Development of biomechanical models to support the design of endovascular protheses

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The general context is the mechanical failure of vascular conduits (plaque and aneurysm rupture) and their treatment with vascular prostheses (stents, grafts, heart valves). For example, it is now considered that one of the main causes of myocardial infarction is the rupture of an atherosclerotic plaque. The use of a stent (endovascular scaffolding prosthesis) is a well established interventional method to treat atherosclerotic arteries. However, in a significant fraction (20%-30%), the stented segment may reobstruct. This phenomenon called in-stent restenosis (ISR) is principally caused by the proliferation of smooth muscle cells (hyperplasia). It has been proposed that possible causes of ISR are wall injury of mechanical origin during angioplasty. The proposed approach using fracture mechanics should help understand these phenomena.