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

Martín, David; Boyle, Fergal

doi:10.1007/s13239-015-0219-9

Cited by 13 publications

(11 citation statements)

References 92 publications

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“…In particular, increasing strut thickness and number of stent struts resulted in an increase of area exposed to low WSS [17]. This has recently been confirmed by a biomechanical analysis, whose results corroborate the findings of the large-scale ISAR STEREO clinical trials and highlight the crucial role of strut thickness in coronary stent design [22]. Moreover, streamlined stent structure profiles (e.g.…”

Section: Local Flow Modifications After Stent Implantationsupporting

confidence: 56%

Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions

et al. 2021

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Although the coronary arteries are uniformly exposed to systemic cardiovascular risk factors, atherosclerosis development has a non-random distribution, which follows the local mechanical stresses including flow-related hemodynamic forces. Among these, wall shear stress plays an essential role and it represents the major flow-related factor affecting the distribution of atherosclerosis in coronary bifurcations. Furthermore, an emerging body of evidence suggests that hemodynamic factors such as low and oscillating wall shear stress may facilitate the development of in-stent restenosis and stent thrombosis after successful drug-eluting stent implantation. Drug-eluting stent implantation represents the gold standard for bifurcation interventions. In this specific setting of interventions on bifurcated lesions, the impact of fluid dynamics is expected to play a major role and constitutes substantial opportunity for future technical improvement. In the present review, available data is summarized regarding the role of local fluid dynamics in the clinical outcome of patients with bifurcated lesions.

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Section: Local Flow Modifications After Stent Implantationsupporting

confidence: 56%

Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions

et al. 2021

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“…During the CFD analysis, the stented coronary lumen is assumed to be completely rigid and no‐slip boundary conditions are applied to the external surface of the fluid . A transient fully developed Hagen‐Poiseuille parabolic velocity profile is applied at the inlet surface.…”

Section: Methodsmentioning

confidence: 99%

Computational modelling of magnesium stent mechanical performance in a remodelling artery: Effects of multiple remodelling stimuli

Boland

Grogan

McHugh

2019

Numer Methods Biomed Eng

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Significant research has been conducted in the area of coronary stents/scaffolds made from resorbable metallic and polymeric biomaterials. These next‐generation bioabsorbable stents have the potential to completely revolutionise the treatment of coronary artery disease. The primary advantage of resorbable devices over permanent stents is their temporary presence which, from a theoretical point of view, means only a healed coronary artery will be left behind following degradation of the stent potentially eliminating long‐term clinical problems associated with permanent stents. The healing of the artery following coronary stent/scaffold implantation is crucial for the long‐term safety of these devices. Computational modelling can be used to evaluate the performance of complex stent devices in silico and assist in the design and development and understanding of the next‐generation resorbable stents. What is lacking in computational modelling literature is the representation of the active response of the arterial tissue in the weeks and months following stent implantation, ie, neointimal remodelling, in particular for the case of biodegradable stents. In this paper, a computational modelling framework is developed, which accounts for two major physiological stimuli responsible for neointimal remodelling and combined with a magnesium corrosion model that is capable of simulating localised pitting (realistic) stent corrosion. The framework is used to simulate different neointimal growth patterns and to explore the effects the neointimal remodelling has on the mechanical performance (scaffolding support) of the bioabsorbable magnesium stent.

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“…Strut thickness, for instance, has been found to be an important factor in predicting a stent's performance. [37][38][39] A benefit of CFD is it makes it possible to accurately analyse the myriad of factors that cause potentially devastating stent-related complications, including malpositioning, neointimal hyperplasia and collapse. 40,41 Vascular surgeons are then able to identify patients at high risk of such complications, and can decide to implement prophylactic interventions.…”

Section: Stent Designmentioning

confidence: 99%

Computational Fluid Dynamics and Aortic Dissections: Panacea or Panic?

Wee

Ong

Syn

et al. 2018

Vascular and Endovascular Review

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This paper reviews the methodology, benefits and limitations associated with computational flow dynamics (CFD) in the field of vascular surgery. Combined with traditional imaging of the vasculature, CFD simulation enables accurate characterisation of real-time physiological and haemodynamic parameters such as wall shear stress. This enables vascular surgeons to understand haemodynamic changes in true and false lumens, and exit and re-entry tears. This crucial information may facilitate triaging decisions. Furthermore, CFD can be used to assess the impact of stent graft treatment, as it provides a haemodynamic account of what may cause procedure-related complications. Efforts to integrate conventional imaging, individual patient data and CFD are paramount to its success, given its potential to replace traditional registry-based, population-averaged data. Nonetheless, methodological limitations must be addressed before clinical implementation. This must be accompanied by further research with large sample sizes, to establish the association between haemodynamic patterns as observed by CFD and progression of aortic dissection.

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

Cited by 13 publications

References 92 publications

Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions

Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions

Computational modelling of magnesium stent mechanical performance in a remodelling artery: Effects of multiple remodelling stimuli

Computational Fluid Dynamics and Aortic Dissections: Panacea or Panic?

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