title: Fatigue of Metallic Stents: From Clinical Evidence to Computational Analysis.
abstract: The great success of stents in treating cardiovascular disease is actually undermined by their long-term fatigue failure. The high variability of stent failure incidence suggests that it is due to several correlated aspects, such as loading conditions, material properties, component design, surgical procedure, and patient functional anatomy. Numerical and experimental non-clinical assessments are included in the recommendations and requirements of several regulatory bodies and they are thus exploited in the analysis of stent fatigue performance. Optimization-based simulation methodologies have been developed as well, to improve the fatigue endurance of novel designs. This paper presents a review on the fatigue issue in metallic stents, starting from a description of clinical evidence about stent fracture up to the analysis of computational approaches available from the literature. The reported discussion on both the experimental and numerical framework aims at providing a general insight into stent lifetime prediction as well as at understanding the factors which affect stent fatigue performance for the design of novel components.
authors.affiliation: Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, Via Ferrata 3, 27100, Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Auricchio
authors.affiliation: Laboratoire de Mécanique des Solides - CNRS UMR 7649, École Polytechnique, 91128, Palaiseau, France.
authors.forename: A
authors.initials: A
authors.lastname: Constantinescu
authors.affiliation: Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, Via Ferrata 3, 27100, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Conti
authors.affiliation: Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, Via Ferrata 3, 27100, Pavia, Italy. giulia.scalet@unipv.it.|Laboratoire de Mécanique des Solides - CNRS UMR 7649, École Polytechnique, 91128, Palaiseau, France. giulia.scalet@unipv.it.
authors.forename: G
authors.initials: G
authors.lastname: Scalet
mesh_terms: D002318:Cardiovascular Diseases / Q000601:surgery*; D006801:Humans; D008962:Models, Theoretical; D015607:Stents; D013314:Stress, Mechanical
keywords: Clinical evidence; Computational analysis; Fatigue criteria; Metallic stent; Stent fatigue