Pericevic, I., Lally, C., Toner, D. and Kelly, D.J., ‘The influence of plaque composition on underlying arterial wall stress during stent expansion: the case for lesion-specific stents’ in Medical Engineering and Physics, 31, (4), 2009, pp 428-433
Medical Engineering and Physics 31 4
Intracoronary stent implantation is a mechanical procedure, the success of which
depends to a large degree on the mechanical properties of each vessel component
involved and the pressure applied to the balloon. Little is know about the influence of
plaque composition on arterial overstretching and the subsequent injury to the vessel
wall following stenting. An idealised finite element model was developed to
investigate the influence of both plaque type (hypercellular, hypocellular and
calcified) and stent inflation pressures (9, 12 and 15 atm) on vessel and plaque
stresses during the implantation of a balloon expandable coronary stent into an
idealised stenosed artery. The plaque type was found to have a significant influence
on the stresses induced within the artery during stenting. Higher stresses were
predicted in the artery wall for cellular plaques, while the stiffer calcified plaque
appeared to play a protective role by reducing the levels of stress within the arterial
tissue for a given inflation pressure. Higher pressures can be applied to calcified
plaques with a lower risk of arterial vascular injury which may reduce the stimulus for
in-stent restenosis. Results also suggest that the risk of plaque rupture, and any
subsequent thrombosis due to platelet deposition at the fissure, is greater for calcified
plaques with low fracture stresses.
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