Prediction of post-stenting biomechanics in coarcted aortas: A pilot finite element study

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Computational Mechanics

Background:

• Endovascular stenting is a standard treatment for native coarctation of the aorta (CoA).
• Despite short-term success, late hypertension remains a significant risk after CoA stenting.
• Understanding the biomechanical impact of stenting on the aorta is crucial for mitigating long-term complications.

Purpose of the Study:

• To assess the impact of endovascular stenting on aortic wall biomechanics in patient-specific coarctation of the aorta (CoA) anatomies.
• To develop and validate a finite element (FE) protocol for simulating endovascular stenting in CoA.
• To investigate the influence of patient-specific anatomical features on post-stenting aortic biomechanics.

Main Methods:

• Development of a novel finite element (FE) protocol for simulating endovascular stenting.
• Application of the FE protocol to three patient-specific CoA anatomies with varying severities.
• Implementation of a remeshing procedure to accommodate different CoA severities and arch types.

Main Results:

• The FE protocol successfully yielded numerical results on stent distortions and stresses.
• The simulation demonstrated changes in aortic wall stresses and distensibility post-stenting.
• Numerical results were consistent with intraprocedural in-vivo evidence and existing literature.

Conclusions:

• The developed FE protocol can simulate endovascular stenting in CoA and analyze its biomechanical effects.
• Patient-specific anatomical features, such as CoA severity and arch type, influence post-stenting aortic biomechanics.
• This numerical approach holds potential for supporting patient selection in endovascular stenting for CoA.