Nitinol Stent Oversizing in Patients Undergoing Popliteal Artery Revascularization: A Finite Element Study

Gökgöl, Can; Diehm, Nicolas Alexander; Rikhtegar Nezami, Farhad; Büchler, Philippe (2015). Nitinol Stent Oversizing in Patients Undergoing Popliteal Artery Revascularization: A Finite Element Study. Annals of biomedical engineering, 43(12), pp. 2868-2880. Springer 10.1007/s10439-015-1358-8

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Nitinol stent oversizing is frequently performed in peripheral arteries to ensure a desirable lumen gain. However, the clinical effect of mis-sizing remains controversial. The goal of this study was to provide a better understanding of the structural and hemodynamic effects of Nitinol stent oversizing. Five patient-specific numerical models of non-calcified popliteal arteries were developed to simulate the deployment of Nitinol stents with oversizing ratios ranging from 1.1 to 1.8. In addition to arterial biomechanics, computational fluid dynamics methods were adopted to simulate the physiological blood flow inside the stented arteries. Results showed that stent oversizing led to a limited increase in the acute lumen gain, albeit at the cost of a significant increase in arterial wall stresses. Furthermore, localized areas affected by low Wall Shear Stress increased with higher oversizing ratios. Stents were also negatively impacted by the procedure as their fatigue safety factors gradually decreased with oversizing. These adverse effects to both the artery walls and stents may create circumstances for restenosis. Although the ideal oversizing ratio is stent-specific, this study showed that Nitinol stent oversizing has a very small impact on the immediate lumen gain, which contradicts the clinical motivations of the procedure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Gökgöl, Can; Rikhtegar Nezami, Farhad and Büchler, Philippe

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

0090-6964

Publisher:

Springer

Language:

English

Submitter:

Philippe Büchler

Date Deposited:

17 Feb 2016 10:27

Last Modified:

24 Jun 2016 02:30

Publisher DOI:

10.1007/s10439-015-1358-8

PubMed ID:

26101031

Uncontrolled Keywords:

Acute lumen gain; Computational fluid dynamics (CFD) analysis; Curved arteries; Finite element analysis (FEA); Patient-specific arterial geometry; Popliteal arterial segment; Self-expanding Nitinol stents; Stent deployment; Stent oversizing

BORIS DOI:

10.7892/boris.75591

URI:

https://boris.unibe.ch/id/eprint/75591

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