A Novel Tram Stent Method In The Treatment Of Coronary Bifurcation Lesions – Finite Element Study
Mark Christopher Arokiaraj, Gianluca De Santis, Matthieu De Beule, Igor F Palacios
Published 2016 · Medicine, Materials Science
Download PDFAnalyze on Scholarcy
A novel stent was designed for the treatment of coronary bifurcation lesion, and it was investigated for its performance by finite element analysis. This study was performed in search of a novel method of treatment of bifurcation lesion with provisional stenting. A bifurcation model was created with the proximal vessel of 3.2 mm diameter, and the distal vessel after the side branch (2.3 mm) was 2.7 mm. A novel stent was designed with connection links that had a profile of a tram. Laser cutting and shape setting of the stent was performed, and thereafter it was crimped and deployed over a balloon. The contact pressure, stresses on the arterial wall, stresses on the stent, the maximal principal log strain of the main artery and the side-branch were studied. The study was performed in Abaqus, Simulia. The stresses on the main branch and the distal branch were minimally increased after deployment of this novel stent. The side branch was preserved, and the stresses on the side branch were lesser; and at the confluence of bifurcation on either side of the side branch origin the von-Mises stress was marginally increased. The stresses and strain at the bifurcation were significantly lesser than the stresses and strain of the currently existing techniques used in the treatment of bifurcation lesions though the study was primarily focused only on the utility of the new technology. There is a potential for a novel Tram-stent method in the treatment of coronary bifurcation lesions.
This paper references
Assessment of wrought ASTM F1058 cobalt alloy properties for permanent surgical implants.
Claude O. Clerc (1997)
Provisional stenting of coronary bifurcations: insights into final kissing balloon post-dilation and stent design by computational modeling.
Peter Mortier (2014)
Feasibility of a Priori Numerical Assessment of Plaque Scaffolding after Carotid Artery Stenting in Clinical Routine: Proof of Concept
Francesco lannaccone (2014)
Provisional Stenting of Coronary Bifurcations
P Mortier (2014)
Una clasificación simple de las lesiones coronarias en bifurcación
Alfonso Medina (2006)
Static circumferential tangential modulus of human atherosclerotic tissue.
Howard Martin Loree (1994)
Stent deformation following simulated side-branch dilatation: a comparison of five stent designs.
John A Ormiston (1999)
Carotid artery stenting simulation: From patient-specific images to finite element analysis
. Auricchioa (2010)
Effects of arterial strain and stress in the prediction of restenosis risk: Computer modeling of stent trials
Shijia Zhao (2012)
A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-Eluting Stents
Peter Mortier (2009)
Serial intravascular ultrasound analysis comparing double kissing and classical crush stenting for coronary bifurcation lesions.
Shao-Liang Chen (2011)
Percutaneous coronary intervention for coronary bifurcation disease: consensus from the first 10 years of the European Bifurcation Club meetings.
Jens Flensted Lassen (2014)
Effect of Endothelial Shear Stress on the Progression of Coronary Artery Disease, Vascular Remodeling, and In-Stent Restenosis in Humans: In Vivo 6-Month Follow-Up Study
Peter Stone (2003)
Biomechanical factors in atherosclerosis: mechanisms and clinical implications.
Brenda R Kwak (2014)
Sidebranch compromise during percutaneous coronary interventions.
Neeraj Prasad (2002)
Flow Patterns at Stented Coronary Bifurcations: Computational Fluid Dynamics Analysis
Demosthenes G. Katritsis (2012)
Stenting of bifurcation lesions: classification, treatments, and results.
Thierry Lefevre (2000)
Expansion and drug elution model of a coronary stent
Francesco Migliavacca (2007)
Kissing balloon technique within a 5 Fr guiding catheter using 0.010 inch guidewires and 0.010 inch guidewire-compatible balloons.
Fuminobu Yoshimachi (2007)
Patient-specific simulations of stenting procedures in coronary bifurcations: two clinical cases.
Stefano Morlacchi (2013)
Fractal geometry of arterial coronary bifurcations: a quantitative coronary angiography and intravascular ultrasound analysis.
Gérard Finet (2008)
Simple or Complex Stenting for Bifurcation Coronary Lesions: A Patient-Level Pooled-Analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study
Miles W H Behan (2011)
Bifurcation stenting: current strategies and new devices
Azeem Latib (2008)
Finite element analysis of balloon-expandable coronary stent deployment: influence of angioplasty balloon configuration.
David Moral Martín (2013)
Impact of Carotid Stent Cell Design on Vessel Scaffolding: A Case Study Comparing Experimental Investigation and Numerical Simulations
Michele Conti (2011)
Dedicated bifurcation stents.
Ajith Ananthakrishna Pillai (2012)
Luminal Flow Amplifies Stent-Based Drug Deposition in Arterial Bifurcations
Vijaya B. Kolachalama (2009)
Simple versus complex stenting strategy for coronary artery bifurcation lesions in the drug-eluting stent era: a meta-analysis of randomised trials
Feng Zhang (2009)
Relationship between stent malapposition and incomplete neointimal coverage after drug-eluting stent implantation.
Byeong-Keuk Kim (2012)
Percutaneous coronary intervention for coronary bifurcation disease: consensus from the first 10 years of the European Bifurcation Club meetings. EuroIntervention
J Lassen (2014)
True coronary bifurcation lesions: meta-analysis and review of literature
Ganesh Athappan (2010)
Local hemodynamic changes caused by main branch stent implantation and subsequent virtual side branch balloon angioplasty in a representative coronary bifurcation.
Andrew Robert Williams (2010)
Randomised study comparing complex versus simple drug-eluting stent strategies for coronary bifurcations
David Hildick–Smith (2010)
The "crush" technique for coronary artery bifurcation stenting: insights from micro-computed tomographic imaging of bench deployments.
John A Ormiston (2008)
New Insights Into the Coronary Artery Bifurcation
V Farooq (2011)
International Conference on Shape Memory and Superelastic Technologies
Lee Casalena (2016)
Shape-memory alloys: macromodelling and numerical simulations of the superelastic behavior
Ferdinando Auricchio (1997)
Assessment of shape memory alloy stent deployment in a stenosed artery
Shijia Zhao (2011)
Randomized Study on Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions: The Nordic Bifurcation Study
Terje K. Steigen (2006)
Virtual evaluation of stent graft deployment: a validated modeling and simulation study.
Sander De Bock (2012)
New insights into the coronary artery bifurcation hypothesis-generating concepts utilizing 3-dimensional optical frequency domain imaging.
Vasim Farooq (2011)
Safety in simple versus complex stenting of coronary artery bifurcation lesions. The nordic bifurcation study 14-month follow-up results.
Jan Skov Jensen (2008)
Finite element analysis of side branch access during bifurcation stenting.
Peter Mortier (2009)
Kissing inflation is feasible with all second-generation drug-eluting balloons.
Gregory A. Sgueglia (2011)
Coronary bifurcation stenting: insights from in vitro and virtual bench testing.
Peter Mortier (2010)
Drug-Eluting Stents in Bifurcations: Bench Study of Strut Deformation and Coating Lesions
Patrice Guérin (2010)
[A new classification of coronary bifurcation lesions].
Alfonso Medina (2006)
The kissing balloon technique with two over-the-wire balloon catheters through a single 8-French guiding catheter.
Peter den Heijer (1991)
Determination of layer-specific mechanical properties of human coronary arteries with nonatherosclerotic intimal thickening and related constitutive modeling.
Gerhard A. Holzapfel (2005)
Hemodynamic shear stress and its role in atherosclerosis.
Adel M. Malek (1999)
Ex vivo analysis of human coronary bifurcation anatomy: defining the main vessel-to-side-branch transition zone.
Mary E. Russell (2009)
Percutaneous coronary intervention of bifurcation coronary disease.
N Suzuki (2007)
Coronary bifurcation lesions: a current update.
Samin K Sharma (2010)
Kissing balloon inflation in percutaneous coronary interventions.
Gregory A. Sgueglia (2012)
Kissing balloon or sequential dilation of the side branch and main vessel for provisional stenting of bifurcations: lessons from micro-computed tomography and computational simulations.
N. Foin (2012)
Randomized Trial of Simple Versus Complex Drug-Eluting Stenting for Bifurcation Lesions: The British Bifurcation Coronary Study: Old, New, and Evolving Strategies
David J R Hildick-Smith (2010)
Patient-specific computational fluid dynamics: structured mesh generation from coronary angiography
Gianluca De Santis (2010)
The 5 Ts of bifurcation intervention: type, technique, two stents, T-stenting, trials.
Ron Waksman (2008)
This paper is referenced by
Design and mechanical behaviors of sutureless prototype composite nitinol stent-grafts
Wen Xue (2018)
Lattice Boltzmann simulation of blood ow properties and vessel geometry in open and closed vessels: A numerical study
H. Akhtari Shishavan (2019)
The current trends of Mg alloys in biomedical applications-A review.
Usman Riaz (2018)
A Study for Parametric Morphogeometric Operators to Assist the Detection of Keratoconus
Laurent Bataille (2017)