Stress-stretch curves of planar biaxial tests of healthy aortic tissue ( ) Average stress in a fiber family at time , see Equation 23 Undeformed collagen fiber orientation vector Deviatoric part of a constituent-specific right Cauchy-Green tensor, see Equation 3

The constrained mixture theory is an elegant way to incorporate the phenomenon of residual stresses in patient-specific finite element models of arteries. This theory assumes an in vivo reference geometry, obtained from medical imaging, and constituent-specific deposition stretches in the assumed reference state.

Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model’s clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.

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Computational investigations of how soft tissues grow and remodel are gaining more and more interest and several growth and remodeling theories have been developed. Roughly, two main groups of theories for soft tissues can be distinguished: kinematic-based growth theory and theories based on constrained mixture theory. Our goal was to apply these two theories on the same experimental data. Within the experiment, a pulmonary artery was exposed to systemic conditions. The change in diameter was followed-up over time.A mechanical and microstructural analysis of native pulmonary artery and pulmonary autograft was conducted. Whereas the kinematic-based growth theory is able to accurately capture the growth of the tissue, it does not account for the mechanobiological processes causing this growth. The constrained mixture theory takes into account the mechanobiological processes including removal, deposition and adaptation of all structural constituents, allowing us to simulate a changing microstructure and mechanical behavior.

Finite element modeling is often used in biomechanical engineering to evaluate medical devices, treatments and diagnostic tools. Using an adequate material model that describes the mechanical behavior of biological tissues is essential for a reliable outcome of the simulation. Pre-programmed material models for biological tissues are available in many finite element software packages. However, since these pre-programmed models are presented to the user as a black box, without the possibility to modify the material description, many researchers turn to implementing their own material formulations. This is a complex undertaking, requiring extensive knowledge while documentation is limited.This paper provides a detailed description, at the level of the biomedical engineer, of the implementation of a nonlinear hyperelastic material model using user subroutines in Abaqus R , in casu UANISOHYPER_INV and UMAT. The Gasser-Ogden-Holzapfel material model is used as an example, resulting in four implementation variations: the built-in implementation, a UANISOHYPER_INV formulation, a UMAT with analytical tangent stiffness formulation and a UMAT with numerical tangent stiffness formulation. In addition, three different element formulations are used: a continuum compressible, a continuum incompressible and a plane stress incompressible. All cases are thoroughly verified by applying a series of deformations on a single cube element and by simulating an

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