Abstract
Numerical analysis of complex physical environment continues to be preferred over “build and test” approach in product development process. Finite Element Analysis (FEA) of coronary artery stenting is studied and researched worldwide for many years. Potential of using FEA for mimicking in-vivo is high as experimental test is ruled out for variety of reasons. This review aims at discussing issues and challenges of numerical simulation based on part of available literature on usage of FEA techniques for investigating behavior of balloon expandable (BE) coronary stents inside artery. Literatures of past 16 years of study on the structural analysis is summarized and potential issues for research is discussed. Study tries to investigate deployment characteristics and biomechanical response of artery post stenting and significance of non-physiological conditions induced. Effects of geometrical parameters, simulation strategies are summarized. Study mainly underscores the potential challenges of reliable numerical investigation. Scope of FEA in predicting contributor for in-stent restenosis (ISR), a major drawback of stenting procedure, by correlating the engineering aspect of stent design and its clinical significance supported by clinical trials are highlighted. Study is expected to serve as qualitative assessment for cardiologists to minimize procedural failure and quantitative tool for the designers for stent optimization.
Highlights
Cardiovascular Disease (CVD) is leading cause of death in modern world accounting for nearly 30% of death worldwide [1], [2]
Simulation ranging from simple free expansion of coronary stents to highly sophisticated balloon/stent/artery contact interactions were reported. [12] reported different level of non-physiological stress on artery based on stent type. [13]–[15] investigated numerically the optimization capabilities of Finite Element Analysis (FEA) tools in complex stented artery environment
Review discusses the numerical simulation of balloon expandable (BE) stents in terms of issues related to geometry, material and boundary conditions (BC)
Summary
Cardiovascular Disease (CVD) is leading cause of death in modern world accounting for nearly 30% of death worldwide [1], [2]. [12] reported different level of non-physiological stress on artery based on stent type. [13]–[15] investigated numerically the optimization capabilities of FEA tools in complex stented artery environment. Investigation on fatigue life assessment, sophisticated sequential structural and fluid dynamic investigation, multiobjective, robust optimization were attempted [18]–[20].Several review studies discussed various aspects of simulation of stented arteries. [21] In his review discussed aspects of free expansion and expansion inside stenotic artery highlighting the results based on different modeling and simulation techniques. [23] summarized the structural and fluid dynamics simulations on image based coronary artery models and emphasized on the need of third generation (Biodegradable) stent revolution. Following sections presents an overview of FEA utility in investigating structural behavior of BE coronary stents with reference to its advances and potential analysis issues
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