1-s2.0-S1751616120303908-main (1).pdf (2.15 MB)
0/0

Patient-specific modelling of stent overlap: lumen gain, tissue damage and in-stent restenosis

Download (2.15 MB)
journal contribution
posted on 28.04.2020 by Ran He, Liguo Zhao, Vadim Silberschmidt, Yang Liu, Felix Vogt
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.

Funding

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)

History

School

  • Mechanical, Electrical and Manufacturing Engineering

Published in

Journal of the Mechanical Behavior of Biomedical Materials

Volume

109

Issue

September 2020

Publisher

Elsevier

Version

VoR (Version of Record)

Rights holder

© The Authors

Publisher statement

This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Acceptance date

26/04/2020

Publication date

2020-05-11

Copyright date

2020

ISSN

1751-6161

Language

en

Depositor

Prof Liguo Zhao . Deposit date: 26 April 2020

Article number

103836

Licence

Exports

Logo branding

Licence

Exports