Abstract
Subintimal angioplasty is a highly challenging technique for percutaneous treatment of chronic total occlusion (CTO) in blood vessels, and the development of predictive tools for preliminary evaluation of potential outcomes and risks could be very useful for clinicians. While finite element (FE) simulation is a well-established approach to investigating partial occlusions, its extension to CTO has not been investigated yet, because of several additional issues that have to be addressed. In this work, we discuss the implementation of a FE model to simulate the main steps of the procedure, i.e., subintimal insertion of an initially folded balloon in a false lumen, inflation from eccentric position, deflation, and extraction. The model includes key morphological features of the CTO and possibility of varying spatial distribution of material properties to account for different constituents and degree of calcification. Both homogeneous and heterogeneous CTO configurations were analyzed, comparing arterial stress state, plaque compression, and postprocedural recoil. For a peak inflation pressure of 12 bar, the degree of lumen restoration was in the range 65-80%, depending on plaque heterogeneity. After balloon extraction, homogeneous highly calcified plaques exhibited substantial recovery of original shape. For homogeneous and heterogeneous CTO, values of peak von Mises stress in the arterial wall were of the same order of magnitude (range 1-1.1 MPa) but at different locations. Results compared favorably with data reported in literature for postprocedural lumen restoration and arterial stress data, confirming potential usefulness of the approach.
Highlights
As an important process step in sheet production, directly determines product quality. e setting and optimization of process parameters have been the focus of research by domestic and foreign scholars due to the nonlinearity of the metal material and the stiffness of the straightening equipment
Gruber and Hirt [3] performed the analysis of curvature change and residual stress during the straightening process based on the finite element method
According to the calculation model in this paper, the calculation is performed on the plate with length × width × height of 1000 mm × 350 mm × 4∼6 mm, assuming that the initial curvature is 0, the material is isotropic, and there is no residual stress distribution. e
Summary
As an important process step in sheet production, directly determines product quality. e setting and optimization of process parameters have been the focus of research by domestic and foreign scholars due to the nonlinearity of the metal material and the stiffness of the straightening equipment. Cui [1] deduced the calculation method of each parameter in the straightening process by studying the continuous supported beam model. He [2] performed an analysis by reinforcing the material and concluded that the large deformation strategy residual-curvature control is better than the small deformation strategy. E straightening of the plate is a process of repeated bending; curvature is a physical quantity that describes the degree of curvature of an object in space
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