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Ann Biomed Eng. 2017 Sep;45(9):2244-2252. doi: 10.1007/s10439-017-1851-3. Epub 2017 May 9.

Numerical Simulation of Stent Angioplasty with Predilation: An Investigation into Lesion Constitutive Representation and Calcification Influence.

Author information

1
Biomechanics Research Centre (BMEC), Biomedical Engineering, College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland. cconway@mit.edu.
2
Institute for Medical Engineering and Science (IMES), Massachusetts Institute of Technology, Cambridge, MA, USA. cconway@mit.edu.
3
Biomechanics Research Centre (BMEC), Biomedical Engineering, College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland.
4
Institute for Medical Engineering and Science (IMES), Massachusetts Institute of Technology, Cambridge, MA, USA.
5
Cardiovascular Division, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.

Abstract

It is acceptable clinical practice to predilate a severely occluded vessel to allow better positioning of endovascular stents, and while the impact of this intervention has been examined for aggregate response in animals there has been no means to examine whether there are specific vessels that might benefit. Finite element methods offer the singular ability to explore the mechanical response of arteries with specific pathologic alterations in mechanics to stenting and predilation. We examined varying representations of atherosclerotic tissue including homogeneous and heterogeneous dispersion of calcified particles, and elastic, pseudo-elastic, and elastic-plastic constitutive representations of bulk atherosclerotic tissue. The constitutive representations of the bulk atherosclerotic tissue were derived from experimental test data and highlight the importance of accounting for testing mode of loading. The impact of arterial predilation is presented and, in particular, its effect on intimal predicted damage, atherosclerotic tissue von Mises and maximum principal stresses, and luminal deformation was dependent on the type of constitutive representation of diseased tissue, particularly in the presence of calcifications.

KEYWORDS:

Atherosclerosis; Calcification; Finite element analysis; Predilation angioplasty; Pseudo-elasticity; Stent

PMID:
28488215
PMCID:
PMC5963267
DOI:
10.1007/s10439-017-1851-3
[Indexed for MEDLINE]
Free PMC Article

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