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Sequential Balloon Modeling for Robust Percutaneous Transluminal Angioplasty Simulation.

Clément Joly^1,2, Adrien Kaladji¹, Aline Bel-Brunon^2,3

¹Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France.

International Journal for Numerical Methods in Biomedical Engineering

|July 9, 2026

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A new sequential balloon modeling (SBM) strategy enhances percutaneous transluminal angioplasty (PTA) simulations for severe arterial stenosis. This robust method improves prediction accuracy for reshaping procedures, optimizing treatment outcomes.

Area of Science:

Biomedical Engineering
Computational Mechanics
Cardiovascular Interventions

Background:

Percutaneous transluminal angioplasty (PTA) is a standard treatment for atherosclerotic stenoses, involving balloon inflation to enlarge lumens.
Accurate numerical simulation of PTA is crucial for predicting outcomes but is challenged by severe stenosis and balloon modeling complexities.
Existing balloon modeling strategies are either computationally expensive or prone to simulation divergence due to excessive element deformation.

Purpose of the Study:

To introduce and validate a novel Sequential Balloon Modeling (SBM) strategy for robust PTA finite element simulations, particularly for severe stenosis.
To enhance the accuracy and versatility of PTA simulations by addressing challenges associated with high inflation ranges and complex arterial geometries.
To develop a reliable computational model for estimating the permanent arterial set after reshaping procedures.

Keywords:

finite element simulation parametric model patient‐specific percutaneous transluminal angioplasty permanent deformation sequential balloon modeling

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Main Methods:

Developed a Sequential Balloon Modeling (SBM) strategy that divides the balloon inflation into sequential steps with limited diametral gain.
Replaced the complex folded balloon model with sequentially activated unfolded balloon models to ensure simulation robustness.
Combined SBM with parametric stenosis modeling to analyze the influence of geometric parameters and plaque type on post-PTA results, including severe stenosis cases.

Main Results:

The SBM strategy demonstrated robustness and versatility in PTA simulations, especially for severe stenosis and large artery calibers, which are underrepresented in current literature.
The model successfully reproduced the pressure-diameter curve of angioplasty balloons as per manufacturer datasheets.
The study successfully replicated a complex, patient-specific iliac artery stenosis case using combined single-stenosis models.

Conclusions:

The Sequential Balloon Modeling (SBM) strategy offers a robust and versatile approach for simulating percutaneous transluminal angioplasty, overcoming limitations of previous methods.
This simulation strategy holds significant potential for validating PTA models and providing mechanical insights to optimize treatment strategies for severe arterial stenosis.
The developed model facilitates more accurate predictions of post-PTA outcomes, aiding in the optimization of interventional procedures.