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Identification of hemodynamically optimal coronary stent designs based on vessel caliber. IEEE Trans Biomed Eng 2012 Jul;59(7):1992-2002

Date

05/02/2012

Pubmed ID

22547450

DOI

10.1109/TBME.2012.2196275

Scopus ID

2-s2.0-84862738945   24 Citations

Abstract

Coronary stent design influences local patterns of wall shear stress (WSS) that are associated with neointimal growth, restenosis, and the endothelialization of stent struts. The number of circumferentially repeating crowns N(C) for a given stent design is often modified depending on the target vessel caliber, but the hemodynamic implications of altering N(C) have not previously been studied. In this investigation, we analyzed the relationship between vessel diameter and the hemodynamically optimal N(C) using a derivative-free optimization algorithm coupled with computational fluid dynamics. The algorithm computed the optimal vessel diameter, defined as minimizing the area of stent-induced low WSS, for various configurations (i.e., N(C)) of a generic slotted-tube design and designs that resemble commercially available stents. Stents were modeled in idealized coronary arteries with a vessel diameter that was allowed to vary between 2 and 5 mm. The results indicate that the optimal vessel diameter increases for stent configurations with greater N(C), and the designs of current commercial stents incorporate a greater N(C) than hemodynamically optimal stent designs. This finding suggests that reducing the N(C) of current stents may improve the hemodynamic environment within stented arteries and reduce the likelihood of excessive neointimal growth and thrombus formation.

Author List

Gundert TJ, Marsden AL, Yang W, Marks DS, LaDisa JF Jr

Authors

John F. LaDisa PhD Professor in the Pediatrics department at Medical College of Wisconsin
David S. Marks MD Vice Chair, Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Algorithms
Blood Vessel Prosthesis
Computer-Aided Design
Coronary Restenosis
Coronary Vessels
Hemodynamics
Humans
Models, Cardiovascular
Prosthesis Design
Stents