Abstract

In-stent restenosis remains a major problem of arteriosclerosis treatment by stenting. Expansion-optimized stents could reduce this problem. With numerical simulations, stent designs/ expansion behaviours can be effectively analyzed. For reasons of efficiency, simplified models of balloon-expandable stents are often used, but their accuracy must be challenged due to insufficient experimental validation. In this work, a realistic stent life-cycle simulation has been performed including balloon folding, stent crimping and free expansion of the balloon-stent-system. The successful simulation and validation of two stent designs with homogenous and heterogeneous stent stiffness and an asymmetrically positioned stent on the balloon catheter confirm the universal applicability of the simulation approach. Dogboning ratio, as well as the final dimensions of the folded balloon, the crimped and expanded stent, correspond well to the experimental dimensions with only slight deviations. In contrast to the detailed stent life-cycle simulation, a displacement-controlled simulation can not predict the transient stent expansion, but is suitable to reproduce the final expanded stent shape and the associated stress states. The detailed stent life-cycle simulation is thus essential for stent expansion analysis/optimization, whereas for reasons of computational efficiency, the displacement-controlled approach can be considered in the context of pure stress analysis.

Highlights

  • Ischemic heart disease is the most common cause of death world wide [1]

  • The superposition of the simulation results with a CT scan (Fig 6A) and an embedded section of a balloon (Fig 6B) shows that the basic shape of the balloon folding can be predicted in the simulation

  • The results presented here have shown that even minor stent design modifications influence the stent expansion behavior

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Summary

Introduction

Ischemic heart disease is the most common cause of death world wide [1]. It is caused by arteriosclerosis, the accumulation of plaque at the inner arterial wall. Arteriosclerosis is mainly treated by percutaneous coronary angioplasty with stent placement. Validated simulation of coronary stents scholarship of the LaKoF (State Conference of Women’s and Equal Opportunities Representatives at Bavarian Universities). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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