Balloon-artery interactions during stent placement - A finite element analysis approach to pressure, compliance, and stent design as contributors to vascular injury
Balloon-artery interactions during stent placement - A finite element analysis approach to pressure, compliance, and stent design as contributors to vascular injury
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DOI：
10.1161/01.res.84.4.378
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发表时间：
1999-03-05
影响因子：
20.1
通讯作者：
Edelman, ER
中科院分区：
文献类型：
--
作者：
Rogers, C;Tseng, DY;Edelman, ER
血管内支架比球囊血管成形术更能扩大动脉管腔，并降低选定患者冠状动脉血管成形术后的再狭窄率。了解支架展开过程中血管损伤所涉及的因素可能有助于优化支架设计和支架置入方案，从而限制血管损伤并可能减少再狭窄。针对先前未描述的支架部署过程中血管损伤机制是球囊-动脉相互作用的假设，我们使用有限元分析来模拟球囊-动脉接触应力和面积如何取决于支架-支柱几何形状、球囊顺应性和充气压力。我们还检查了不同设计的支架在体内和体外模型模型中展开过程中的表面损伤，以表明球囊引起的损伤可以通过改变支架设计来调节。我们的结果表明，更高的充气压力、更宽的支架支柱开口和更顺应的球囊材料会导致支架支柱之间的表面接触面积和接触应力显着增大。了解接触应力和接触面积是放置压力、支架几何形状和球囊顺应性的函数，可能有助于直接开发新型支架设计和支架展开方案，从而最大限度地减少支架置入期间的血管损伤，并可能优化长期结果。
Endovascular stents expand the arterial lumen more than balloon angioplasty and reduce rates of restenosis after coronary angioplasty in selected patients. Understanding the factors involved in vascular injury imposed during stent deployment may allow optimization of stent design and stent-placement protocols so as to limit vascular injury and perhaps reduce restenosis. Addressing the hypothesis that a previously undescribed mechanism of vascular injury during stent deployment is balloon-artery interaction, we have used finite element analysis to model how balloon-artery contact stress and area depend on stent-strut geometry, balloon compliance, and inflation pressure. We also examined superficial injury during deployment of stents of varied design in vivo and in a phantom model ex vivo to show that balloon-induced damage can be modulated by altering stent design. Our results show that higher inflation pressures, wider stent-strut openings, and more compliant balloon materials cause markedly larger surface-contact areas and contact stresses between stent struts. Appreciating that the contact stress and contact area are functions of placement pressure, stent geometry, and balloon compliance may help direct development of novel stent designs and stent-deployment protocols so as to minimize vascular injury during stenting and perhaps to optimize long-term outcomes.