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Numerical Investigation of Flexibility: Open-Cell Versus Closed-Cell Stent Designs


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DOI: https://doi.org/10.15866/ireme.v14i4.18496

Abstract


This numerical study investigates the advantages/disadvantages of two commercial coronary stent designs for its flexibility. Coronary stents are medical devices used to treat atherosclerotic coronary arteries. A variety of geometrical designs of stents are available in the market which can be broadly classified as open cell and closed cell stent designs based on ‘link’ positioning. Flexibility, one of the factors impacting implantation success, is influenced by stent geometry, particularly the ‘link’. In this study flexibility of two commercial stent designs SupraflexTM (Open-cell) and Yukon Choice (Closed-cell) are investigated using Finite Element Analysis package ANSYS workbench. Realistic and idealized stent models are used for simulation to measure the performance in terms of bending moment versus curvature index plot. Results suggest an upper hand for Stent T, as Stent S demonstrated direction-specific bending nature. Results also underscore the necessity of realistic modeling of geometry as ideal models over/underestimated the stress and bending in comparison to realistic models. The study highlights the drawbacks of the two-ring ‘unit cell’ model for flexibility measurement and recommends a model based on link positioning. The results throw light on the importance of the positioning of links in improving stent flexibility.
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Keywords


Coronary Stents; Finite Element Analysis; Flexibility of Balloon Expandable Stents; Stent Bending; Stent Designs

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References


R. Ross, Atherosclerosis — An Inflammatory Disease” New Engl. J. Med. growth, vol. 340, no. 2, pp. 115–126, 1999.

L. Roger et al., Heart Disease and Stroke Statistics — 2011 Update, A Report From the American Heart Association, 2011.

D. Mozaffarian et al., AHA Statistical Update Heart Disease and Stroke Statistics — 2016 Update, A Report From the American Heart Association. 2016.

M. N. Krishnan, Coronary heart disease and risk factors in India-On the brink of an epidemic ?, Indian Heart J., vol. 64, no. 4, pp. 364–367, 2012.
https://doi.org/10.1016/j.ihj.2012.07.001

S. Ramakrishnan and S. Mishra, The report on the Indian coronary intervention data for the year 2011- National Interventional, Indian Heart J., vol. 65, no. 5, pp. 518–521, 2013.
https://doi.org/10.1016/j.ihj.2013.08.009

P. M. Looser, L. K. Kim, and D. N. Feldman, In-Stent Restenosis : Pathophysiology and Treatment, Curr Treat Options Cardio Med, vol. 18, p. 10, 2016.
https://doi.org/10.1007/s11936-015-0433-7

A. Farb et al., Pathology of Acute and Chronic Coronary Stenting in Humans, Circulation, vol. 99, pp. 44–53, 1999.

S. Garg and P. W. Serruys, Coronary Stents Current Status, J. Am. Coll. Cardiol., vol. 56, no. 10, pp. S1–S42, 2010.
https://doi.org/10.1016/j.jacc.2010.06.007

R. S. Schwartz et al., Restenosis and the Proportional Neointimal Response to Coronary Artery Injury : Results in a Porcine Model, J. Am. Coll. Cardiol., vol. 19, no. 2, pp. 267–274, 1992.
https://doi.org/10.1016/0735-1097(92)90476-4

R. A. N. Kornowski, M. U. N. K. Hong, F. O. Tio, O. Bramwell, H. Wu, and M. B. Leon, In-Stent Restenosis : Contributions of Inflammatory Responses and Arterial Injury to Neointimal Hyperplasia, J. Am. Coll. Cardiol., vol. 31, no. 1, pp. 224–230, 1998.
https://doi.org/10.1016/s0735-1097(97)00450-6

K. C. Koskinas, Y. S. Chatzizisis, A. P. Antoniadis, and G. D. Giannoglou, Role of Endothelial Shear Stress in Stent Restenosis and Thrombosis Pathophysiologic Mechanisms and Implications for Clinical Translation, J. Am. Coll. Cardiol., vol. 59, no. 15, pp. 1337–1349, 2012.
https://doi.org/10.1016/j.jacc.2011.10.903

C. Rogers, Balloon-Artery Interactions During Stent Placement A Finite Element Analysis Approach to Pressure, Compliance, and Stent Design as Contributors to Vascular Injury, Circ. Res., vol. 84, pp. 378–383, 1999.
https://doi.org/10.1161/01.res.84.4.378

J. Bedoya, Effects of Stent Design Parameters on Normal Artery Wall Mechanics, J. Biomech. Eng., vol. 128, no. 5, pp. 757–765, 2006.
https://doi.org/10.1115/1.2246236

C. Lally, Cardiovascular stent design and vessel stresses: A finite element analysis, J. Biomech., vol. 38, no. 8, pp. 1574–1581, 2005.
https://doi.org/10.1016/j.jbiomech.2004.07.022

D. Martin, Computational Fluid Dynamics Analysis of Balloon-Expandable Coronary Stents: Influence of Stent and Vessel Deformation, Med. Eng. Phys., vol. 36, no. 8, pp. 1047–1056, 2014.
https://doi.org/10.1016/j.medengphy.2014.05.011

S. Morlacchi et al., Hemodynamics and In-stent restenosis: Micro-CT images, histology, and computer simulations, Ann. Biomed. Eng., vol. 39, no. 10, pp. 2615–2626, 2011.
https://doi.org/10.1007/s10439-011-0355-9

C. Chiastra, Numerical modeling of hemodynamics in stented coronary arteries, PhD. Thesis, Politecnico di Milano, 2013.

S. Pant, G. Limbert, N. P. Curzen, and N. W. Bressloff, Multiobjective design optimisation of coronary stents, Biomaterials, vol. 32, no. 31, pp. 7755–7773, 2011.
https://doi.org/10.1016/j.biomaterials.2011.07.059

S. Pant, N. W. Bressloff, and G. Limbert, Geometry parameterization and multidisciplinary constrained optimization of coronary stents, Biomech. Model. Mechanobiol., vol. 11, no. 1–2, pp. 61–82, 2012.
https://doi.org/10.1007/s10237-011-0293-3

C. Conway, F. Sharif, J. P. McGarry, and P. E. McHugh, A Computational Test-Bed to Assess Coronary Stent Implantation Mechanics Using a Population-Specific Approach, Cardiovasc. Eng. Technol., vol. 3, no. 4, pp. 374–387, 2012.
https://doi.org/10.1007/s13239-012-0104-8

L. Petrini, Numerical investigation of the intravascular coronary stent flexibility, J. Biomech., vol. 37, no. 4, pp. 495–501, 2004.
https://doi.org/10.1016/j.jbiomech.2003.09.002

W. Wu, D. Z. Yang, M. Qi, and W. Q. Wang, An FEA method to study flexibility of expanded coronary stents, J. Mater. Process. Technol., vol. 184, no. 1–3, pp. 447–450, 2007.
https://doi.org/10.1016/j.jmatprotec.2006.12.010

M. Azaouzi, A. Makradi, and S. Belouettar, Numerical investigations of the structural behavior of a balloon expandable stent design using finite element method, Comput. Mater. Sci., vol. 72, pp. 54–61, 2013.
https://doi.org/10.1016/j.commatsci.2013.01.031

A. Edy Tontowi, O. S. Ramadhan, and N. Taufiq, Numerical Investigation on Flexibility of Metal Cardiovascular Stent, Proc. - 2018 4th Int. Conf. Sci. Technol. ICST 2018, pp. 1–5, 2018.
https://doi.org/10.1109/icstc.2018.8528703

L. Wiesent, U. Schultheiß, C. Schmid, T. Schratzenstaller, and A. Nonn, Experimentally validated simulation of coronary stents considering different dogboning ratios and asymmetric stent positioning, PLoS One, vol. 14, no. 10, pp. 1–25, 2019.
https://doi.org/10.1371/journal.pone.0224026

C. Chen, Y. Xiong, W. Jiang, Y. Wang, Z. Wang, and Y. Chen, Experimental and Numerical Simulation of Biodegradable Stents with Different Strut Geometries, Cardiovasc. Eng. Technol., vol. 11, no. 1, pp. 36–46, 2020.
https://doi.org/10.1007/s13239-019-00433-2

F. Migliavacca, L. Petrini, V. Montanari, I. Quagliana, F. Auricchio, and G. Dubini, A predictive study of the mechanical behaviour of coronary stents by computer modelling, Med. Eng. Phys., vol. 27, no. 1, pp. 13–18, 2005.
https://doi.org/10.1016/j.medengphy.2004.08.012

M. Azaouzi, A. Makradi, J. Petit, S. Belouettar, and O. Polit, On the numerical investigation of cardiovascular balloon-expandable stent using finite element method, Comput. Mater. Sci., vol. 79, pp. 326–335, 2013.
https://doi.org/10.1016/j.commatsci.2013.05.043

J. Bukala, P. Kwiatkowski, and J. Malachowski, Numerical analysis of stent expansion process in coronary artery stenosis with the use of non-compliant balloon, Biocybern. Biomed. Eng., vol. 36, no. 1, pp. 145–156, 2016.
https://doi.org/10.1016/j.bbe.2015.10.009


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