Key result
In finite element simulations of six coronary stent designs, the percentage of malapposed struts ranged from 9% for the Integrity stent to 43% for the Promus Element stent.
Why the study?
Do different coronary stent designs differ in strut apposition and vessel wall stresses in an idealised stenosed vessel model?
Do different coronary stent designs differ in strut apposition and vessel wall stresses in an idealised stenosed vessel model?
Virtual bench testing reveals considerable differences in strut apposition and vessel wall stresses among contemporary coronary stent designs, which may help explain their clinical performance.
Simulated malapposition differences by stent design are hypothesis-generating; leaves open clinical impact and requires patient-level validation.
AIMS: The aim of this study was to compare the stent strut apposition and stent induced vessel wall stresses of currently used coronary stent designs. This may help to better understand their clinical performance and provide the insights necessary for further optimisation. METHODS AND RESULTS: We compared the stent strut apposition of six different stent designs when deployed (at 12 atm) in an idealised stenosed vessel using a novel approach based on finite element simulations. Additional insights into the mechanical behaviour of the investigated stents were obtained by virtually quantifying the stent induced vessel wall stresses. For the investigated stenosed vessel model, the percentage of malapposed struts (distance to wall>10 µm) ranged between 9% (Integrity stent) and 43% (Promus Element stent). The largest strut-artery distances were observed at the plaque shoulders. The 95 percentile of the axial stress within the intima ranges from 32 (Promus Element stent) to 83 kPa (Liberté stent). Stress peaks were mainly located at the inner curvatures of the vessel model and at the stent ends. CONCLUSIONS: For the investigated case, considerable differences were observed between the studied stent platforms in terms of stent strut apposition and stent induced vessel wall stresses. These differences in mechanical behaviour may help to explain clinical observations.
No takes yet. Share an insight, caveat, or question.
Mortier et al. (2011) studied Coronary artery disease (virtual model) (n=6). Coronary stent designs vs. Different stent designs was evaluated on Percentage of malapposed struts (distance to wall > 10 µm). In finite element simulations of six coronary stent designs, the percentage of malapposed struts ranged from 9% for the Integrity stent to 43% for the Promus Element stent.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: