Abstract
In this study, a finite element simulation of in-stent restenosis (ISR) is conducted to simulate the deployment and expansion of a stent in an occluded artery with a contact model and a mechanics-based growth model. A tissue growth model based on the multiplicative decomposition of deformation is applied to investigate the growth of the plaque and artery wall upon the stent’s implantation. Due to the high stresses at the contact points between the stent struts and the tissue, further tissue injury or restenosis is observed. The simulation results show that after the stent deployment, the von Mises stress is significantly larger in the plaque compared to the artery wall, especially in the region that is in contact with the stent. However, the growth of the plaque and artery tends to even out the stress concentration over time. The tissue growth is found to be more significant near the inner wall than the outer layer. A 0.77 mm restenosis is predicted, which agrees with published clinical observations. The features of the artery growth are carefully analyzed, and the underlying mechanism is discussed. This study is the first attempt to apply finite element analysis to artery restenosis, which establishes a framework for predicting ISR’s occurrence and severity. The results also provide insights into understanding the underlying mechanism of in-stent restenosis.
Highlights
Cardiovascular disease (CVD) is the leading cause of mortality in the United States in men and women of every major ethnic group
Coronary stenting has become a major treatment for coronary stenosis, narrowing a blood vessel leading to restricted blood flow, since its first use in 1986
Promus PREMIERTM is a relatively new coronary stent designed by Boston Scientific that has a higher strength and less restenosis rate compared to older generations
Summary
Cardiovascular disease (CVD) is the leading cause of mortality in the United States in men and women of every major ethnic group. Unlike the mathematical models cited previously, a mechanical growth model based on the multiplicative decomposition of the deformation was developed [27, 28] In this open system thermodynamics framework, an incompatible “growth” configuration was postulated between the material configuration and current configuration, resembling the idea of multiplicative decomposition in the context of finite plasticity, see [29]. This method has been applied in modeling multiple biological structures including arterial wall [30], heart [31], skin [32], brain [33] etc.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
