Is modeling stents still an important issue?

Numerical models of cardiovascular devices have always appeared in literature studies few years after their use in clinical practice. As example, FDA approval of Palmaz-Schatz stent was in 1994, while the first numerical studies on a similar stent model appeared after 1999. The same temporal delay can be observed for degradable stents, transcatheter valves or more recently for devices like the stent retrievers. This observation does not necessarily mean that numerical modeling had not been used in the design of the stents or cardiovascular devices. Companies might have used numerical tools but not published the results. Was the publication activity committed mainly to the academic world? Or was the numerical modeling an exclusive academic activity until a few years ago? Modeling has intrinsic errors, while prototyping looks immune, as it is the natural design process for a company. The real world has always attracted more attention than the virtual world. Models are useful and the gap between the industrial production and numerical tools in the designing of devices is being reduced recently. Nowadays advances in medical images and augmentation of computer power allow to think of building real-time simulations as well as patient-specific models to be used to predict the device behavior; this is a plus that numerical modeling has over the traditional design process of cardiovascular devices. Furthermore, as in the past, the identification of new unknown problems/failures will always make the usage of numerical modeling a useful tool to explain the reasons of failure. The future in modeling stents is envisioned in their use for in silico trials and in the link between biology, engineering, and science.