Document Detail


Assessment of tissue prolapse after balloon-expandable stenting: influence of stent cell geometry.
MedLine Citation:
PMID:  19109049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Restenosis is a re-narrowing or blockage of an artery at the same site where treatment, such as a balloon angioplasty or stent procedure, has already taken place. Several clinical trials have shown a significant reduction in the restenosis rates with endovascular stenting. The purpose of stenting is to maintain the arterial lumen open by a scaffolding action that provides radial support. However, stenting can cause a vascular injury during the deployment. Indeed, in-stent restenosis remains a major problem in percutaneous coronary intervention, requiring patients to undergo repeated procedures and surgery. The loading imposed by the deployment of the stent on the artery is involved in the restenosis process. Furthermore, it is well known that the stent design plays a role in the outcome of the stenting interventional procedure. This study compares the mechanical effects of the expansion of five different designs of balloon-expandable stents in a coronary artery by means of numerical models based on the finite element method. An index for the evaluation of the tissue prolapse based on the expanded configuration reached by the stent cells is proposed. The effects of the balloon inflation and deflation are included in the present study. Wall stresses and tissue prolapse of the vessel wall within the stent cells are evaluated and compared among the different stent designs. Results show that the printed area does not predict prolapse, and that the proposed index (PI) does correlate with tissue prolapse.
Authors:
Claudio Capelli; Francesca Gervaso; Lorenza Petrini; Gabriele Dubini; Francesco Migliavacca
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-23
Journal Detail:
Title:  Medical engineering & physics     Volume:  31     ISSN:  1873-4030     ISO Abbreviation:  Med Eng Phys     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  England    
Other Details:
Languages:  eng     Pagination:  441-7     Citation Subset:  IM    
Affiliation:
Politecnico di Milano, Department of Structural Engineering, Laboratory of Biological Structure Mechanics, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation / adverse effects*
Blood Vessel Prosthesis / adverse effects*
Computer Simulation
Computer-Aided Design
Coronary Restenosis / etiology*,  physiopathology*
Equipment Design
Equipment Failure Analysis
Humans
Models, Cardiovascular
Reproducibility of Results
Sensitivity and Specificity
Stents / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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