A computational workflow for modeling complex patient-specific coronary stenting cases

Area of Science:

• Computational mechanics
• Biomedical engineering
• Medical imaging

Background:

• In silico clinical trials require reliable simulation of coronary stenting.
• Current digital twins of arteries often simplify mechanical behavior for usability.
• Complex cases like bifurcations with overstretching present simulation challenges.

Purpose of the Study:

• To develop a phenomenological approach for patient-specific coronary artery mechanical description during stenting.
• To improve the reliability and usability of digital twins for coronary stenting simulations.
• To accurately model complex arterial geometries and overstretching scenarios.

Main Methods:

• Utilized pre- and post-operative images to create four vessel models.
• Developed multi-step structural stenting simulations with distinct media and adventitia layer properties.
• Incorporated a hyperelastic response with strain-dependent softening to simulate overstretching damage.
• Classified plaque components (lipidic, calcified, generic) with associated mechanical properties.

Main Results:

• Simulation outcomes closely matched clinical results for all stenting procedures.
• Recovered lumen area errors were consistently below 15%.
• The framework demonstrated improved performance and reliability, particularly for overstretching scenarios.

Conclusions:

• The proposed approach effectively accounts for in vivo conditions in simulations.
• It accurately predicts lumen reopening and malapposed struts post-stent deployment.
• This enhances the utility of digital twins for complex coronary stenting analysis.