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Tissue Stresses in Stented Coronary Arteries with Different Geometries: Effect of the Relation Between Stent Length and Lesion Length

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Abstract

In-stent restenosis after stent deployment remains an obstruction in the long-term benefits of stenting. This study sought to investigate the influence of the relation between stent length and lesion length on the mechanics of the arterial wall with different geometries, including straight and tapered vessels. Results showed that when the length of the stent was longer than the lesion length, the maximum stress in plaque and vessel increased as the length of stent increased. When the length of the stent was shorter than the lesion length, the vessel stress induced by stent inflation was lower; both ends of the stenosis plaque could not be fully expanded. When the length of the stent was equal to the lesion length, the plaque and vessel stress induced by stent inflation was minimal, and stent foreshortening was minimal. Compared with the straight vessel, the stent implantation in the tapered vessel with the same stent length resulted in greater stress in vessel and plaque, an increased stent recoil, and a decreased stent foreshortening. When the length of the stent is equal to lesion length, it may be the reasonable choice for straight vessels and tapered vessels. Conclusions drawn from this article can help surgeons to choose appropriate stent lengths.

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References

  • Auricchio F, Constantinescu A, Conti M et al (2015) A computational approach for the lifetime prediction of cardiovascular balloon-expandable stents. Int J Fatigue 75:69–79

    Article  Google Scholar 

  • Caputo RP, Goel A, Pencina M et al (2012) Impact of drug eluting stent length on outcomes of percutaneous coronary intervention (from the EVENT registry). Am J Cardiol 110(3):350–355

    Article  Google Scholar 

  • Cui FS, Lee HP, Lu C et al (2010) Effects of balloon length and compliance on vascular stent expansion. Int J Appl Mech 2(03):681–697

    Article  Google Scholar 

  • Dottori S, Flamini V, Vairo G (2016) Mechanical behavior of peripheral stents and stent-vessel interaction: a computational study. Int J Comput Methods Eng Sci Mech 17(3):196–210

    Article  Google Scholar 

  • Eshghi N, Hojjati MH, Imani M et al (2011) Finite element analysis of mechanical behaviors of coronary stent. Proc Eng 10:3056–3061

    Article  Google Scholar 

  • Foley DP, Pieper M, Wijns W et al (2001) The influence of stent length on clinical and angiographic outcome in patients undergoing elective stenting for native coronary artery lesions; final results of the Magic 5L Study. Eur Heart J 22(17):1585–1593

    Article  Google Scholar 

  • Gervaso F, Capelli C, Petrini L et al (2008) On the effects of different strategies in modelling balloon-expandable stenting by means of finite element method. J Biomech 41(6):1206–1212

    Article  Google Scholar 

  • Gu L, Zhao S, Muttyam AK et al (2010) The relation between the arterial stress and restenosis rate after coronary stenting. J Med Dev 4(3):031005

    Article  Google Scholar 

  • Hara H, Nakamura M, Palmaz JC et al (2006) Role of stent design and coatings on restenosis and thrombosis. Adv Drug Deliv Rev 58(3):377–386

    Article  Google Scholar 

  • Hsiao HM, Chiu YH, Lee KH, Lin CH (2012) Computational modeling of effects of intravascular stent design on key mechanical and hemodynamic behavior. Comput Aided Des 44(8):757–765

    Article  Google Scholar 

  • Hyre MR, Pulliam RM (2008) Balloon/stent expansion dynamics in stenotic arteries. ASME 2008 international mechanical engineering congress and exposition. American Society of Mechanical Engineers, pp 565–573

  • Imani M (2013) Simulation of mechanical behaviors of NIR stent in a stenotic artery using finite element method. World Appl Sci J 22(7):892–897

    Google Scholar 

  • Imani M, Goudarzi AM, Hojjati MH (2013a) Finite element analysis of mechanical behaviors of multi-link stent in a coronary artery with plaque. World Appl Sci J 3(21):1600–1601

    Google Scholar 

  • Imani M, Goudarzi AM, Ganji DD et al (2013b) The comprehensive finite element model for stenting: the influence of stent design on the outcome after coronary stent placement. J Theor Appl Mech 51(3):639–648

    Google Scholar 

  • Imani SM, Goudarzi AM, Ghasemi SE et al (2014) Analysis of the stent expansion in a stenosed artery using finite element method: application to stent versus stent study. Proc Inst Mech Eng Part H J Eng Med 228(10):996–1004

    Article  Google Scholar 

  • Imani SM, Goudarzi AM, Valipour P, Barzegar M, Mahdinejad J, Ghasemi SE (2015) Application of finite element method to comparing the NIR stent with the multi-link stent for narrowings in coronary arteries. Acta Mech Solida Sin 28(5):605–612

    Article  Google Scholar 

  • Kasaoka S, Tobis JM, Akiyama T et al (1998) Angiographic and intravascular ultrasound predictors of in-stent restenosis. J Am Coll Cardiol 32(6):1630–1635

    Article  Google Scholar 

  • Kim MS, Dean LS (2011) In-stent restenosis. Cardiovasc Ther 29(3):190–198

    Article  Google Scholar 

  • Lally C, Dolan F, Prendergast PJ (2005) Cardiovascular stent design and vessel stresses: a finite element analysis. J Biomech 38(8):1574–1581

    Article  Google Scholar 

  • Liang DK, Yang DZ, Qi M et al (2005) Finite element analysis of the implantation of a balloon-expandable stent in a stenosed artery. Int J Cardiol 104(3):314–318

    Article  Google Scholar 

  • Mauri L, O’Malley AJ, Cutlip DE et al (2004) Effects of stent length and lesion length on coronary restenosis. Am J Cardiol 93(11):1340–1346

    Article  Google Scholar 

  • Mauri L, O’Malley AJ, Popma JJ et al (2005) Comparison of thrombosis and restenosis risk from stent length of sirolimus-eluting stents versus bare metal stents. Am J Cardiol 95(10):1140–1145

    Article  Google Scholar 

  • Schiavone A, Zhao LG, Abdel-Wahab AA (2014) Effects of material, coating, design and plaque composition on stent deployment inside a stenotic artery—finite element simulation. Mater Sci Eng C 42:479–488

    Article  Google Scholar 

  • Shen X, Xie ZM, Sun YY et al (2014) Balloon-expandable stents expansion in tapered vessels and their interactions. J Mech Med Biol 14(06):1440013

    Article  Google Scholar 

  • Suh J, Park DW, Lee JY et al (2010) The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC Cardiovasc Interv 3(4):383–389

    Article  Google Scholar 

  • Terzian Z, Gasser TC, Blackwell F et al (2017) Peristrut microhemorrhages: a possible cause of in-stent neoatherosclerosis? Cardiovasc Pathol 26:30–38

    Article  Google Scholar 

  • Wei L, Chen Q, Li Z (2016) Study on the impact of straight stents on arteries with different curvatures. J Mech Med Biol 16(07):1650093

    Article  MathSciNet  Google Scholar 

  • Wong SC, Hong MK, Ellis SG et al (2005) Influence of stent length to lesion length ratio on angiographic and clinical outcomes after implantation of bare metal and drug-eluting stents (the TAXUS-IV Study). Am J Cardiol 95(9):1043–1048

    Article  Google Scholar 

  • Zbinden R, Felten S, Wein B et al (2017) Impact of stent diameter and length on in-stent restenosis after DES vs BMS implantation in patients needing large coronary stents—a clinical and health-economic evaluation. Cardiovasc Ther 35(1):19–25

    Article  Google Scholar 

  • Zhao S, Liu XC, Gu L (2012a) The impact of wire stent fabrication technique on the performance of stent placement. J Med Dev 6(1):011007

    Article  Google Scholar 

  • Zhao S, Gu L, Froemming SR (2012b) Performance of self-expanding Nitinol stent in a curved artery: impact of stent length and deployment orientation. J Biomech Eng 134(7):071007

    Article  Google Scholar 

Download references

Acknowledgements

This project is supported by the National Natural Science Foundation of China (51305171), Natural Science Foundation of Jiangsu Province (BK20130525), Natural Science Foundation of the Higher Education Institutions of Jiangsu Province (13KJB460006), China Postdoctoral Science Foundation (2011M500858), Foundation of Jiangsu University (10JDG123), and Project of Jiangsu University for training young backbone teachers.

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Correspondence to Xiang Shen.

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Shen, X., Ji, S., Deng, YQ. et al. Tissue Stresses in Stented Coronary Arteries with Different Geometries: Effect of the Relation Between Stent Length and Lesion Length. Iran J Sci Technol Trans Mech Eng 43 (Suppl 1), 957–964 (2019). https://doi.org/10.1007/s40997-018-0206-5

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  • DOI: https://doi.org/10.1007/s40997-018-0206-5

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