Abstract. BACKGROUND: Vascular stenting has been widely used to treat vessel stenosis. However, long-term successes of the procedure are often compromised by late stent thrombosis (ST) and in-stent restenosis (ISR), especially in tapered arteries. OBJECTIVE: The aim of this study was to choose a reasonable expansion strategy for tapered arteries. METHODS: A balloonexpandable coronary stent deployment in a tapered vessel was numerically studied fol-lowing three strategies: (i) selecting the proximal diameter of the tapered vessel as the reference diameter to expand the stent, (ii) selecting the middle diameter of the tapered vessel as the reference diameter to expand the stent, and (iii) selecting the distal diameter of the tapered vessel as the reference diameter to expand the stent. RESULTS: Computational results showed that the first expansion strategy resulted in the maximum vessel stress and the best stent apposition, while the third strategy resulted in the minimal vessel stress and the worst stent appo-sition. Meanwhile, the second expansion strategy achieved a trade-off between the first and third strategies, leading to acceptable vessel stress and stent apposition. CONCLUSIONS: The second expansion strategy is the most reasonable choice for tapered vessels, and it should be considered when implanting a stent.
Flexibility is one of the important mechanical performance parameters of stent. The flexibility of tapered stents, especially self-expanding tapered stents, remains unknown. In this study, we developed a new selfexpanding tapered stent for tapered arteries and performed a numerical investigation of stent flexibility by using finite element method. The effect of stent design parameters, including taper and link space width, on stent flexibility was studied. The flexibility of the proposed stent was also compared with that of traditional cylindrical stents. Results show that the tapered stent is more flexible than the traditional cylindrical stent. Furthermore, the flexibility of the tapered stent increases with increasing stent taper and stent link space width. The increase in the stent link space width can contribute to the reduction in the peak stress. Therefore, tapered stents with high link space width will improve the stent flexibility. This work provides useful information for improvement of stent design and clinical selection.
Vessel flexure can be triggered naturally by surgical operation, heart pulsation and body movement. It may affect the mechanical behavior of the stent and the existence of a stent may in turn cause vessel injury. In the present study, the finite element method is employed to study the interaction between stent and vessel during vessel flexure. Two- and four-link stents made of stainless steel 316L and magnesium alloy WE43 are considered. Results indicate that longitudinal deformation of the stent can be caused by vessel flexure, and the higher levels of stress exist in the link struts. The existence of the stent could induce significant stress concentration and straightened deformation on vessel wall in the course of vessel flexure. Stents with more links or made of harder materials show greater anti-deformation capability, thus inducing a more severe stress concentration and straightened deformation on the vessel wall. The bending direction also affects the mechanical performance of the vessel-stent system. The results obtained could provide useful information for better stent designs and clinical decisions.
Flexibility is a vital property of stents and different stent structures lead to different flexibility behaviors. In this study, the finite element analysis was adopted and a virtual bending deformation was imposed to quantify the effects of linker pattern, linker number, bending direction and linker location on flexibility. Stent performance indicators, including stress distribution, deformation patterns and bending stiffness, were examined. Results indicate that higher levels of stresses are found on the linker struts, associated with much larger deformation. The linker number plays the most significant role in flexibility, and simply decreasing linker number could result in a sharp increase in flexibility and a decrease in stress. The linker pattern has great impact on stent flexibility, especially on the behavior of self-contact. Stents with different linker patterns could respond differently in the course of bending, and the stent with an offset peak-to-peak linker pattern is the best choice. It is also found that stent flexibility can be improved when fewer linkers lie in the compression area and the linker directions between two adjacent rows are consistent. The results obtained could provide useful information for the improvement of stent design and clinical choice.
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