Finite element evaluation of artery damage in deployment of polymeric stent with pre- and post-dilation

Using finite element method, this paper evaluates damage in an arterial wall and plaque caused by percutaneous coronary intervention. Hyperelastic damage models, calibrated with experimental results, are used to describe stress-stretch responses of arterial layers and plaque; these models are capable to simulate softening behaviour of the tissue due to damage. Abaqus CAE is employed to create the finite element models for the artery wall (with media and adventitia layers), a symmetric uniform plaque, a bioresorbable polymeric stent and a tri-folded expansion balloon. The effect of percutaneous coronary intervention on vessel damage is investigated by simulating the processes of vessel pre-dilation, stent deployment and post-stenting dilation. Energy-dissipation density is used to assess the extent of damage in the tissue. Softening of the plaque and the artery, due to the pre-dilation-induced damage, can facilitate the subsequent stent-deployment process. The plaque and the artery experienced heterogeneous damage behaviour after the stent deployment, caused by non-uniform deformation. The post-stenting dilation was effective to achieve a full expansion of the stent but caused additional damage to the artery. The continuous and discontinuous damage models yielded similar results in the percutaneous coronary intervention simulations, while the incorporation of plaque rupture affected the simulated outcomes of stent deployment. The computational evaluation of the artery damage can be potentially used to assess the risk of in-stent restenosis after percutaneous coronary intervention.