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Toledo JP, Martínez-Castillo J, Cardenas D, Delgado-Alvarado E, Vigueras-Zuñiga MO, Herrera-May AL. Simplified Models to Assess the Mechanical Performance Parameters of Stents. Bioengineering (Basel) 2024; 11:583. [PMID: 38927819 PMCID: PMC11200851 DOI: 10.3390/bioengineering11060583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/19/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Ischemic heart disease remains a leading cause of mortality worldwide, which has promoted extensive therapeutic efforts. Stenting has emerged as the primary intervention, particularly among individuals aged 70 years and older. The geometric specifications of stents must align with various mechanical performance criteria outlined by regulatory agencies such as the Food and Drug Administration (FDA). Finite element method (FEM) analysis and computational fluid dynamics (CFD) serve as essential tools to assess the mechanical performance parameters of stents. However, the growing complexity of the numerical models presents significant challenges. Herein, we propose a method to determine the mechanical performance parameters of stents using a simplified FEM model comprising solid and shell elements. In addition, a baseline model of a stent is developed and validated with experimental data, considering parameters such as foreshortening, radial recoil, radial recoil index, and radial stiffness of stents. The results of the simplified FEM model agree well with the baseline model, decreasing up to 80% in computational time. This method can be employed to design stents with specific mechanical performance parameters that satisfy the requirements of each patient.
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Affiliation(s)
- Juan P. Toledo
- Micro and Nanotechnology Research Center, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico; (J.P.T.); (E.D.-A.)
| | - Jaime Martínez-Castillo
- Micro and Nanotechnology Research Center, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico; (J.P.T.); (E.D.-A.)
- Facultad de Ingeniería Eléctrica y Electrónica, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico
| | - Diego Cardenas
- School of Engineering and Sciences, Tecnologico de Monterrey, Zapopan 45138, Jalisco, Mexico;
| | - Enrique Delgado-Alvarado
- Micro and Nanotechnology Research Center, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico; (J.P.T.); (E.D.-A.)
| | | | - Agustín L. Herrera-May
- Micro and Nanotechnology Research Center, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico; (J.P.T.); (E.D.-A.)
- Facultad de Ingeniería de la Construcción y el Hábitat, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico
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Yao J, Bosi GM, Burriesci G, Wurdemann H. Computational Analysis of Balloon Catheter Behaviour at Variable Inflation Levels. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3015-3019. [PMID: 36083934 DOI: 10.1109/embc48229.2022.9871164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aortic valvuloplasty is a minimally invasive procedure for the dilatation of stenotic aortic valves. Rapid ventricular pacing is an established technique for balloon stabilization during this procedure. However, low cardiac output due to the pacing is one of the inherent risks, which is also associated with several potential complications. This paper proposes a numerical modelling approach to understand the effect of different inflation levels of a valvuloplasty balloon catheter on the positional instability caused by a pulsating blood flow. An unstretched balloon catheter model was crimped into a tri-folded configuration and inflated to several levels. Ten different inflation levels were then tested, and a Fluid-Structure Interaction model was built to solve interactions between the balloon and the blood flow modelled in an idealised aortic arch. Our computational results show that the maximum displacement of the balloon catheter increases with the inflation level, with a small step at around 50% inflation and a sharp increase after reaching 85% inflation. This work represents a substantial progress towards the use of simulations to solve the interactions between a balloon catheter and pulsating blood flow.
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Tarrahi I, Colombo M, Hartman EMJ, Tovar Forero MN, Torii R, Chiastra C, Daemen J, Gijsen FJH. Impact of bioresorbable scaffold design characteristics on local haemodynamic forces: an ex vivo assessment with computational fluid dynamics simulations. EUROINTERVENTION 2020; 16:e930-e937. [PMID: 31951204 DOI: 10.4244/eij-d-19-00657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIMS Bioresorbable scaffold (BRS) regions exposed to flow recirculation, low time-averaged wall shear stress (TAWSS) and high oscillatory shear index (OSI) develop increased neointima tissue. We investigated haemodynamic features in four different BRSs. METHODS AND RESULTS Fantom (strut height [SH] = 125 µm), Fantom Encore (SH = 98 µm), Absorb (SH = 157 µm) and Magmaris (SH = 150 µm) BRSs were deployed in phantom tubes and imaged with microCT. Both 2D and 3D geometrical scaffold models were reconstructed. Computational fluid dynamics (CFD) simulation was performed to compute TAWSS and OSI. Thicker struts had larger recirculation zones and lower TAWSS in 2D. Absorb had the largest recirculation zone and the lowest TAWSS (240 µm and -0.18 Pa), followed by Magmaris (170 µm and -0.15 Pa), Fantom (140 µm and -0.14 Pa) and Fantom Encore (100 µm and -0.13 Pa). Besides strut size, stent design played a dominant role in 3D. The highest percentage area adverse TAWSS (<0.5 Pa) and OSI (>0.2) were found for Fantom (56% and 30%) and Absorb (53% and 33%), followed by Fantom Encore (30% and 25%) and Magmaris (25% and 20%). Magmaris had the smallest areas due to a small footprint and rounded struts. CONCLUSIONS Due to stent design, both Fantom Encore and Magmaris showed smaller TAWSS and OSI than Fantom and Absorb. This study quantifies which scaffold features are most important to reduce long-term restenosis.
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Affiliation(s)
- Imane Tarrahi
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, the Netherlands
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Genuardi L, Chatzizisis YS, Chiastra C, Sgueglia G, Samady H, Kassab GS, Migliavacca F, Trani C, Burzotta F. Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions. Cardiol J 2020; 28:321-329. [PMID: 32052855 DOI: 10.5603/cj.a2020.0024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/10/2020] [Accepted: 01/25/2020] [Indexed: 12/14/2022] Open
Abstract
Although the coronary arteries are uniformly exposed to systemic cardiovascular risk factors, atherosclerosis development has a non-random distribution, which follows the local mechanical stresses including flow-related hemodynamic forces. Among these, wall shear stress plays an essential role and it represents the major flow-related factor affecting the distribution of atherosclerosis in coronary bifurcations. Furthermore, an emerging body of evidence suggests that hemodynamic factors such as low and oscillating wall shear stress may facilitate the development of in-stent restenosis and stent thrombosis after successful drug-eluting stent implantation. Drug-eluting stent implantation represents the gold standard for bifurcation interventions. In this specific setting of interventions on bifurcated lesions, the impact of fluid dynamics is expected to play a major role and constitutes substantial opportunity for future technical improvement. In the present review, available data is summarized regarding the role of local fluid dynamics in the clinical outcome of patients with bifurcated lesions.
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Affiliation(s)
- Lorenzo Genuardi
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy
| | - Yiannis S Chatzizisis
- Cardiovascular Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA., Omaha, United States
| | - Claudio Chiastra
- Laboratory of Biological Structure Mechanics (LaBS), Chemistry, Materials and Chemical engineering "Giulio Natta" Department, Politecnico di Milano, Milan, Italy, Milan, Italy
| | - Gregory Sgueglia
- Division of Cardiology, Sant'Eugenio Hospital, Rome, Italy, Rome, Italy
| | - Habib Samady
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA, Atlanta, United States
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, USA, San Diego, United States
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Chemistry, Materials and Chemical engineering "Giulio Natta" Department, Politecnico di Milano, Milan, Italy, Milan, Italy
| | - Carlo Trani
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy
| | - Francesco Burzotta
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy.
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Boland EL, Grogan JA, McHugh PE. Computational modelling of magnesium stent mechanical performance in a remodelling artery: Effects of multiple remodelling stimuli. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2019; 35:e3247. [PMID: 31393090 DOI: 10.1002/cnm.3247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 05/01/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
Significant research has been conducted in the area of coronary stents/scaffolds made from resorbable metallic and polymeric biomaterials. These next-generation bioabsorbable stents have the potential to completely revolutionise the treatment of coronary artery disease. The primary advantage of resorbable devices over permanent stents is their temporary presence which, from a theoretical point of view, means only a healed coronary artery will be left behind following degradation of the stent potentially eliminating long-term clinical problems associated with permanent stents. The healing of the artery following coronary stent/scaffold implantation is crucial for the long-term safety of these devices. Computational modelling can be used to evaluate the performance of complex stent devices in silico and assist in the design and development and understanding of the next-generation resorbable stents. What is lacking in computational modelling literature is the representation of the active response of the arterial tissue in the weeks and months following stent implantation, ie, neointimal remodelling, in particular for the case of biodegradable stents. In this paper, a computational modelling framework is developed, which accounts for two major physiological stimuli responsible for neointimal remodelling and combined with a magnesium corrosion model that is capable of simulating localised pitting (realistic) stent corrosion. The framework is used to simulate different neointimal growth patterns and to explore the effects the neointimal remodelling has on the mechanical performance (scaffolding support) of the bioabsorbable magnesium stent.
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Affiliation(s)
- Enda L Boland
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
| | - James A Grogan
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
| | - Peter E McHugh
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
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Wee I, Ong CW, Syn N, Choong A. Computational Fluid Dynamics and Aortic Dissections: Panacea or Panic? VASCULAR AND ENDOVASCULAR REVIEW 2018. [DOI: 10.15420/ver.2018.8.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This paper reviews the methodology, benefits and limitations associated with computational flow dynamics (CFD) in the field of vascular surgery. Combined with traditional imaging of the vasculature, CFD simulation enables accurate characterisation of real-time physiological and haemodynamic parameters such as wall shear stress. This enables vascular surgeons to understand haemodynamic changes in true and false lumens, and exit and re-entry tears. This crucial information may facilitate triaging decisions. Furthermore, CFD can be used to assess the impact of stent graft treatment, as it provides a haemodynamic account of what may cause procedure-related complications. Efforts to integrate conventional imaging, individual patient data and CFD are paramount to its success, given its potential to replace traditional registry-based, population-averaged data. Nonetheless, methodological limitations must be addressed before clinical implementation. This must be accompanied by further research with large sample sizes, to establish the association between haemodynamic patterns as observed by CFD and progression of aortic dissection.
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Affiliation(s)
- Ian Wee
- SingVaSC, Singapore Vascular Surgical Collaborative; Yong Loo Lin School of Medicine, National University of Singapore
| | - Chi Wei Ong
- SingVaSC, Singapore Vascular Surgical Collaborative; Department of Biomedical Engineering, National University of Singapore
| | - Nicholas Syn
- SingVaSC, Singapore Vascular Surgical Collaborative; Yong Loo Lin School of Medicine, National University of Singapore
| | - Andrew Choong
- SingVaSC, Singapore Vascular Surgical Collaborative; Cardiovascular Research Institute, National University of Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore; Division of Vascular Surgery, National University Heart Centre, Singapore
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Nogic J, McCormick LM, Francis R, Nerlekar N, Jaworski C, West NE, Brown AJ. Novel bioabsorbable polymer and polymer-free metallic drug-eluting stents. J Cardiol 2018; 71:435-443. [DOI: 10.1016/j.jjcc.2017.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/16/2017] [Accepted: 12/04/2017] [Indexed: 01/07/2023]
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Plourde BD, Vallez LJ, Sun B, Nelson-Cheeseman BB, Abraham JP, Staniloae CS. Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity. Cardiovasc Eng Technol 2016; 7:280-9. [DOI: 10.1007/s13239-016-0269-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
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