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Acta Mechanica Solida Sinica

, Volume 28, Issue 5, pp 605–612 | Cite as

Application of Finite Element Method to Comparing the Nir Stent with the Multi-Link Stent for Narrowings in Coronary Arteries

  • S. Misagh Imani
  • A. M. Goudarzi
  • P. Valipour
  • M. Barzegar
  • J. Mahdinejad
  • Seiyed E. Ghasemi
Article

Abstract

‘Stent versus stent’ studies are a kind of randomized trials which are designed to show the superiority of the new stent designs compared with the previously approved ones. These studies are usually used by regulatory agencies, such as the U.S. Food and Drug Administration (FDA), to give an approval to new stent designs. The problem with these clinical trials is their high cost and difficulty. In this paper, a numerical alternative for ‘stent versus stent’ complicated clinical studies is presented. A finite element model is developed to investigate the influence of stent design on the outcome after coronary stent placement. Two commercially available stents (the NIR and Multi-Link stents) are modeled and their behavior during the deployment is compared in terms of stress distribution, radial gain, outer diameter changes and foreshortening. Moreover, the effect of stent design on the restenosis rate is investigated by comparing the stress distribution within the arteries. An analysis of the arterial wall stresses in the stented arteries indicates that the Multi-Link stent design causes lower stress to an atherosclerotic vessel with a localized stenotic lesion compared to the slotted tube NIR design. The findings correlate with the observed clinical restenosis rates, which have reported higher restenosis rates in the NIR compared with the Multi-Link stent design.

Key Words

stent vs. stent studies finite element method coronary stent plaque vessel 

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References

  1. 1.
    Imani, M., Goudarzi, A.M., Ganji, D.D. and Latif Aghili, A., The comprehensive finite element model for stenting: The influence of stent design on the outcome after coronary stent placement. J. Theor. Appl. Mech., 2013, 51: 639–648.Google Scholar
  2. 2.
    Pericevic, I., Lally, C., Toner, D. and Kelly, D.J., The influence of plaque composition on underlying arterial wall stress during stent expansion: The case of lesion-specific stents. Med. Eng. Phys., 2009, 31: 428–433.CrossRefGoogle Scholar
  3. 3.
    Katritsis, D.G., Karvouni, E. and Ioannidis, J.P., Meta-analysis comparing drug-eluting stents with bare metal stents. Am. J. Cardiol., 2005, 95: 640–643.CrossRefGoogle Scholar
  4. 4.
    Stettler, C., Wandel, S., Allemann, S., Kastrati, A., Morice, M.C., Schomiq, A., et al., Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis. Lancet., 2007, 370: 937–948.CrossRefGoogle Scholar
  5. 5.
    Gu, L., Zhao, S., Muttyam, A.K. and Hammel, J.M., The relation between the arterial stress and restenosis rate after coronary stenting. J. Med. Devices, 2010, 4: 031005.CrossRefGoogle Scholar
  6. 6.
    Eshghi, N., Hojjati, M.H., Imani, M. and Goudarzi, A.M., Finite element analysis of mechanical behaviors of coronary stent. Procedia Eng., 2011, 10: 3056–3061.CrossRefGoogle Scholar
  7. 7.
    Baim, D.S., Cutlip, D.E., Midei, M., Linnemeier, T.J., Schreiber, T., Cox, D., et al., Final results of a randomized trial comparing the MULTI-LINK stent with the Palmaz-Schatz stent for narrowings in native coronary arteries. Am. J. Cardiol., 2001, 87: 157–162.CrossRefGoogle Scholar
  8. 8.
    Kastrati, A., Dirschinger, J., Boekstegers, P., Elezi, S., Schuhlen, H., Pache, J., et al., Influence of stent design on 1-year outcome after coronary stent placement: A randomized comparison of five stent types in 1147 unselected patients. Catheter. Cardiovasc. Interv., 2000, 50: 290–297.CrossRefGoogle Scholar
  9. 9.
    Kastrati, A., Mehilli, J., Dirschinger, J., Pache, J., Ulm, K., Schuhlen, H., et al., Restenosis after coronary placement of various stent types. Am. J. Cardiol., 2001, 87: 34–39.CrossRefGoogle Scholar
  10. 10.
    Pache, J., Kastrati, A., Mehilli, J., Schuhlen, H., Dotzer, F., Hausleiter, J., et al., Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO-2) trial. J. Am. Coll. Cardiol., 2003, 41: 1283–1288.CrossRefGoogle Scholar
  11. 11.
    Chua, S.N.D., MacDonald, B.J. and Hashmi, M.S.J., Finite-element simulation of stent expansion. J. Mater. Process. Technol., 2002, 120: 335–340.CrossRefGoogle Scholar
  12. 12.
    Dumoulin, C. and Cochelin, B., Mechanical behaviour modelling of balloon-expandable stents. J. Biomech., 2000, 33: 1461–1470.CrossRefGoogle Scholar
  13. 13.
    Gu, L., Santra, S., Mericle, R.A. and Kumar, A.V., Finite element analysis of covered microstents. J. Biomech., 2005, 38: 1221–1227.CrossRefGoogle Scholar
  14. 14.
    Chua, S.N.D., MacDonald, B.J. and Hashmi, M.S.J., Effects of varying slotted tube (stent) geometry on its expansion behaviour using finite element method. J. Mater. Process. Technol., 2004, 155–156: 1764–1771.Google Scholar
  15. 15.
    Chua, S.N.D., MacDonald, B.J. and Hashmi, M.S.J., Finite element simulation of stent and balloon interaction. J. Mater. Process. Technol, 2003, 143–144: 591–597.Google Scholar
  16. 16.
    Xia, Z., Ju, F. and Sasaki, K., A general finite element analysis method for balloon expandable stents based on repeated unit cell (RUC) model. Finite Elem. Anal. Des., 2007, 43: 649–658.CrossRefGoogle Scholar
  17. 17.
    Lally, C., Dolan, F. and Prendergast, P.J., Cardiovascular stent design and vessel stresses: a finite element analysis. J. Biomech., 2005, 38: 1574–1581.CrossRefGoogle Scholar
  18. 18.
    Walke, W., Paszenda, Z. and Filipiak, J., Experimental and numerical biomechanical analysis of vascular stent. J. Mater. Process. Technol., 2005, 164–165: 1263–1268.Google Scholar
  19. 19.
    Imani, M., Simulation of mechanical behaviors of NIR stent in a stenotic artery using finite element method. World Appl. Sci. J., 2013, 22: 892–897.Google Scholar
  20. 20.
    Serruys, P.W. and Kutryk, M.J.B., Handbook of Coronary Stents, third ed., Martin Dunitz Ltd., London, 2000.Google Scholar
  21. 21.
    Prendergast, P.J., Lally, C., Daly, S., Reid, A.J., Lee, T.C., Quinn, D., et al., Analysis of prolapse in cardiovascular stents: a constitutive equation for vascular tissue and finite element modelling. ASME J Biomech Eng, 2003, 125: 692–699.CrossRefGoogle Scholar
  22. 22.
    Mario, C.D. and Karvouni, E., The bigger, the better: true also for in-stent restenosis? Eur. Heart J., 2000, 21: 710–711.CrossRefGoogle Scholar
  23. 23.
    Versaci, F., Gaspardone, A., Tomai, F., Crea, F., Chiariello, L. and Gioffre, P.A., A comparison of coronaryartery stenting with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery. N. Engl J. Med., 1997, 336: 817–822..CrossRefGoogle Scholar
  24. 24.
    Kobayashi, Y., J., Kobayashi, N., Reimers, B., Albiero, R., Vaghetti, M., et al., Comparison of immediate and follow-up results of the short and long NIR stent with the Palmaz-Schatz stent. Am. J. Cardiol., 1999, 84: 499–504.CrossRefGoogle Scholar
  25. 25.
    Ju, F., Xia, Z. and Sasaki, K., On the finite element modelling of balloon-expandable stents. J. Mech. Behav. Biomed. Mater., 2008, 1: 86–95..CrossRefGoogle Scholar

Copyright information

© The Chinese Society of Theoretical and Applied Mechanics and Technology 2015

Authors and Affiliations

  • S. Misagh Imani
    • 1
  • A. M. Goudarzi
    • 1
  • P. Valipour
    • 2
  • M. Barzegar
    • 1
  • J. Mahdinejad
    • 1
  • Seiyed E. Ghasemi
    • 3
  1. 1.Department of Mechanical EngineeringBabol University of TechnologyBabolIran
  2. 2.Department of Textile and Apparel, Qaemshahr BranchIslamic Azad UniversityQaemshahrIran
  3. 3.Young Researchers and Elite Club, Qaemshahr BranchIslamic Azad UniversityQaemshahrIran

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