The Consequences Of The Mechanical Environment Of Peripheral Arteries For Nitinol Stenting
M. Early, D. Kelly
Published 2011 · Computer Science, Medicine, Mathematics
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The use of stents in peripheral arteries has not been as successful as in coronary arteries, with high rates of restenosis and stent fracture common. Normal joint flexion induces a range of forces on the arteries, which has an unknown effect on the outcomes of stenting. The objective of this study is to determine how physiological levels of vessel bending and compression following stent implantation will influence the magnitude of stent stresses and hence the risks of fatigue fracture. A further objective is to compare how this mechanical environment will influence arterial stresses following implantation of either stainless steel or nitinol stents. To this end, models of both nitinol and stainless steel stents deployed in peripheral arteries were created, with appropriate loading conditions applied. At high levels of bending and compression, the strain amplitude threshold value for fatigue failure is exceeded for nitinol stents. Bending was predicted to induce high stresses in the artery following stenting, with higher arterial stresses predicted following implantation of a stainless steel stent compared to a nitinol stent. Both bending and compression may contribute to stent fracture by increasing the strain amplitude within the stent, with the dominant factor dependant on location within the arterial tree. For the specific stent types investigated in this study, the model predictions suggest that compression is the dominant mechanical factor in terms of stent fatigue in the femoral arteries, whereas bending is the most significant factor in the popliteal artery. To increase fatigue life and reduce arterial injury, location specific stent designs are required for peripheral arteries.
This paper references
Stresses in peripheral arteries following stent placement: a finite element analysis.
M. Early (2009)
The influence of plaque composition on underlying arterial wall stress during stent expansion: the case for lesion-specific stents.
Ian Owens Pericevic (2009)
Stent expansion in curved vessel and their interactions: a finite element analysis.
Wei Wu (2007)
Biomechanical Forces in the Femoropopliteal Arterial Segment
A. Nikanorov (2005)
Fatigue and fracture in materials used for micro-scale biomedical components.
S. Wiersma (2006)
A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-Eluting Stents
P. Mortier (2009)
The role of vessel geometry and material properties on the mechanics of stenting in the coronary and peripheral arteries
M. Early (2010)
Assessment of tissue prolapse after balloon-expandable stenting: influence of stent cell geometry.
Claudio Capelli (2009)
Effects of stent design parameters on normal artery wall mechanics.
Julian Bedoya (2006)
On the effects of different strategies in modelling balloon-expandable stenting by means of finite element method.
F. Gervaso (2008)
Fatigue and durability of Nitinol stents.
A. Pelton (2008)
Influence of thermomechanical processing on the superelastic properties of a Ni-rich Nitinol shape memory alloy
D. Favier (2006)
Stainless and shape memory alloy coronary stents: a computational study on the interaction with the vascular wall
F. Migliavacca (2004)
Mechanics of angioplasty: wall, balloon and stent
GA Hozapfel (2000)
Effects of Stent Design and Atherosclerotic Plaque Composition on Arterial Wall Biomechanics
L. Timmins (2008)
In vivo MR angiographic quantification of axial and twisting deformations of the superficial femoral artery resulting from maximum hip and knee flexion.
Christopher P. Cheng (2006)
Intramural stress increases exponentially with stent diameter: a stress threshold for neointimal hyperplasia.
P. D. Ballyk (2006)
Simulation of a balloon expandable stent in a realistic coronary artery-Determination of the optimum modelling strategy.
H. Zahedmanesh (2010)
Randomized trial of Sirolimus-Eluting Stent Versus Bare-Metal Stent in Acute Myocardial Infarction (SESAMI).
M. Menichelli (2007)
Computational simulation methodologies for mechanobiological modelling: a cell-centred approach to neointima development in stents
C. J. Boyle (2010)
Analysis of Side Branch Access During Bifurcation Stenting
P. Mortier (2008)
Passive biaxial mechanical response of aged human iliac arteries.
C. Schulze-Bauer (2003)
Drug-Eluting and Bare Nitinol Stents for the Treatment of Atherosclerotic Lesions in the Superficial Femoral Artery: Long-Term Results from the SIROCCO Trial
S. Duda (2006)
Sirolimus-eluting versus bare nitinol stent for obstructive superficial femoral artery disease: the SIROCCO II trial.
S. Duda (2005)
Analysis of prolapse in cardiovascular stents: a constitutive equation for vascular tissue and finite-element modelling.
P. Prendergast (2003)
Prevalence and clinical impact of stent fractures after femoropopliteal stenting.
D. Scheinert (2005)
Cardiovascular stent design and vessel stresses: a finite element analysis.
C. Lally (2005)
Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery.
M. Schillinger (2006)
Late Stent Expansion and Neointimal Proliferation of Oversized Nitinol Stents in Peripheral Arteries
H. Zhao (2009)
Improvements and algorithmical considerations on a recent three‐dimensional model describing stress‐induced solid phase transformations
F. Auricchio (2002)
Biomechanical Forces in the Femoropopliteal Arterial Segment What happens during extremity movement and what is the effect on stenting
H. Smouse (2005)
Delivery and release of nitinol stent in carotid artery and their interactions: a finite element analysis.
Wei Wu (2007)
Fracture of self-expanding nitinol stents stressed in vitro under simulated intravascular conditions.
A. Nikanorov (2008)
Simulation of Renal Stent in Respiration
Hao-Ming Hsiao (2006)
Patient specific finite element analysis results in more accurate prediction of stent fractures: application to percutaneous pulmonary valve implantation.
S. Schievano (2010)
Changes in the mechanical environment of stenotic arteries during interaction with stents: computational assessment of parametric stent designs.
G. Holzapfel (2005)
PTA versus Palmaz stent placement in femoropopliteal artery obstructions: a multicenter prospective randomized study.
M. Cejna (2001)
The nature of SFA disease
M Jaff (2004)
This paper is referenced by
Bending Analysis of Stented Coronary Artery: the Interaction Between Stent and Vessel
X. Shen (2019)
Microcrack distributions in bone : effects of stress and bone mineral density
Gerardo Presbítero (2011)
Site specific inelasticity of arterial tissue.
E. Maher (2012)
Simplified Multistage Computational Approach to Assess the Fatigue Behavior of a Niti Transcatheter Aortic Valve During In Vitro Tests: A Proof-of-Concept Study
Lorenza Petrini (2017)
Development of new endovascular stent-graft system for type B thoracic aortic dissection with finite element analysis and experimental verification
Zhou Xiao-chen (2019)
The Medical and Endovascular Treatment of PAD: A Review of the Guidelines and Pivotal Clinical Trials.
Rajan A. G. Patel (2018)
Computational Modeling to Predict Fatigue Behavior of NiTi Stents: What Do We Need?
Elena Dordoni (2015)
Endovascular treatment of femoro-popliteal artery stenosis/obstruction using a repositionable self-expanding nitinol stent: a preliminary study
Seyhan Yılmaz (2016)
An anisotropic inelastic constitutive model to describe stress softening and permanent deformation in arterial tissue.
E. Maher (2012)
New nitinol endovascular stent-graft system for abdominal aortic aneurysm with finite element analysis and experimental verification
Xiaochen Zhou (2019)
JEVT 13-4332 MR Quantification of Deformation of the Popliteal Arterial Tract During Leg Flexion in Subjects with Peripheral Arterial Disease : A Pilot Study
Can Gökgöl (2016)
Open preperitoneal mesh repair of inguinal hernias using a mesh with nitinol memory frame
F. Berrevoet (2013)
Paclitaxel-coated balloon or primary bare nitinol stent for revascularization of femoropopliteal artery: a meta-analysis of randomized trials versus uncoated balloon and an adjusted indirect comparison.
M. Fusaro (2013)
Multi-scale mechanical investigation of stainless steel and cobalt-chromium stents.
Konstantinos Kapnisis (2014)
Cross-sectional pinching in human femoropopliteal arteries due to limb flexion, and stent design optimization for maximum cross-sectional opening and minimum intramural stresses
A. Desyatova (2018)
Morphological and Stent Design Risks Factors to Prevent Migration Phenomena and Type 1a Endoleak for Thoracic Aneurysm: A Numerical Analysis
H-E Altnji (2015)
Assessment of mechanical integrity for drug-eluting renal stent with micro-sized drug reservoirs
Hao-Ming Hsiao (2013)
Fatigue behaviour of Nitinol peripheral stents: the role of plaque shape studied with computational structural analyses.
E. Dordoni (2014)
Stent placement in the superficial femoral and proximal popliteal arteries with the innova self‐expanding bare metal stent system
R. Powell (2017)
Finite element analysis for fatigue behaviour of a self-expanding Nitinol peripheral stent under physiological biomechanical conditions
Long Lei (2019)
A method for coating fucoidan onto bare metal stent and in vivo evaluation
J. Kim (2015)
Safety, clinical outcome, and fracture rate of femoropopliteal stenting using a 4F compatible delivery system.
H. Sarkadi (2015)
A Computational Approach for the Prediction of Fatigue Behaviour in Peripheral Stents: Application to a Clinical Case
Lorenza Petrini (2015)
An Animal Model of Human Peripheral Arterial Bending and Deformation.
Rym El Khoury (2019)
The hemodynamic alterations induced by the vascular angular deformation in stent-assisted coiling of bifurcation aneurysms
W. Jeong (2014)
In Vivo Quantification of the Deformations of the Femoropopliteal Segment
Can Gökgöl (2017)
Quantification of Popliteal Artery Deformation During Leg Flexion in Subjects With Peripheral Artery Disease: A Pilot Study
Can Gökgöl (2013)
Structural Mechanics Predictions Relating to Clinical Coronary Stent Fracture in a 5 Year Period in FDA MAUDE Database
K. Everett (2015)