title: Covered Stent Membrane Design for Treatment of Atheroembolic Disease at Carotid Artery Bifurcation and Prevention of Thromboembolic Stroke: An In Vitro Experimental Study.
abstract: In this study, a polymeric membrane has been designed and developed for carotid stents to prevent detachment of emboli from the arterial wall and subsequent stroke, while maintaining side-branch flow. Prototypes of different geometrical design parameters have been fabricated and their performance has been evaluated in vitro under physiological pulsatile flow condition in a life-size silicone anastomotic model of carotid artery bifurcation. These evaluations include both quantitative and qualitative experimental (in vitro) assessments of emboli prevention capability, side-branch flow preservation, and flow visualization. The covered stents with the novel membrane demonstrated significantly higher emboli prevention capability than the corresponding bare nitinol stent as well as some earlier related designs, while preserving more than 93% of the original flow of the external carotid artery (ECA). Flow in the ECA through these covered stents was uniform without evidence of undesirable flow recirculation or retrograde flow that might predispose the vessel wall to intimal thickening and atherosclerotic plaque formation. This study demonstrated the potential of these novel covered stent designs for the treatment of carotid atherosclerotic stenosis and prevention of late embolic stroke. However, further in vivo investigations of biological effects and mechanical performance of this covered stent design (e.g., its thrombogenicity potential and biocompatibility) are warranted.
authors.affiliation: Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.|Department of Surgery, National University of Singapore, Singapore, Singapore.
authors.forename: Foad
authors.identifier: http://orcid.org/0000-0002-4125-5064
authors.initials: F
authors.lastname: Kabinejadian
authors.affiliation: Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.
authors.forename: Mercedeh Kaabi
authors.initials: MK
authors.lastname: Nezhadian
authors.affiliation: Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
authors.forename: Fangsen
authors.initials: F
authors.lastname: Cui
authors.affiliation: Department of Surgery, National University of Singapore, Singapore, Singapore.|Department of Cardiac, Thoracic & Vascular Surgery, National University Health System, Singapore, Singapore.
authors.forename: Pei
authors.initials: P
authors.lastname: Ho
authors.affiliation: Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.
authors.forename: Hwa Liang
authors.initials: HL
authors.lastname: Leo
mesh_terms: D000497:Alloys / Q000737:chemistry; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000033:anatomy & histology / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000628:therapy; D020099:Coated Materials, Biocompatible / Q000737:chemistry*; D006801:Humans; D008567:Membranes, Artificial; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D011108:Polymers / Q000737:chemistry; D011474:Prosthesis Design; D011673:Pulsatile Flow; D015607:Stents; D020521:Stroke / Q000503:physiopathology / Q000517:prevention & control; D013923:Thromboembolism / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; D008567:Membranes, Artificial; D011108:Polymers; C013616:nitinol
keywords: Carotid stent; Embolic prevention; Flow visualization; Hemodynamic; Stroke