Effects of different stent designs on local hemodynamics in stented arteries

Abstract

Following the deployment of a coronary stent and disruption of an atheromatous plaque, the deformation of the arterial wall and the presence of the stent struts create a new fluid dynamic field, which can cause an abnormal biological response. In this study 3D computational models were used to analyze the fluid dynamic disturbances induced by the placement of a stent inside a coronary artery. Stents models were first expanded against a simplified arterial plaque, with a solid mechanics analysis, and then subjected to a fluid flow simulation under pulsatile physiological conditions. Spatial and temporal distribution of arterial wall shear stress (WSS) was investigated after the expansion of stents of different designs and different strut thicknesses. Common oscillatory WSS behavior was detected in all stent models. Comparing stent and vessel wall surfaces, maximum WSS values (in the order of 1Pa) were located on the stent surface area. WSS spatial distribution on the vascular wall surface showed decreasing values from the center of the vessel wall portion delimited by the stent struts to the wall regions close to the struts. The hemodynamic effects induced by two different thickness values for the same stent design were investigated, too, and a reduced extension of low WSS region (<0.5Pa) was observed for the model with a thicker strut.

Predicting neointimal hyperplasia in stented arteries using time-dependant computational fluid dynamics: A review

“…Balossino et al [44] have also compared four commercially available stent designs. In the paper, stents A, B, C and D correspond to the Bx-Velocity stent, Jostent Flex (JOMED AB, Helsingborg, Sweden), Sorin Carbostent (Sorin Biomedica, Saluggia, Italy) and the Palmaz-Schatz (Johnson and Johnson Interventional system, NJ, USA) respectively.…”

Sequential Structural and Fluid Dynamics Analysis of Balloon-Expandable Coronary Stents: A Multivariable Statistical Analysis

“…Despite this observation, very few studies have adopted a sequential analysis methodology to assess both the mechanical and hemodynamic impact of stent deployment. 2,11,38,43,58,60,61,70,93 Furthermore, no study has yet employed a sequential analysis methodology to compare and contrast the performance of several different coronary stent designs.…”

“…In studies carried out by Bolassino et al in 2008, 2 Chiastra et al in 2013 11 and Martin et al in 2014, 58 a sequential structural and fluid dynamics analysis methodology was employed to investigate the hemodynamic impact of several stent designs. Although a number of stent designs were evaluated in these studies, they focused exclusively on the hemodynamic impact of the stents and their mechanical impact was not reported.…”

Fusion of optical coherence tomography and angiography for numerical simulation of hemodynamics in bioresorbable stented coronary artery based on patient-specific model

“…Eric et al [10] investigated the hemodynamic changes associated with stent malapposition in an idealized coronary artery. Balossino et al [11] illustrated the effects of different stent designs on local hemodynamics in stented arteries. Berry et al [12] performed the flow evaluation of coronary stents.…”