title: Evaluation of carotid stent scaffolding through patient-specific finite element analysis.
abstract: After carotid artery stenting, the plaque remains contained between the stent and the vessel wall, moving consequently physicians' concerns toward the stent capability of limiting the plaque protrusion, that is, toward vessel scaffolding, to avoid that some debris is dislodged after the procedure. Vessel scaffolding is usually measured as the cell area of the stent in free-expanded configuration, neglecting thus the actual stent configuration within the vascular anatomy. In the present study, we measure the cell area of four different stent designs deployed in a realistic carotid artery model through patient-specific finite element analysis. The results suggest that after deployment, the cell area change along the stent length and the related reduction with respect to the free-expanded configuration are functions of the vessel tapering. Hence, the conclusions withdrawn from the free-expanded configuration appear to be qualitatively acceptable for comparative purposes, but they should be carefully handled because they neglect the post-implant variability, which seems to be more pronounced in open-cell designs, especially at the bifurcation segment. Even though the investigation is limited to few stent designs and one vascular anatomy, our study confirms the capability of dedicated computer-based simulations to provide useful information about complex stent features as vessel scaffolding.
authors.affiliation: Dipartimento di Ingegneria Civile ed Architettura, Università degli Studi di Pavia, Via Ferrata 1, 27100, Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Auricchio
authors.forename: M
authors.initials: M
authors.lastname: Conti
authors.forename: M
authors.initials: M
authors.lastname: Ferraro
authors.forename: A
authors.initials: A
authors.lastname: Reali
mesh_terms: D001698:Biomedical Engineering; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D008955:Models, Cardiovascular; D008959:Models, Neurological; D011474:Prosthesis Design / Q000706:statistics & numerical data; D015607:Stents / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed