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Assessment of tissue prolapse after balloon-expandable stenting: Influence of stent cell geometry

Capelli, C; Gervaso, F; Petrini, L; Dubini, G; Migliavacca, F; (2009) Assessment of tissue prolapse after balloon-expandable stenting: Influence of stent cell geometry. MEDICAL ENGINEERING & PHYSICS , 31 (4) 441 - 447. 10.1016/j.medengphy.2008.11.002.

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Abstract

Restenosis is a re-narrowing or blockage of an artery at the same site where treatment, such as a balloon angioplasty or stent procedure, has already taken place. Several clinical trials have shown a significant reduction in the restenosis rates with endovascular stenting. The purpose of stenting is to maintain the arterial lumen open by a scaffolding action that provides radial support. However, stenting can cause a vascular injury during the deployment. Indeed, in-stent restenosis remains a major problem in percutaneous coronary intervention, requiring patients to undergo repeated procedures and surgery. The loading imposed by the deployment of the stent on the artery is involved in the restenosis process. Furthermore, it is well known that the stent design plays a role in the outcome of the stenting interventional procedure. This study compares the mechanical effects of the expansion of five different designs of balloon-expandable stents in a coronary artery by means of numerical models based on the finite element method. An index for the evaluation of the tissue prolapse based on the expanded configuration reached by the stent cells is proposed. The effects of the balloon inflation and deflation are included in the present study. Wall stresses and tissue prolapse of the vessel wall within the stent cells are evaluated and compared among the different stent designs. Results show that the printed area does not predict prolapse, and that the proposed index (PI) does correlate with tissue prolapse. (C) 2008 IPEM. Published by Elsevier Ltd. All rights reserved.

Type:Article
Title:Assessment of tissue prolapse after balloon-expandable stenting: Influence of stent cell geometry
Location:Dublin, IRELAND
DOI:10.1016/j.medengphy.2008.11.002
Keywords:Angioplasty balloon, Numerical model, Coronary stent, Finite element method, FINITE-ELEMENT-ANALYSIS, CORONARY-ARTERY DISEASE, NEOINTIMAL HYPERPLASIA, MECHANICAL-BEHAVIOR, DESIGN OPTIMIZATION, SHEAR-STRESS, RESTENOSIS, ANGIOPLASTY, IMPLANTATION, EXPANSION
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science

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