Med Biol Eng Comput - The consequences of the mechanical environment of peripheral arteries for nitinol stenting.


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The use of stents in peripheral arteries has not been as successful as in coronary arteries, with high rates of restenosis and stent fracture common. Normal joint flexion induces a range of forces on the arteries, which has an unknown effect on the outcomes of stenting. The objective of this study is to determine how physiological levels of vessel bending and compression following stent implantation will influence the magnitude of stent stresses and hence the risks of fatigue fracture. A further objective is to compare how this mechanical environment will influence arterial stresses following implantation of either stainless steel or nitinol stents. To this end, models of both nitinol and stainless steel stents deployed in peripheral arteries were created, with appropriate loading conditions applied. At high levels of bending and compression, the strain amplitude threshold value for fatigue failure is exceeded for nitinol stents. Bending was predicted to induce high stresses in the artery following stenting, with higher arterial stresses predicted following implantation of a stainless steel stent compared to a nitinol stent. Both bending and compression may contribute to stent fracture by increasing the strain amplitude within the stent, with the dominant factor dependant on location within the arterial tree. For the specific stent types investigated in this study, the model predictions suggest that compression is the dominant mechanical factor in terms of stent fatigue in the femoral arteries, whereas bending is the most significant factor in the popliteal artery. To increase fatigue life and reduce arterial injury, location specific stent designs are required for peripheral arteries.

Resumo Limpo

use stent peripher arteri success coronari arteri high rate restenosi stent fractur common normal joint flexion induc rang forc arteri unknown effect outcom stent object studi determin physiolog level vessel bend compress follow stent implant will influenc magnitud stent stress henc risk fatigu fractur object compar mechan environ will influenc arteri stress follow implant either stainless steel nitinol stent end model nitinol stainless steel stent deploy peripher arteri creat appropri load condit appli high level bend compress strain amplitud threshold valu fatigu failur exceed nitinol stent bend predict induc high stress arteri follow stent higher arteri stress predict follow implant stainless steel stent compar nitinol stent bend compress may contribut stent fractur increas strain amplitud within stent domin factor depend locat within arteri tree specif stent type investig studi model predict suggest compress domin mechan factor term stent fatigu femor arteri wherea bend signific factor poplit arteri increas fatigu life reduc arteri injuri locat specif stent design requir peripher arteri

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