Analysis of Prolapse in Cardiovascular Stents: A Constitutive Equation for Vascular Tissue and Finite-Element Modelling

[+] Author and Article Information
P. J. Prendergast, C. Lally, S. Daly, A. J. Reid

Department of Mechanical Engineering, Trinity College, Dublin, Ireland

T. C. Lee

Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland

D. Quinn, F. Dolan

Medtronic AVE, Parkmore Industrial Estate, Galway, Ireland

J Biomech Eng 125(5), 692-699 (Oct 09, 2003) (8 pages) doi:10.1115/1.1613674 History: Received August 27, 2001; Revised February 10, 2003; Online October 09, 2003
Copyright © 2003 by ASME
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Sigwart,  U., Puel,  J., Mirkovitch,  V., Joffre,  F., and Kappenberger,  L., 1987, “Intravascular Stents to Prevent Occlusion and Restenosis After Transluminal Angioplasty,” N. Engl. J. Med., 316, pp. 701–707.
Duerg,  T., Pelton,  A., and Stöckel,  D., 1999, “An Overview of Nitinol for Medical Applications,” Materials Science and Engineering, A273–275, pp. 149–160.
Schwartz,  R. S., 1998, “Pathophysiology of Restenosis: Interaction of Thrombosis, Hyperplasic, and/or Remodelling,” Am. J. Cardiol., 81, pp. 14E–17E.
Kastrati,  A., Mehilli,  J., Dirchinger,  J., Pache,  J., Ulm,  K., Schühlen,  H., Seyfarth,  M., Schmitt,  C., Blasini,  R., Neumann,  F.-J., and Schömig,  A., 2001, “Restenosis After Coronary Placement of Various Stent Types,” Am. J. Cardiol., 87, pp. 34–39.
Edelman,  E. R., and Rogers,  C., 1995, “Endovascular Stent Design Dictates Experimental Restenosis and Thrombosis,” Circulation, 91, pp. 2995–3001.
Dumoulin,  C., and Cochelin,  B., 2000, “Mechanical Behavior Modelling of Balloon-Expandable Stents,” J. Biomech., 33, pp. 1461–1470.
Whitcher,  F. D., 1997, “Simulation of In Vivo Loading Conditions of Nitinol Vascular Stent Structures,” Computers and Structures, 64, pp. 1005–1011.
Veress,  A. I., Vince,  D. G., Anderson,  P. M., Cornhill,  J. F., Herderick,  E. E., Killingensmith,  J. D., Kuban,  B. D., and Thomas,  J. D., 2000, “Vascular Mechanics of the Coronary Artery,” Z. Kardiol., 89(Suppl. 2), pp. 92–100.
Rogers,  C., Tseng,  D. Y., Squire,  J. C., and Edelman,  E. R., 1999, “Balloon-Artery Interactions During Stent Placement—A Finite-Element Analysis Approach to Pressure, Compliance, and Stent Design as Contributors to Vascular Injury,” Circ. Res., 84, pp. 378–383.
Hayashi,  K., and Imai,  Y., 1997, “Tensile Property of Atheromatous Plaque and an Analysis of Stress in the Artherosclerotic Wall,” J. Biomech., 30, pp. 573–579.
Green, A. E., and Zerna, W., 1968, Theoretical Elasticity, Clarendon Press, Oxford.
Carew,  T. E., Vaishnav,  R. N., and Patel,  D. J., 1968, “Compressibility of the Vascular Wall,” Circ. Res., 27, pp. 105–119.
Mooney,  M., 1940, “A Theory of Large Elastic Deformation,” J. Appl. Phys., 11, pp. 582–592.
Sacks,  M. S., 2000, “Biaxial Mechanical Evaluation of Biological Materials,” Journal of Elasticity, 61, pp. 199–246.
Ponde,  C. K., Aroney,  C. N., McEniery,  P. T., and Bett,  J. H. N., 1997, “Plaque Prolapse Between the Struts of the Intracoronary Palmaz-Schantz Stent,” Catheterization and Cardiovascular Interventions, 40, pp. 353–357.
Hong,  M.-K., Park,  S.-W., Lee,  C. W., Kang,  D.-K., Song,  J.-J., and Park,  A.-J., 2000, “Long-Term Outcomes of Minor Plaque Prolapsed Within Stents Documented With Intravascular Untrasound,” Catheterization and Cardiovascular Interventions, 51, pp. 22–26.
Jang,  I.-K., Tearney,  G., and Bouma,  B., 2001, “Visualization of Tissue Prolapse Between Coronary Stent Struts by Optical Coherence Tomography,” Comparison With Intravascular Untrasound. Circulation, 104, p. 2754.
Treloar,  L. R. G., 1943, “The Elasticity of a Network of Long-Chain Molecules,” Transactions of the Faraday Society, 39, pp. 241–246.
Truesdell,  C. A., 1952, “The Mechanical Foundations of Elasticity and Fluid Dynamics,” Journal of Rational Mechanics and Analysis, 1, pp. 173–182.
Holzapfel,  G. A., Gasser,  T. C., and Ogden,  R. W., 2000, “A New Constitutive Framework for Arterial Wall Mechanics and a Comparative Study of Material Models,” Journal of Elasticity, 61, pp. 1–48.
Burton,  A. C., 1962, “Physical Principles of Circulatory Phenomena: The Physical Equilibria of the Heart and Blood Vessels,” Handbook of Physiology,1(Section 2), pp. 85–106, American Physiological Society, Washington.
Beyar, R., and Serruys, P., 1999, The BeStent, In: Handbook of Coronary Stents, P. W. Serruys and M. J. B. Kutryk (Eds.), 1998 second edition, Martin Dunitz, London, p. 159.
Edelman,  E. R., and Rogers,  C., 1998, “Pathobiologic Responses to Stenting,” Am. J. Cardiol., 81(7A), pp. 4E–6E.
Fung, Y. C., Biomechanics. Mechanical Behavior of Living Tissues, Springer, New York, NY.
Holzapfel, G., 2000, In: Mechanics in Biology, eds. J. Casey and G. Bao, American Society of Mechanical Engineers, New York, NY, pp. 157–169.
Truesdell,  C. A., 1952, “The Mechanical Foundations of Elasticity and Fluid Dynamics,” Journal of Rational Mechanics and Analysis, 1, p. 182.
Vorp, D. A., and Wang, D. H.-J., 2000, “Use of Finite Elasticity in Abdominal Aortic Aneurysm Research,” In: Mechanics in Biology (eds. J. Casey and G. Bao), American Society of Mechanical Engineers: New York, NY, pp. 157–169.
Sacks,  M. S., and Chuong,  C., 1998, “Orthotropic Mechanical Properties of Chemically Treated Bovine Pericardium,” Ann. Biomed. Eng., 26, pp. 892–902.
Jemiolo,  S., and Telega,  J. J., 2001, “Transversely Isotropic Materials Undergoing Large Deformations and Application to Modelling of Soft Tissues,” Mech. Res. Commun., 28, pp. 397–404.
Hoffmann,  R., Mintz,  G. S., Dussaillant,  G. R., Popma,  J. J., Pichard,  A. D., Salter,  L. F., Kent,  K. M., Griffin,  J., and Leon,  M. B., 1996, “Patterns and Mechanisms of In-Stent Restenosis,” Circulation, 94, pp. 1247–1254.
Messenger,  J. C., Chen,  S. Y. J., Carroll,  J. D., Burchenal,  J. E. B., Kioussopoulos,  K., and Groves,  B. M., 2000, “3-D Coronary Reconstruction From Routine Single-Plane Coronary Angiograms: Clinical Validation and Quantitative Analysis of the Right Coronary Artery in 100 Patients,” Int. J. Card. Imaging, 16, pp. 413–427.
Lally, C., Prendergast, P. J., Lennon, A. B., Quinn, D., and Dolan, F., 2002, “Finite-Element Analysis of Tissue Prolapse Within Intravascular Stents Calculated Using a Single Repeating Unit of a Stent and a Full 3-D Model of a Stent,” Proceedings of the 13th Conference of the European Society of Biomechanics, Wroclaw, Poland. Acta of Bioengineering and Biomechanics, 4 (Suppl. 1), pp. 537–538.


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(a) Luminal tissue prolapse within a stented vessel (indicated by black lines)1, (b) A 2-D schematic of a stented vessel before stenting with vessel wall ideally cylindrical and (c) after stenting where the tissue drapes between the stent wiresGrahic Jump Location
Schematic illustration of the biaxial testing device
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Close-up view of a biaxial specimen with the array of dots used to measure stretch and the crocodile clips used to clamp the tissue
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Four types of stent analyzed in this study; (BeStent 2, Medtronic AVE; NIROYAL, Boston Scientific; VELOCITY, Cordis, and the TETRA Stent, Guidant) and a plan view of finite element meshes within an expanded repeating unit. The red arrow indicates the direction and the start point from which the distance around the periphery of the stent is taken.
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Five uniaxial stress-stretch curves for pig aorta, with the fitted elastic model (dashed line)
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Five biaxial stress-stretch curves for pig aorta, with the fitted elastic model (dashed line)
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Uniaxial and biaxial data for the human femoral artery, with the fitted biaxial and uniaxial constitutive models (dashed line)
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The maximum prolapse of the vascular tissue within the repeating unit of the stent for each of the four stents analyzed. The result is given for both the porcine aorta properties and the human femoral properties.
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Prolapse of the four stents: Contour plot of the displacements in the BeStent 2, Medtronic AVE, the NIROYAL, Boston Scientific, the VELOCITY, Cordis; and the Tetra Stent, Guidant
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Maximum principal stress in the mid-layer of the vessel around the periphery of the repeating-unit (i.e., directly above the stent wire). High stresses are indicative of a likelihood of tissue damage and intimal hyperplasia.
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Peak stress vs. mesh type. Mesh type 1: 4 elements through vessel wall; Mesh type 2: 8 elements through vessel wall; Mesh type 3: 12 elements through vessel wall; Mesh type 4: 12 elements through vessel wall, with double the mesh density shown in Fig. 4.




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