Design considerations for studies of the biomechanical environment of the femoropopliteal arteries

Ansari, Farzana; Pack, Lindsay K.; Brooks, Steven S.; Morrison, Tina

doi:10.1016/j.jvs.2013.03.052

Cited by 84 publications

(87 citation statements)

References 23 publications

(30 reference statements)

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“…because the SFA and PA that comprise the FPA segment, undergo large deformations during flexion of the limb [9,14]. These severe deformations are reflected clinically by the frequency of disease development and the high incidence of stent fractures [2,31 -33], and are believed to contribute to poor clinical outcomes of current open and endovascular PAD treatments [9]. Torsion is one of the main deformation modes, but is also the most challenging to measure in vivo due to lack of identifiable arterial markers that can be tracked with limb flexion.…”

Section: Discussionmentioning

confidence: 99%

“…A major difference between the FPA and other arterial segments are the large deformations experienced by the SFA and PA during flexion of the limbs. These deformations are particularly important for the design of FPA stents, as the inability of certain stent designs to accommodate these severe deformations during locomotion may result in arterial wall injury, poor device apposition and even fracture of the stent [9]. All these can lead to deleterious cellular and biochemical responses, culminating in restenosis and reconstruction failure [2,[10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

Desyatova

Poulson

Deegan

et al. 2017

J. R. Soc. Interface.

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High failure rates of femoropopliteal artery (FPA) interventions are often attributed to severe mechanical deformations that occur with limb movement. Torsion of the FPA likely plays a significant role, but is poorly characterized and the associated intramural stresses are currently unknown. FPA torsion in the walking, sitting and gardening postures was characterized in n ¼ 28 in situ FPAs using intra-arterial markers. Principal mechanical stresses and strains were quantified in the superficial femoral artery (SFA), adductor hiatus segment (AH) and the popliteal artery (PA) using analytical modelling. The FPA experienced significant torsion during limb flexion that was most severe in the gardening posture. The associated mechanical stresses were non-uniformly distributed along the length of the artery, increasing distally and achieving maximum values in the PA. Maximum twist in the SFA ranged 10-138 cm 21, at the AH 8-168 cm 21, and in the PA 14-268 cm 21 in the walking, sitting and gardening postures. Maximum principal stresses were 30-35 kPa in the SFA, 27-37 kPa at the AH and 39-43 kPa in the PA. Understanding torsional deformations and intramural stresses in the FPA can assist with device selection for peripheral arterial disease interventions and may help guide the development of devices with improved characteristics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

Desyatova

Poulson

Deegan

et al. 2017

J. R. Soc. Interface.

View full text Add to dashboard Cite

show abstract

“…De-spite that stent implants are efficient in restoring normal blood flow over time new blockage can form called restenosis [1]. Research studies based on clinical data have concluded that in addition to stent design, the geometry of the artery can contribute to the development of restenosis [4,21,22]. For example several conditions such as twisting, compression, elongation and flexion as shown in Figure 3 can be noted for artery.…”

Section: J Biomed Eng Res 2016 | Vol 1: 102 Jscholar Publishersmentioning

confidence: 99%

“…The possibilities of Finite Element Analysis (FEA) and Computational Fluid Dynamics (CFD), combined with contemporary imaging techniques, greatly facilitate stent research. Tremendous amount of research has been done on coronary artery stenting, on stent geometry, and on estimating artery-stent interaction however, very little is reported on superficial artery stenting and the process of using real artery geometry from patient data for the computational models [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Most studies estimate the geometry of the artery as cylinder with uniform diameter across its length where in reality arteries have curves and tortuosity specific to the patient anatomy [1,2,4]. Several aspects need to be considered in order for computational models to accurately estimate the artery-stent biomechanical environment and the issues causing stent failure.…”

Section: Introductionmentioning

confidence: 99%

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Study of Non-Linear Deformation of Peripheral Stent Mechanics Using Computational Approach

Fortier¹

2016

Journal of Biomedical Engineering and Research

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Stent implants, specifically those implanted in Superficial Femoral Artery (SFA) in the lower limbs, are prone to high failure rates. The failures can occur due to abnormal behavior of the blood flow, mechanical forces from the arterial wall imposed on the stent, as well as leg movements such as bending, torsion, compression, and elongation that can create dynamic arterial environment imposed on the stent. In order to prevent high failure rates of peripheral stents there is a need to understand the unique biomechanical environment and the characteristics of the SFA arterial segment where stent is implanted. This study presents several steps that need to be taken into consideration before the complex and combined stent-artery-environment model can be created and analyzed. Results show finite element computational approach that demonstrates stent characteristics upon insertion inside the artery, creation of arterial segment with geometry and characteristics from real patient data, and theoretical approach to accurately impose blood flow onto the artery-stent model. This study recommends procedure for analyzing biomechanical environment of the stent-artery system using real artery geometry. Results show that stent design and artery specific geometry play a critical role in stent performance.

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Design and use of an ex vivo peripheral simulating bioreactor system for pharmacokinetic analysis of a drug coated stent

Chen,

Krinsky,

Phillips

et al. 2023

Bioengineering & Transla Med

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Currently, there are no ex vivo systems that can model the motion of peripheral arteries and allow for the evaluation of pharmacokinetics (PK) of endovascular devices. The objective of this study was to develop a novel peripheral simulating bioreactor system to evaluate drug pharmacokinetics of stents. We utilized 3D‐printed and off‐the‐shelf components to construct a peripheral‐simulating bioreactor system capable of mimicking the motion of peripheral arteries. Servo motors were primarily used to shorten/elongate, twist, and bend explanted porcine carotid arteries. To evaluate the pharmacokinetics in the bioreactor, drug‐eluting stents were deployed within explanted arteries and subjected to vascular motion along with pulsatile flow conditions. Following 30 min and 24 h, the arteries were removed, and paclitaxel levels were measured. Scanning electron microscopy was also performed to evaluate the stent surface. Arterial paclitaxel levels of the stent‐treated arteries were found to be higher at 30 min than at 24 h following pulsatile and no vascular motion and even higher at 24 h following pulsatile flow and vascular motion. The residual drug on the stent significantly decreased from 30 min to 24 h. Scanning electron microscopy confirmed the loss of paclitaxel coating at 24 h and greater disturbance in stents under peripheral motion versus pulsatile only. This system represents the first ex vivo system to determine the PK of drug‐eluting stents under physiological flow and vascular motion conditions. This work provides a novel system for a quick and inexpensive preclinical tool to study acute drug tissue concentration kinetics of drug‐releasing interventional vascular devices designed for peripheral applications.

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Design considerations for studies of the biomechanical environment of the femoropopliteal arteries

Cited by 84 publications

References 23 publications

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

Limb flexion-induced twist and associated intramural stresses in the human femoropopliteal artery

Study of Non-Linear Deformation of Peripheral Stent Mechanics Using Computational Approach

Design and use of an ex vivo peripheral simulating bioreactor system for pharmacokinetic analysis of a drug coated stent

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