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Vulnerability analysis on the interaction between Asymmetric stent and arterial layer.

Achmad Syaifudin1, Julendra B Ariatedja1, Yusuf Kaelani1

  • 1Department of Mechanical Engineering, Faculty of Industrial Technology, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.

Bio-Medical Materials and Engineering
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Asymmetric stents show promise for atherosclerotic diseases. Plaque vulnerability in eccentric plaque is primarily due to plaque characteristics, not stent design, though non-symmetric balloon inflation can increase fibrous cap vulnerability.

Keywords:
FEMTissue ruptureasymmetriccarotid artery stentingeccentricity

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Computational Mechanics

Background:

  • Atherosclerotic diseases, especially non-symmetric obstructions, present complex challenges for current treatments.
  • Eccentric plaque, characterized by non-uniform arterial stiffness, exacerbates plaque vulnerability.
  • Asymmetric stents are being explored as a potential breakthrough treatment for these conditions.

Purpose of the Study:

  • To investigate the interaction between asymmetric stents and the arterial wall in the context of eccentric plaque.
  • To evaluate plaque vulnerability under different stent deployment scenarios.
  • To identify key factors contributing to plaque rupture.

Main Methods:

  • Structural transient dynamic analysis was performed using ANSYS simulations.
  • Four stent deployment combinations were studied: Sinusoidal/Asymmetric stents with offset/ordinary cylindrical balloons.
  • Multilayer arterial material properties (fibrous cap, lipid core, intima, media) and location-specific rupture criteria were utilized.

Main Results:

  • Plaque vulnerability in eccentric plaque is predominantly influenced by plaque shape and composition, not stent geometry or balloon expansion method.
  • Non-symmetric balloon inflation, particularly when directed against the plaque, was found to increase fibrous cap vulnerability in fibroatheroma plaques.
  • Cauchy stresses and Hencky strains were employed as stress measures for comparison with experimental data.

Conclusions:

  • Stent design and standard balloon expansion methods are less critical for eccentric plaque vulnerability than the intrinsic plaque properties.
  • Careful consideration of balloon inflation dynamics is necessary to mitigate increased fibrous cap vulnerability.
  • Further research into plaque-specific treatments and optimized deployment strategies is warranted.