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Future Balloon-Expandable Stents: High or Low-Strength Materials?

Cardiovascular Engineering and Technology volume 11, pages 188–204 (2020)Cite this article

Abstract

Purpose

Recent progress in material science allows researchers to use novel materials with enhanced capabilities like optimum biodegradability, higher strength, and flexibility in the design of coronary stents. Considering the wide range of mechanical properties of existing and newfangled materials, finding the influence of variations in mechanical properties of stent materials is critical for developing a practical design.

Methods

The sensitivity of stent functional characteristics to variations in its material plastic properties is obtained through FEM modeling. Balloon-expandable coronary stent designs: Absorb BVS, and Xience are examined for artificial and commercial polymeric, and metallic materials, respectively. Standard tests including (1) the crimping process followed by stent implantation in an atherosclerotic artery and (2) the three-point bending test, have been simulated according to ASTM standards.

Results

In Absorb BVS, materials with higher yield stress than PLLA have similar residual deflection and maximum bending force to PLLA, which is not the case for Xience stent and Co–Cr. Moreover, elevated yield stress significantly reduces stent flexibility only in Xience stent. For both stents, with different degree of influence, an increase in yield or ultimate stress improves stent radial strength and stiffness and reduces arterial stress and plastic strain of stent, which consequently enhances the stent mechanical performance. Contrarily, yield or ultimate stress elevation increases stent recoil which adversely affects stent performance.

Conclusion

Using high-strength materials has a double-edged sword effect on the stent performance and existing uncertainty in the precise estimate of stent mechanical properties adversely affects the reliability of numerical models’ predictions.

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Acknowledgments

We convey our thanks to Dr. M. Dehghani and Dr. A. Alamdar for their great help.

Conflict of Interest

Ali Khalilimeybodi, Amir Alishzadeh Khoei and Babak Sharif-Kashani declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Affiliations

  1. Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, 22908, USA

    Ali Khalilimeybodi

  2. Department of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran

    Amir Alishzadeh Khoei

  3. Department of Cardiology, Massih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Babak Sharif-Kashani

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  1. Ali Khalilimeybodi
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Correspondence to Ali Khalilimeybodi.

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Khalilimeybodi, A., Alishzadeh Khoei, A. & Sharif-Kashani, B. Future Balloon-Expandable Stents: High or Low-Strength Materials?. Cardiovasc Eng Tech 11, 188–204 (2020). https://doi.org/10.1007/s13239-019-00450-1

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  • DOI: https://doi.org/10.1007/s13239-019-00450-1

Keywords

  • Finite element analysis
  • Coronary stents
  • Material strength
  • Flexibility
  • Sensitivity analysis