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Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section
Published on: July 19, 2016
A full-range, multi-variable, CFD-based methodology to identify abnormal near-wall hemodynamics in a stented coronary
Jonathan B Murphy1, Fergal J Boyle
1Department of Mechanical Engineering, Dublin Institute of Technology, Dublin, Ireland. jonathan.murphy@dit.ie
Insights
Excessive intimal hyperplasia after coronary stent implantation can be reduced by evaluating artery wall viscous stress. A new method using computational fluid dynamics offers a more comprehensive assessment than traditional techniques for improved stent performance.
Area of Science:
- Cardiovascular Science
- Biomedical Engineering
- Medical Device Technology
Background:
- Coronary stent implantation is limited by intimal hyperplasia, leading to artery re-narrowing.
- Abnormal blood flow dynamics and viscous stress on the artery wall are key causes of intimal hyperplasia.
- Accurate evaluation of viscous stress is crucial for assessing stent performance and preventing hyperplasia.
Purpose of the Study:
- To develop and validate a comprehensive methodology for evaluating viscous stress on the artery wall after stent implantation.
- To compare the proposed methodology with the conventional "threshold technique" for assessing stent hemodynamic performance.
- To highlight the limitations of existing methods and advocate for a more thorough approach.
Main Methods:
- Utilized 3D computational fluid dynamics (CFD) to model blood flow.
- Analyzed key viscous stress variables: wall shear stress (WSS), WSS gradient (WSSG), and WSS angle gradient (WSSAG).
- Employed statistical analysis to interpret the viscous stress data and compared results with the "threshold technique".
Main Results:
- The "threshold technique" was found to be inadequate and potentially misleading for analyzing arterial viscous stress.
- The proposed CFD-based methodology provides a more comprehensive evaluation of hemodynamic performance.
- Each variable (WSS, WSSG, WSSAG) offers unique insights into abnormal arterial viscous stress.
Conclusions:
- The proposed methodology offers a superior and more detailed assessment of stent hemodynamic performance compared to existing methods.
- Considering WSS, WSSG, and WSSAG together provides a more complete understanding of the risks associated with intimal hyperplasia.
- This advanced evaluation can guide the development of better stents and improve clinical outcomes by mitigating restenosis.
Abstract:
The benefit of coronary stent implantation is reduced by excessive intimal hyperplasia which re-narrows the artery and the prevention of which is still a primary concern for clinicians. Abnormal hemodynamics create non-physiological viscous stress on the artery wall, one of the root causes of intimal hyperplasia following stent implantation. A methodology to comprehensively evaluate the viscous stress on the artery wall following stent implantation would be useful to evaluate a stent's hemodynamic performance.The proposed methodology employs 3D computational fluid dynamics, the variables wall shear stress (WSS), WSS gradient (WSSG), WSS angle gradient (WSSAG) and a statistical analysis to evaluate the viscous stress. The methodology is demonstrated and compared to a commonly used "threshold technique" for evaluating a stent's hemodynamic performance.It is demonstrated that the threshold technique is not adequate to fully analyse the viscous stress on the artery wall and can even be misleading. Furthermore, all three of the aforementioned variables should be considered as each provides a different perspective on the abnormalities that can arise in the arterial viscous stress.The hemodynamic performance of a stent can be assessed more comprehensively than with previously used methods by examining the arterial viscous stresses using the proposed methodology.
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