Computational Evaluation of Artery Damage in Stent Deployment

This paper aims to evaluate damage in an arterial wall and plaque caused by percutaneous coronary intervention using a finite-element (FE) method. Hyperelastic damage models, verified against experimental results, were used to describe stress-stretch responses of arterial layers and plaque in the lumen; these models are capable to simulate softening behaviour of the tissue due to damage. Abaqus CAE was employed to create the FE models for an artery wall with two constituent layers (media and adventitia), a symmetric uniform plaque, a bioresorbable polymeric stent and a tri-folded expansion balloon. The effect of percutaneous coronary intervention on vessel damage was investigated by simulating the processes of vessel pre-dilation, stent deployment and post-stenting dilation. Energy dissipation density was used to assess the extent of damage in the tissue. Overall, the plaque experienced the most severe damage due to its direct contact with the stent, followed by the media and adventitia layers. Softening of the plaque and the artery due to the pre dilation -induced damage can facilitate the subsequent stent-deployment process. The plaque and artery experienced heterogeneous damage behaviour after the stent deployment, caused by non-uniform deformation. The post-stenting dilation was effective to achieve a full expansion of the stent but caused additional damage to the artery. The computational evaluation of artery damage can be also potentially used to assess the risk of in-stent restenosis after percutaneous coronary intervention. (C) 2018 The Authors. Published by Elsevier B.V.

本文旨在使用有限元（FE）方法评估经皮冠状动脉介入治疗对动脉壁和斑块造成的损伤。通过实验结果验证的超弹性损伤模型被用于描述管腔内动脉层和斑块的应力 - 应变响应；这些模型能够模拟由于损伤导致的组织软化行为。采用Abaqus CAE为具有两层组成结构（中膜和外膜）的动脉壁、一个对称均匀的斑块、一个生物可吸收聚合物支架以及一个三折叠扩张球囊创建有限元模型。通过模拟血管预扩张、支架展开和支架植入后扩张过程，研究了经皮冠状动脉介入治疗对血管损伤的影响。能量耗散密度被用于评估组织损伤的程度。总体而言，由于斑块与支架直接接触，其受损最为严重，其次是中膜和外膜层。由于预扩张引起的损伤导致的斑块和动脉软化可以促进后续的支架展开过程。支架展开后，由于不均匀变形，斑块和动脉出现了不均匀的损伤行为。支架植入后的扩张有效地实现了支架的完全扩张，但对动脉造成了额外的损伤。动脉损伤的计算评估也可能潜在地用于评估经皮冠状动脉介入治疗后支架内再狭窄的风险。（C）2018作者。由爱思唯尔B.V.出版。