title: Impact of carotid stent cell design on vessel scaffolding: a case study comparing experimental investigation and numerical simulations.
abstract: OBJECTIVE
  To quantitatively evaluate the impact of carotid stent cell design on vessel scaffolding by using patient-specific finite element analysis of carotid artery stenting (CAS).
  
  
  METHODS
  The study was organized in 2 parts: (1) validation of a patient-specific finite element analysis of CAS and (2) evaluation of vessel scaffolding. Micro-computed tomography (CT) images of an open-cell stent deployed in a patient-specific silicone mock artery were compared with the corresponding finite element analysis results. This simulation was repeated for the closed-cell counterpart. In the second part, the stent strut distribution, as reflected by the inter-strut angles, was evaluated for both cell types in different vessel cross sections as a measure of scaffolding.
  
  
  RESULTS
  The results of the patient-specific finite element analysis of CAS matched well with experimental stent deployment both qualitatively and quantitatively, demonstrating the reliability of the numerical approach. The measured inter-strut angles suggested that the closed-cell design provided superior vessel scaffolding compared to the open-cell counterpart. However, the full strut interconnection of the closed-cell design reduced the stent's ability to accommodate to the irregular eccentric profile of the vessel cross section, leading to a gap between the stent surface and the vessel wall.
  
  
  CONCLUSIONS
  Even though this study was limited to a single stent design and one vascular anatomy, the study confirmed the capability of dedicated computer simulations to predict differences in scaffolding by open- and closed-cell carotid artery stents. These simulations have the potential to be used in the design of novel carotid stents or for procedure planning.
authors.affiliation: Department of Structural Mechanics, Università degli Studi di Pavia, Italy. michele.conti@unipv.it
authors.forename: Michele
authors.initials: M
authors.lastname: Conti
authors.forename: Denis
authors.initials: D
authors.lastname: Van Loo
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Auricchio
authors.forename: Matthieu
authors.initials: M
authors.lastname: De Beule
authors.forename: Gianluca
authors.initials: G
authors.lastname: De Santis
authors.forename: Benedict
authors.initials: B
authors.lastname: Verhegghe
authors.forename: Stefano
authors.initials: S
authors.lastname: Pirrelli
authors.forename: Attilio
authors.initials: A
authors.lastname: Odero
mesh_terms: D000369:Aged, 80 and over; D017130:Angioplasty / Q000295:instrumentation*; D002339:Carotid Arteries / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D003198:Computer Simulation; D017076:Computer-Aided Design; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D009716:Numerical Analysis, Computer-Assisted; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012828:Silicones; D015607:Stents; D055114:X-Ray Microtomography
chemical_list: D012828:Silicones