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

  • Gökgöl C Institute for Surgical Technology & Biomechanics, University of Bern, Bern, Switzerland.
  • Diehm N Clinical and Interventional Angiology, Kantonsspital Aarau, Tellstrasse, Aarau, 5001, Switzerland. nicolas.diehm@ksa.ch.
  • Nezami FR Institute for Surgical Technology & Biomechanics, University of Bern, Bern, Switzerland.
  • Büchler P Institute for Surgical Technology & Biomechanics, University of Bern, Bern, Switzerland.
  • 2015-06-24
Published in:
  • Annals of biomedical engineering. - 2015
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
Aged
Alloys
Female
Finite Element Analysis
Humans
Male
Middle Aged
Models, Cardiovascular
Popliteal Artery
Regional Blood Flow
Stents
Stress, Mechanical
English 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.
Language
  • English
Open access status
green
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Persistent URL
https://sonar.ch/global/documents/140419
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