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Simulation of longitudinal stent deformation in a patient-specific coronary artery

Simulation of longitudinal stent deformation in a patient-specific coronary artery
Simulation of longitudinal stent deformation in a patient-specific coronary artery
In percutaneous coronary intervention (PCI), stent malapposition is a common complication often leading to stent thrombosis (ST). More recently, it has also been associated with longitudinal stent deformation (LSD) normally occurring through contact of a post balloon catheter tip and the protruding malapposed stent struts.

The aim of this study was to assess the longitudinal integrity of first and second generation drug eluting stents in a patient specific coronary artery segment and to compare the range of variation of applied loads with those reported elsewhere. We successfully validated computational models of three drug-eluting stent designs when assessed for longitudinal deformation. We then reconstructed a patient specific stenosed right coronary artery segment by fusing angiographic and intravascular ultrasound (IVUS) images from a real case. Within this model the mechanical behaviour of the same stents along with a modified device was compared. Specifically, after the deployment of each device, a compressive point load of 0.3 N was applied on the most malapposed strut proximally to the models. Results indicate that predicted stent longitudinal strength (i) is significantly different between the stent platforms in a manner consistent with physical testing in a laboratory environment, (ii) shows a smaller range of variation for simulations of in vivo performance relative to models of in vitro experiments, and (iii) the modified stent design demonstrated considerably higher longitudinal integrity. Interestingly, stent longitudinal stability may differ drastically after a localised in vivo force compared to a distributed in vitro force.
longitudinal stent deformation, stents, stent malapposition, finite element analysis, patient specific model
1350-4533
467-476
Ragkousis, G.
a61b817c-7578-49da-94d8-dfa8ec6fd4a2
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Bressloff, N.W.
4f531e64-dbb3-41e3-a5d3-e6a5a7a77c92
Ragkousis, G.
a61b817c-7578-49da-94d8-dfa8ec6fd4a2
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Bressloff, N.W.
4f531e64-dbb3-41e3-a5d3-e6a5a7a77c92

Ragkousis, G., Curzen, N. and Bressloff, N.W. (2014) Simulation of longitudinal stent deformation in a patient-specific coronary artery. Medical Engineering & Physics, 36 (4), 467-476. (doi:10.1016/j.medengphy.2014.02.004).

Record type: Article

Abstract

In percutaneous coronary intervention (PCI), stent malapposition is a common complication often leading to stent thrombosis (ST). More recently, it has also been associated with longitudinal stent deformation (LSD) normally occurring through contact of a post balloon catheter tip and the protruding malapposed stent struts.

The aim of this study was to assess the longitudinal integrity of first and second generation drug eluting stents in a patient specific coronary artery segment and to compare the range of variation of applied loads with those reported elsewhere. We successfully validated computational models of three drug-eluting stent designs when assessed for longitudinal deformation. We then reconstructed a patient specific stenosed right coronary artery segment by fusing angiographic and intravascular ultrasound (IVUS) images from a real case. Within this model the mechanical behaviour of the same stents along with a modified device was compared. Specifically, after the deployment of each device, a compressive point load of 0.3 N was applied on the most malapposed strut proximally to the models. Results indicate that predicted stent longitudinal strength (i) is significantly different between the stent platforms in a manner consistent with physical testing in a laboratory environment, (ii) shows a smaller range of variation for simulations of in vivo performance relative to models of in vitro experiments, and (iii) the modified stent design demonstrated considerably higher longitudinal integrity. Interestingly, stent longitudinal stability may differ drastically after a localised in vivo force compared to a distributed in vitro force.

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More information

e-pub ahead of print date: 7 March 2014
Published date: April 2014
Keywords: longitudinal stent deformation, stents, stent malapposition, finite element analysis, patient specific model
Organisations: Human Development & Health, Computational Engineering & Design Group

Identifiers

Local EPrints ID: 365208
URI: http://eprints.soton.ac.uk/id/eprint/365208
ISSN: 1350-4533
PURE UUID: 33703ee6-cfb1-4cbf-bc82-92f014beacce
ORCID for N. Curzen: ORCID iD orcid.org/0000-0001-9651-7829

Catalogue record

Date deposited: 27 May 2014 16:05
Last modified: 17 Mar 2021 02:39

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