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Numerical analysis of stent expansion process in coronary artery stenosis with the use of non-compliant balloon

Bukala J., Kwiatkowski P., Malachowski J.

Biocybernetics and Biomedical Engineering

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2016

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Vol. 36, no. 1

145--156

EN

In the paper the authors present an applied methodology, data and numerical results for numerical analysis of the stent crimping process and stent implantation in the coronary artery stenosis with the use of a non-compliant angioplasty balloon. The authors focused on the modeling methodology of balloon angioplasty with minimum possible simplification, i.e.: a full load path (compression and inflation in single analysis), 3D unsymmetrical geometry and discretization, highly nonlinear material models (hyperelasticity, plastic kinematic formulation, crushable foam) and sophisticated contact models (bodies with highly different stiffness). The use of a highly compressible crushable foam material model for an arterial plaque is considered as the most original part of the work. The presented results allow for better understanding of the mechanisms governing stent crimping and implementation.

2

Finite element analysis of the percutaneous coronary intervention in a coronary bifurcation

Bukała J. K., Małachowski J., Kwiatkowski P.

Acta of Bioengineering and Biomechanics

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2014

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Vol. 16, no. 4

23--31

EN

Purpose: The paper presents the process of numerical modeling and simulation of balloon angioplasty of the coronary artery using Finite Element Method. Methods: The authors focused on the issue of adequate pressure applying in an arterial tissue during the post-dilatation process in the 'kissing balloon' stenting technique applied to patients with bifurcation stenosis. Despite great progress in the field of interventional cardiology, angioplasty in bifurcations still belongs to the most difficult interventions, generally being less effective and more risky than in the cases of straight stenosis.Results: During the modeling procedures and further simulations, the authors focused on mutual cooperation of non - compliant angioplasty balloons and the coronary artery. The other goal was to develop a sufficiently accurate model of the coronary artery fragment, including its bifurcation and angioplasty balloons, however it was decided to ignore the modeling of coronary stents.Conclusions: The undertaken issue is considered as relatively complicated and complex but, in the authors opinion, the implementation of advanced computer aided engineering techniques may, in this case, answer several important questions without the need of performing costly and aggravating in vivo tests.

3

The comprehensive finite element model for stenting: the influence of stent design on the outcome after coronary stent placement

Imani M., Goudarzi A. M., Ganji D. D., Aghili A. L.

Journal of Theoretical and Applied Mechanics

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2013

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Vol. 51 nr 3

639--648

EN

Stenting is one of the most important methods to treat atherosclerosis. Due to its simplicity and efficiency, the use of coronary stents in interventional procedures has rapidly increased, and different stent designs have been introduced in the market. In order to select the most appropriate stent design, it is necessary to analyze and compare the mechanical behavior of different types of stents. In this paper, the finite element method is used for analyzing the behavior of stents. The aim of this work is to investigate the expansion characteristics of a stent as it is deployed and implanted in an artery containing a plaque and propose a model as close to real conditions of stent implantation as possible. Furthermore, two commercially available stents (the Palmaz-Schatz and Multi-Link stents) are modeled and their behavior during the deployment is compared in terms of stress distribution, radial gain, outer diameter changes and dogboning. Moreover, the effect of stent design on the restenosis rate is investigated by comparing the stress distribution in the arteries. The results show the importance of considering the plaque in finite element simulation of mechanical behavior of the coronary stent. According to the findings, the possibility of restenosis is nonsignificantly lower for the Multi-Link stent in comparison with the Palmaz-Schatz stent, which is in good agreement with clinical results.