Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design ConsiderationsReport as inadecuate




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Annals of Biomedical Engineering

, Volume 44, Issue 2, pp 315–329

First Online: 16 July 2015Received: 26 February 2015Accepted: 08 July 2015DOI: 10.1007-s10439-015-1387-3

Cite this article as: Beier, S., Ormiston, J., Webster, M. et al. Ann Biomed Eng 2016 44: 315. doi:10.1007-s10439-015-1387-3

Abstract

Stent induced hemodynamic changes in the coronary arteries are associated with higher risk of adverse clinical outcome. The purpose of this study was to evaluate the impact of stent design on wall shear stress WSS, time average WSS, and WSS gradient WSSG, in idealized stent geometries using computational fluid dynamics. Strut spacing, thickness, luminal protrusion, and malapposition were systematically investigated and a comparison made between two commercially available stents Omega and Biomatrix. Narrower strut spacing led to larger areas of adverse low WSS and high WSSG but these effects were mitigated when strut size was reduced, particularly for WSSG. Local hemodynamics worsened with luminal protrusion of the stent and with stent malapposition, adverse high WSS and WSSG were identified around peak flow and throughout the cardiac cycle respectively. For the Biomatrix stent, the adverse effect of thicker struts was mitigated by greater strut spacing, radial cell offset and flow-aligned struts. In conclusion, adverse hemodynamic effects of specific design features such as strut size and narrow spacing can be mitigated when combined with other hemodynamically beneficial design features but increased luminal protrusion can worsen the stent’s hemodynamic profile significantly.

KeywordsHemodynamics Coronary artery disease Computational fluid dynamics CFD Stent design Wall shear stress WSS Stent Associate Editor Peter E. McHugh oversaw the review of this article.

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Author: Susann Beier - John Ormiston - Mark Webster - John Cater - Stuart Norris - Pau Medrano-Gracia - Alistair Young - Brett Cow

Source: https://link.springer.com/







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