Research Papers

Numerical Simulation of Vertebral Artery Stenosis Treated With Different Stents

[+] Author and Article Information
Aike Qiao

College of Life Science and Bio-engineering,
Beijing University of Technology,
Beijing 100124, China
e-mail: qak@bjut.edu.cn

Zhanzhu Zhang

College of Life Science and Bio-engineering,
Beijing University of Technology,
Beijing 100124, China
e-mail: jsdxjwc@163.com

1Corresponding author.

Contributed by the Bioengineering Division of ASME for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received July 23, 2013; final manuscript received December 6, 2013; accepted manuscript posted December 12, 2013; published online March 24, 2014. Assoc. Editor: Dalin Tang.

J Biomech Eng 136(4), 041007 (Mar 24, 2014) (9 pages) Paper No: BIO-13-1324; doi: 10.1115/1.4026229 History: Received July 23, 2013; Revised December 06, 2013; Accepted December 12, 2013

We sought to investigate the effects of endovascular stents with different links for treating stenotic vertebral artery and to determine the relationship between the shape of the link and in-stent restenosis (ISR). We also attempted to provide scientific guidelines for stent design and selection for clinical procedures. Models of three types of stent with different links (L-stent, V-stent, and S-stent) and an idealized stenotic vertebral artery were established. The deployment procedure for the stent in the stenotic vertebral artery was simulated for solid mechanics analysis. Next, the deformed models were extracted to construct the blood flow domain, and numerical simulations of the hemodynamics in these models were performed using the finite element method. The numerical results demonstrated that: (1) Compared with the L-stent and V-stent, the S-stent has a better flexibility and induces less stress in the stent strut. Furthermore, less stress is generated in the arterial wall. (2) Vascular straightening is scarcely influenced by the shape of the link, but it is closely related to the flexibility of the stent. (3) The S-stent has the smallest foreshortening among the three types of stents. (4) Compared with the V-stent and S-stent, the L-stent causes a smaller area with low wall shear stress, less blood stagnation area, and better blood flow close to the artery wall. From the viewpoint of the combination of solid mechanics and hemodynamics, the S-stent has better therapeutic effects because of its lower potential for inducing ISR and its better prospects in clinical applications compared with the L-stent and V-stent.

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Caplan, L. R., Wityk, R. J., and GlassT. A., 2004, “New England Medical Center Posterior Circulation Registry,” Ann. Neurol., 56(3), pp. 389–398. [CrossRef]
Savitz, S. I., and Caplan, L. R., 2005, “Vertebrobasilar Disease,” N. Engl. J. Med., 352(25), pp. 2618–2626. [CrossRef]
Dabus, G., Gerstle, R. J., and DerdeynC. P., 2006, “Endovascular Treatment of the Vertebral Artery Origin in Patients With Symptoms of Vertebrobasilar Ischemia,” Neuroradiology, 48(12), pp. 917–923. [CrossRef]
Taylor, R. A., Siddiq, F., and Suri, M. F., 2008, “Risk Factors for In-Stent restenosis after Vertebral ostium Stenting,” J. Endovasc. Ther., 15(2), pp. 203–212. [CrossRef]
Wholey, M. H., Wholey, M., and Mathias, K., 2000, “Global Experience in Cervical Carotid Artery Stent Placement,” Catherization Cardiovasc. Interven., 50(2), pp. 160–167. [CrossRef]
Wehman, J. C., Hanel, R. A., and Guidot, C. A., 2004, “Atherosclerotic Occlusive Extracranial Vertebral Artery Disease,” J. Interven. Cardiol., 17(4), pp. 219–232. [CrossRef]
Mortier, P., Holzapfel, G. A., and De Beule, M., 2010, “A Novel Simulation strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-Eluting Stents,” Ann. Biomed. Eng., 38(1), pp. 88–99. [CrossRef]
Gijsen, F., Migliavacca, F., and Schievano, S., 2008, “Simulation of Stent Deployment in a Realistic Human Coronary Artery,” Biomed. Eng. Online, 7, p. 23. [CrossRef]
Wu, W., Wang, W. Q., and Yang, D. Z., 2007, “Stent Expansion in Curved Vessel and Their Interactions: A Finite Element Analysis,” J. Biomech., 40(11), pp. 2580–2585. [CrossRef]
Gu, L. X., Zhao, S. J., and Muttyam, A. K., 2010, “The Relation Between the Arterial Stress and Restenosis Rate After Coronary Stenting,” ASME J. Med. Devices, 4(3), p. 031005. [CrossRef]
Colombo, A., Stankovic, G., and Moses, J. W., 2002, “Selection of Coronary Stents,” J. Am. College Cardiol., 40(6), pp. 1021–1033. [CrossRef]
Balossino, R., Gervaso, F., and Migliavacca, F., 2008, “Effects of Different Stent Designs on Local Hemodynamics in Stented Arteries,” J. Biomech., 41(5), pp. 1053–1061. [CrossRef]
Cheng, J., and Ni, Z., 2010, “A Numerical Study on the Wall Shear Stress of Stented Artery Model,” IEEE 2010 International Conference on Mechatronics and Automation (ICMA), Piscataway, NJ.
Morlacchi, S., Keller, B., and Arcangeli, P., 2011, “Hemodynamics and In-Stent Restenosis: Micro-CT Images, Histology, and Computer Simulations,” Ann. Biomed. Eng., 39(10), pp. 2615–2626. [CrossRef]
Chiu, J. J., and Chien, S., 2011, “Effects of Disturbed Flow on Vascular Endothelium: Pathophysiological Basis and Clinical Perspectives,” Physiol. Rev., 91(1), pp. 327–387. [CrossRef]
Takashima, K., Shimomura, R., and Kitou, T., 2007, “Contact and Friction Between Catheter and Blood Vessel,” Trib. Int., 40(2), pp. 319–328. [CrossRef]
Auricchio, F., Conti, M., and De Beule, M., 2011, “Carotid Artery Stenting Simulation: From Patient-Specific Images to Finite Element Analysis,” Med. Eng. Phys., 33(3), pp. 281–289. [CrossRef]
Holazpfel, G. A., Stadlr, M., and Gasser, T. C., 2005, “Changes in the Mechanical Environment of Stenotic Arteries During Interaction With Stents: Computational Assessment of Parametric Stent Designs,” ASME J. Biomech. Eng., 127(1), pp. 166–180. [CrossRef]
Rieu, R., Barragan, P., and Garitey, V., 2003, “Assessment of the Trackability, Flexibility, and Conformbility of Coronary Stents: A Comparative Analysis,” Catheterization Cardiovasc. Interven., 59(4), pp. 496–503. [CrossRef]
Wang, W. Q., Liang, D. K., and Yang, D. Z., 2006, “Analysis of the Transient Expansion Behavior and Design Optimization of Coronary Stents by Finite Element Method,” J. Biomech., 39(1), pp. 21–32. [CrossRef]
Wentzel, J. J., Whelan, D. M., and Van Der Giessen, W. J., 2000, “Coronary Stent Implantation Changes 3-D Vessel Geometry and 3-D Shear Stress Distribution,” J. Biomech., 33(10), pp. 1287–1295. [CrossRef]
Chen, M. C. Y., Lu, P. C., and Chen, J. S. K., 2005, “Computational Hemodynamics of an Implanted Coronary Stent Based on Three-Dimensional Cine Angiography Reconstruction,” Am. Soc. Art. Organs J., 51(4), pp. 313–320. [CrossRef]
Johnston, B. M., Johnston, P. R., and Corney, S., 2006, “Non-Newtonian Blood Flow in Human Right Coronary Arteries: Transient Simulations,” J. Biomech., 39(6), pp. 1116–1128. [CrossRef]
LaDisa, J. F., Olson, L. E., and Guler, I., 2005, “Circumferential Vascular Deformation After Stent Implantation Alters Wall Shear Stress Evaluated With Time-Dependent 3D Computational Fluid Dynamics Models,” J. Appl. Physiol., 98(3), pp. 947–957. [CrossRef]
Niu, J., Qiao, A. K., and Jiao, L. Q., 2013, “Hemodynamic Analysis of Stent Expansion Ratio for the Vertebral Artery Ostium Stenosis Intervention,” J. Mech. Med. Biol., 13(4), p. 1350058. [CrossRef]
Augsburger, L., Farhat, M., and Reymond, P., 2009, “Effect of Flow Diverter Porosity on Intraaneurysmal Blood Flow,” Clin. Neuroradiol., 19(3), pp. 204–214. [CrossRef]
Chua, S., Macdonald, B. J., and Hashmi, M., 2004, “Effects of Varying Slotted Tube (Stent) Geometry on Its Expansion Behaviour Using Finite Element Method,” J. Mat. Process. Tech., 155(SIPart 2), pp. 1764–1771. [CrossRef]
Mills, C. L., Gabe, I. T., and Gault, J. H., 1970, “Pressure-Flow Relationships and Vascular Impedance in Man,” Cardiovasc. Res., 4(4), pp. 405–417. [CrossRef]
Malek, A. M., Alper, S. L., and Izumo, S.1999, “Hemodynamic Shear Stress and Its role in Atherosclerosis,” JAMA, 282(21), pp. 2035–2042. [CrossRef]
Lee, S. W., Lee, S., and Fischer, P. F., 2008, “Direct simulations of transitional flow in a Patient-Specific Carotid Bifurcation With Stenosis,” IFOST 2008: Proceeding of the Third International Forum on Strategic Technologies, Novosibirsk-Tomsk, Russia, pp. 475–479.
Moore, J. E., and Berry, J. L., 2002, “Fluid and Solid Mechanical Implications of Vascular Stenting,” Ann. Biomed. Eng., 30(4), pp. 498–508. [CrossRef]
Edelman, E. R., and Rogers, C., 1998, “Pathobiologic Responses to Stenting,” Am. J. Cardiol., 81(7ASI), pp. 4E–6E. [CrossRef]
Tang, D., Yang, C., and Mondal, S., 2008, “A Negative Correlation Between Human Carotid Atherosclerosis Plaque Progression and Plaque Wall Stress: In Vivo MRI-Based 2D/3D FSI Models,” J. Biomech., 41(4), pp. 727–736. [CrossRef]
Malvè, M., Chandra, S., García, A., Mena, A., Martínez, M. A., Finol, E. A. and Doblaré, M., 2013, “Impedance-Based Outflow Boundary Conditions for Human Carotid Haemodynamics,” Comput. Meth. Biomech. Biomed. Eng. 2013 Feb 6. [Epub ahead of print] [CrossRef]
Torii, R., Oshima, M., and Kobayashi, T., 2006, “Computer Modeling of Cardiovascular Fluid-Structure Interactions With the Deforming-Spatial-Domain/Stabilized Space-Time Formulation,” Comput. Meth. Appl. Mech. Eng., 195(16), pp. 1885–1895. [CrossRef]
Lantz, J., Renner, J., and KarlssonM., 2011, “Wall Shear Stress in a Subject Specific Human Aorta—Influence of Fluid-Structure Interaction,” Int. J. Appl. Mech., 4(3), pp. 759–778. [CrossRef]
Kelly, S., and O'Rourke, M., 2012, “Fluid, Solid and Fluid–Structure Interaction Simulations on Patient-Based Abdominal Aortic Aneurysm Models,” Proc. IMechE H J. Eng. Med., 226(4), pp. 288–304. [CrossRef]


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Fig. 4

Meshes for the solid mechanics simulation (left: local view of the stent and stenosis) and the hemodynamics simulation (right: local view of the cross section of stented lumen)

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Fig. 3

Inlet velocity waveform

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Fig. 6

Foreshortening of the stent

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Fig. 7

Contours of the strain in the vessel wall (the arrow marks the location of the maximum value)

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Fig. 2

The blood flow boundary surface reconstructed with the deformed surfaces of the deployed stents and arteries

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Fig. 1

Models of the artery (left) and the stents (right)

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Fig. 5

Straightening of the artery

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Fig. 8

Contours of Von Mises stress (left), axial stress (middle), and circumferential stress (right) in the L-stent (first row), V-stent (second row), and S-stent (third row) (the arrow marks the location of the maximum value)

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Fig. 9

Contours of the WSS using a scale of 0–10 Pa (upper) and using a scale of 0–30 Pa (lower)

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Fig. 10

Contours of OSI distributed on the vessel wall




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