title: Comparison of second-generation stents for application in the superficial femoral artery: an in vitro evaluation focusing on stent design.
abstract: OBJECTIVE
  To examine and compare in an ex vivo study different nitinol stent designs intended for the superficial femoral artery (SFA) with regard to the appearance of fracture.
  
  
  METHODS
  Seven different 8-×40-mm nitinol stents were evaluated (Misago, Absolute, Smart, Luminexx, Sentinol, Lifestent NT, and Sinus-Superflex). Finite element analysis (FEA) was used for digitalized stent design comparison; the strain during stent movement was calculated for bending, compression, and torsion. Additional mechanical fatigue tests for bending (70°), compression (40%), and torsion (twisted counterclockwise by 180°) were performed up to 650,000 cycles or until a fracture was observed.
  
  
  RESULTS
  The FEA bending test showed that only the Misago, LifeStent, and Absolute stents presented no zones of high strain; in the torsion test, the Smart stent also had no zones of high strain. Macroscopic evaluation after mechanical bending indicated that the LifeStent performed the best (no stent fracture after 650,000 cycles). Misago and Absolute stents showed fractures at 536,000 cycles and 456,667 cycles, respectively (range 320,000-650,000 cycles). After compression and torsion testing, Misago showed no stent fracture after 650,000 cycles. The worst performing stent was Luminexx during all test cycles.
  
  
  CONCLUSIONS
  The 7 SFA stents showed differences in the incidence of high strain zones, which indicates a potential for stent fracture, as demonstrated by the mechanical fatigue tests. Differences in stent design might play a major role in the appearance of stent strut fracture related to restenosis and reocclusion.
authors.affiliation: Department of Diagnostic and Interventional Radiology/Neuroradiology, Academic Hospitals Flensburg, Flensburg, Germany. muehue@diako.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Müller-Hülsbeck
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Schäfer
authors.forename: Nikolas
authors.initials: N
authors.lastname: Charalambous
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.forename: Martin
authors.initials: M
authors.lastname: Heller
authors.forename: Thomas
authors.initials: T
authors.lastname: Jahnke
mesh_terms: D000497:Alloys; D019245:Compressive Strength; D019544:Equipment Failure Analysis; D005263:Femoral Artery / Q000502:physiology*; D020342:Finite Element Analysis; D006801:Humans; D008422:Materials Testing; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents; D013314:Stress, Mechanical; D013718:Tensile Strength
chemical_list: D000497:Alloys; C013616:nitinol