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Research Papers

The Relation Between the Arterial Stress and Restenosis Rate After Coronary Stenting

[+] Author and Article Information
Linxia Gu1

Department of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588-0656lgu2@unl.edu

Shijia Zhao

Department of Mechanical Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588-0656

Aswini K. Muttyam

 C-Lock Technology Inc., Rapid City, SD 57701

James M. Hammel

Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68114

1

Corresponding author.

J. Med. Devices 4(3), 031005 (Aug 31, 2010) (7 pages) doi:10.1115/1.4002238 History: Received May 19, 2010; Revised July 16, 2010; Published August 31, 2010; Online August 31, 2010

Two commercially available stents (the Palmaz–Schatz (PS) and S670 stents) with reported high and low restenosis rates, respectively, have been investigated in this paper. Finite element models simulating the stent, plaque, and artery interactions in 3 mm stenosed right coronary arteries were developed. These models were used to determine the stress field in artery walls after stent implantation. The material properties of porcine arteries were measured and implemented in the numerical models. The stress concentration induced in the artery by the PS stent was found to be more than double that of the S670 stent. It demonstrated a good correlation with the reported restenosis rate. The effects of stent structures, compliance mismatch, plaque geometry, and level of stenosis were studied. Results suggested that stent designs and tissue properties cause alterations in vascular anatomy that adversely affect arterial stress distributions within the wall, which impact vessel responses such as restenosis. Appropriate modeling of stent, plaque, and artery interactions provided insights for evaluating alterations to the arterial mechanical environment, as well as biomechanical factors leading to restenosis.

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Copyright © 2010 by American Society of Mechanical Engineers
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Figures

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Figure 1

Solid model of a symmetric stenosed coronary artery segment with PS stent in its constricted form (half model) and an asymmetric plaque with edge ratio of 2:1

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Figure 2

Geometry of (a) PS stent and (b) S670 stent

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Figure 3

True stress versus stretch ratio curve for plaque and artery

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Figure 4

Maximum radial displacement in the artery wall with five different meshes

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Figure 5

In vitro expansion of a PS stent from 1.2 mm to 3 mm diameter

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Figure 6

Expanded PS stent

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Figure 11

The von Mises stress distribution in the stented artery (40% stenosis) with a thinner plaque edge

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Figure 7

von Mises stress distribution on the 40% stenosed artery wall treated with PS stent (top) and S670 stent (bottom)

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Figure 8

Radial displacement in the 40% stenosed artery treated with PS stent (top) and S670 stent (bottom)

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Figure 9

von Mises stress in the artery along the strut path, and the cross sectional details of the artery-plaque interaction (zoom-in)

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Figure 10

Arterial stress along the strut path induced by S670 stent

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