural stress increases exponentially with stent diameter: a stress threshold for neointimal hyperplasia. , 2006, Journal of vascular and interventional radiology : JVIR.

[22]  E Peña,et al.  Influence of geometrical parameters on radial force during self-expanding stent deployment. Application for a variable radial stiffness stent. , 2012, Journal of the mechanical behavior of biomedical materials.

[23]  Lorenza Petrini,et al.  On the effects of different strategies in modelling balloon-expandable stenting by means of finite element method. , 2008, Journal of biomechanics.

[24]  Lorenza Petrini,et al.  Assessment of tissue prolapse after balloon-expandable stenting: influence of stent cell geometry. , 2009, Medical engineering & physics.

[25]  Pascal Verdonck,et al.  A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-Eluting Stents , 2009, Annals of Biomedical Engineering.

[26]  Qing Li,et al.  Effects of Material on the Deployment of Coronary Stents , 2010 .

[27]  Pascal Verdonck,et al.  Realistic finite element-based stent design: the impact of balloon folding. , 2008, Journal of biomechanics.

[28]  Adel A. Abdel-Wahab,et al.  Dynamic simulation of stent deployment - effects of design, material and coating , 2013 .

[29]  C Dumoulin,et al.  Mechanical behaviour modelling of balloon-expandable stents. , 2000, Journal of biomechanics.