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Technical Brief

Numerical Study of Incomplete Stent Apposition Caused by Deploying Undersized Stent in Arteries With Elliptical Cross Sections

[+] Author and Article Information
Bo Jiang

Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne, Victoria 3010, Australia
e-mail: bjiang1@student.unimelb.edu.au

Vikas Thondapu

Department of Medicine,
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne, Victoria 3010, Australia;
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne, Victoria 3010, Australia
e-mail: vthondapu@student.unimelb.edu.au

Eric K. W. Poon

Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne, Victoria 3010, Australia
e-mail: epoon@unimelb.edu.au

Peter Barlis

Department of Medicine,
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne, Victoria 3010, Australia
e-mail: pbarlis@unimelb.edu.au

Andrew S. H. Ooi

Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne, Victoria 3010, Australia
e-mail: a.ooi@unimelb.edu.au

1Corresponding author.

Manuscript received June 15, 2018; final manuscript received February 6, 2019; published online March 25, 2019. Assoc. Editor: Alison Marsden.

J Biomech Eng 141(5), 054501 (Mar 25, 2019) (7 pages) Paper No: BIO-18-1283; doi: 10.1115/1.4042899 History: Received June 15, 2018; Revised February 06, 2019

Incomplete stent apposition (ISA) is one of the causes leading to poststent complications, which can be found when an undersized or an underexpanded stent is deployed at lesions. The previous research efforts have focused on ISA in idealized coronary arterial geometry with circular cross section. However, arterial cross section eccentricity plays an important role in both location and severity of ISA. Computational fluid dynamics (CFD) simulations are carried out to systematically study the effects of ISA in arteries with elliptical cross section, as such stents are partially embedded on the minor axis sides of the ellipse and malapposed elsewhere. Overall, ISA leads to high time-averaged wall shear stress (TAWSS) at the proximal end of the stent and low TAWSS at the ISA transition region and the distal end. Shear rate depends on both malapposition distance and blood stream locations, which is found to be significantly higher at the inner stent surface than the outer surface. The proximal high shear rate signifies increasing possibility in platelet activation, when coupled with low TAWSS at the transition and distal regions which may indicate a nidus for in-stent thrombosis.

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Figures

Grahic Jump Location
Fig. 1

(a) Side view and cross-sectional view of the model geometry and locations of ISA and (b) inlet pulsatile velocity waveform

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Fig. 2

Instantaneous WSS distribution of the moderate ISA case

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Fig. 3

Area percentage of lumen covered by low WSS (<0.5 Pa) at different time instants in a cardiac cycle

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Fig. 4

Spatial TAWSS distribution and plots of data from extracted lines on each side. The upper and lower dashed lines depict the undisturbed, normal TAWSS along the minor and major axes, respectively.

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Fig. 5

Mean velocity and shear rate magnitude distribution in cross-sectional planes at selected locations

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Fig. 6

Instantaneous WSS distribution of the apposed case

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Fig. 7

Instantaneous WSS distribution of the severe ISA case

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