Patient-specific modelling of stent overlap: lumen gain, tissue damage and in-stent restenosis
journal contributionposted on 28.04.2020 by Ran He, Liguo Zhao, Vadim Silberschmidt, Yang Liu, Felix Vogt
Any type of content formally published in an academic journal, usually following a peer-review process.
This paper investigates the effects of multiple stents, with and without overlap, on the outcome of stent deployment in a patient-specific coronary artery using the finite element method. Specifically, the objective of this study is to reveal the effect of stent overlap on lumen gain, tissue damage and in-stent restenosis in percutaneous coronary intervention. Based on intravital optical coherency tomography imaging, three-dimensional model of a specific patient’s coronary artery was developed, with two constituent layers (media and adventitia) and plaque, using Mimics. Hyperelastic models with damage, verified against experimental results, were used to describe stress-stretch responses of arterial layers and plaque. Abaqus CAE was used to create the models for Resolute Integrity™ drug-eluting stents and tri-folded expansion balloons. The results showed that lumen gain was improved by the overlapping stents than a single stent after deployment; however, damage to the media layer was greater, promoting a higher rate of in-stent restenosis. Meanwhile, the lumen gain achieved with the non-overlapping stents was smaller than that with the overlapping ones, due to an increased recoiling effect. Also, non-overlapping stents induced more tissue damage and higher rate of in-stent restenosis than overlapping stents. With respect to long-term clinical outcomes, the study recommended the use of a single stent where possible or multiple stents with minimal overlaps to treat long or angulated lesions.
EPSRC UK (Grant number: EP/R001650/1; Title: Smart peripheral stents for the lower extremity - design, manufacturing and evaluation)
British Heart Foundation (Grant number: FS/15/21/31424; Title: Towards controlling the mechanical performance of polymeric bioresorbable vascular scaffold during biodegradation)
Royal Society of UK (Grant number: IE160066; Title: Evaluating the performance of additively manufactured endovascular scaffolds)
- Mechanical, Electrical and Manufacturing Engineering