Abstract

The purpose of this work is to propose a workflow that couples experimental and computational activities aimed at developing a credible digital twin of a commercial coronary bioresorbable vascular scaffold when direct access to data about material mechanical properties is not possible. Such a situation is be faced when the manufacturer is not involved in the study, thus directly investigating the actual device is the only source of information available. The object of the work is the Fantom® Encore polymeric stent (REVA Medical) made of Tyrocore™. Four devices were purchased and used in mechanical tests that are easily reproducible in any mechanical laboratory, i.e. free expansion and uniaxial tension testing, the latter performed with protocols that emphasized the rate-dependent properties of the polymer. Given the complexity of the mechanical behaviour observed experimentally, it was chosen to use the Parallel Rehological Framework material model, already used in the literature to describe the behaviour of other polymers, such as PLLA. Calibration of the material model was based on simulations that replicate the tensile test performed on the device. Given the high number of material parameters, a plan of simulations was done to find the most suitable set, varying each parameter value in a feasible range and considering a single repetitive unit of the stent, neglecting residual stresses generated by crimping and expansion. This strategy resulted in a significant reduction of computational cost. The performance of the set of parameters thus identified was finally evaluated considering the whole delivery system, by comparing the experimental results with the data collected simulating free expansion and uniaxial tension testing. Moreover, radial force testing was numerically performed and compared with literature data. The obtained results demonstrated the effectiveness of the digital twin development pipeline, a path applicable to any commercial device whose geometric structure is based on repetitive units.

Highlights

  • The global burden of cardiovascular disease (CVD) is a health issue but an economic challenge to healthcare systems that is expected to grow exponentially in future years

  • This study proposes an experimental and computational strategy that allows developing a digital twin of a commercial Bioresorbable vascular scaffold (BVS), exploiting and maximizing the information available from few simple in-vitro tests on a small number of purchased devices

  • The results in terms of load-displacement curves are reported for the two stents tested according to the “fast” tension testing protocol (Fig 5, left column) and for the two stents tested according to the “slow” tension testing protocol (Fig 5, right column)

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Summary

Introduction

The global burden of cardiovascular disease (CVD) is a health issue but an economic challenge to healthcare systems that is expected to grow exponentially in future years. The common treatment consisted of the percutaneous transluminal angioplasty (PTA), which was upgraded into the PTA followed by implantation of a stent. Over time, these medical devices experienced great technological innovation up to their establishment as the golden standard for obstructive atherosclerotic vascular disease [2, 3]. These medical devices experienced great technological innovation up to their establishment as the golden standard for obstructive atherosclerotic vascular disease [2, 3] They were made of bare metal (BMS), replaced by metal covered by a drug-eluting layer (DES) [4]. Permanent devices were proved to cause long-term complications limiting the successful vascular repair, opening the community toward the use of bioresorbable vascular scaffolds (BVSs), which are tailored to temporarily sustain the injured coronary artery and to be resorbed when the vessel has healed [6]

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