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A novel simulation strategy for stent insertion and deployment in curved coronary bifurcations: comparison of three drug-eluting stents

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Abstract
The introduction of drug-eluting stents (DES) has reduced the occurrence of restenosis in coronary arteries. However, restenosis remains a problem in stented coronary bifurcations. This study investigates and compares three different second generation DESs when being implanted in the curved main branch of a coronary bifurcation with the aim of providing better insights into the related changes of the mechanical environment. The 3D bifurcation model is based on patient-specific angiographic data that accurately reproduce the in vivo curvatures of the vessel segments. The layered structure of the arterial wall and its anisotropic mechanical behavior are taken into account by applying a novel algorithm to define the fiber orientations. An innovative simulation strategy considering the insertion of a folded balloon catheter over a guide wire is proposed in order to position the stents within the curved vessel. Straightening occurs after implantation of all stents investigated. The resulting distributions of the wall stresses are strongly dependent on the stent design. Using a parametric modeling approach, two design modifications, which reduce the predicted maximum values of the wall stress, are proposed and analyzed.
Keywords
finite element anlaysis, insertion, patient-specific bifurcation model, FINITE-ELEMENT-ANALYSIS, drug-eluting stents, ARTERIES, BEHAVIOR, DESIGNS, VESSEL, MODEL, VIVO

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Chicago
Mortier, Peter, Gerhard A Holzapfel, Matthieu De Beule, Denis Van Loo, Yvo Taeymans, Patrick Segers, Pascal Verdonck, and Benedict Verhegghe. 2010. “A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-eluting Stents.” Annals of Biomedical Engineering 38 (1): 88–99.
APA
Mortier, P., Holzapfel, G. A., De Beule, M., Van Loo, D., Taeymans, Y., Segers, P., Verdonck, P., et al. (2010). A novel simulation strategy for stent insertion and deployment in curved coronary bifurcations: comparison of three drug-eluting stents. ANNALS OF BIOMEDICAL ENGINEERING, 38(1), 88–99.
Vancouver
1.
Mortier P, Holzapfel GA, De Beule M, Van Loo D, Taeymans Y, Segers P, et al. A novel simulation strategy for stent insertion and deployment in curved coronary bifurcations: comparison of three drug-eluting stents. ANNALS OF BIOMEDICAL ENGINEERING. 2010;38(1):88–99.
MLA
Mortier, Peter et al. “A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-eluting Stents.” ANNALS OF BIOMEDICAL ENGINEERING 38.1 (2010): 88–99. Print.
@article{973459,
  abstract     = {The introduction of drug-eluting stents (DES) has reduced the occurrence of restenosis in coronary arteries. However, restenosis remains a problem in stented coronary bifurcations. This study investigates and compares three different second generation DESs when being implanted in the curved main branch of a coronary bifurcation with the aim of providing better insights into the related changes of the mechanical environment. The 3D bifurcation model is based on patient-specific angiographic data that accurately reproduce the in vivo curvatures of the vessel segments. The layered structure of the arterial wall and its anisotropic mechanical behavior are taken into account by applying a novel algorithm to define the fiber orientations. An innovative simulation strategy considering the insertion of a folded balloon catheter over a guide wire is proposed in order to position the stents within the curved vessel. Straightening occurs after implantation of all stents investigated. The resulting distributions of the wall stresses are strongly dependent on the stent design. Using a parametric modeling approach, two design modifications, which reduce the predicted maximum values of the wall stress, are proposed and analyzed.},
  author       = {Mortier, Peter and Holzapfel, Gerhard A and De Beule, Matthieu and Van Loo, Denis and Taeymans, Yvo and Segers, Patrick and Verdonck, Pascal and Verhegghe, Benedict},
  issn         = {0090-6964},
  journal      = {ANNALS OF BIOMEDICAL ENGINEERING},
  language     = {eng},
  number       = {1},
  pages        = {88--99},
  title        = {A novel simulation strategy for stent insertion and deployment in curved coronary bifurcations: comparison of three drug-eluting stents},
  url          = {http://dx.doi.org/10.1007/s10439-009-9836-5},
  volume       = {38},
  year         = {2010},
}

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