title: A numerical model to study the interaction of vascular stents with human atherosclerotic lesions.
abstract: A methodology is proposed that identifies optimal stent devices for specific clinical criteria. It enables to predict the effect of stent designs on the mechanical environment of stenotic arteries. In particular, we present a numerical study which is based on the interaction of a vascular stent with a patient-specific, atherosclerotic human iliac lesion of type V. The stress evolution in four different tissue components during and after stenting is investigated. The geometric model of the artery is obtained through MRI, while anisotropic material models are applied to describe the behavior of tissues at finite strains. In order to model the observed fissuring and dissection of the plaque under dilation, the undeformed configuration of the arterial wall incorporates two initial tears. The 3D balloon-stent-artery interaction problem is modeled by means of a contact algorithm, which is based on a C(2)-continuous surface parametrization, hence avoiding numerical instabilities of standard facet-based techniques. In the simulations three different stent designs are studied. The performance of each stent is characterized by scalar quantities relating to stress changes in the artery, contact forces, and changes in lumen area after stenting. The study concludes by suggesting two optimal stent designs for two different clinically relevant parameters.
authors.affiliation: Department of Solid Mechanics, School of Engineering Sciences, Royal Institute of Technology (KTH), Stockholm, Sweden.
authors.forename: Dimitrios E
authors.initials: DE
authors.lastname: Kiousis
authors.forename: T Christian
authors.initials: TC
authors.lastname: Gasser
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Holzapfel
mesh_terms: D000465:Algorithms; D000784:Aortic Dissection / Q000209:etiology / Q000503:physiopathology; D000800:Angioplasty, Balloon / Q000009:adverse effects; D016880:Anisotropy; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000601:surgery; D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology*; D003198:Computer Simulation; D017076:Computer-Aided Design; D020342:Finite Element Analysis; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology / Q000503:physiopathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008955:Models, Cardiovascular; D015233:Models, Statistical; D015607:Stents; D013314:Stress, Mechanical