Hemodynamic analysis of edge stenosis in peripheral artery stent grafts

Ramsey Al-Hakim, E. W. Lee, S. T. Kee, K. Seals, B. Varghese, A. Chien, M. Quirk, J. McWilliams

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose The purpose of this study was to characterize the hemodynamics of peripheral artery stent grafts to guide intelligent stent redesign. Materials and methods Two surgically explanted porcine arteries were mounted in an ex vivo system with subsequent deployment of an Xpert self-expanding nitinol stent or Viabahn stent graft. The arteries were casted with radiopaque resin, and the cast then scanned using micro-computed tomography at 8 μm isotropic voxel resolution. The arterial lumen was segmented and a computational mesh grid surface generated. Computational fluid dynamics (CFD) analysis was subsequently performed using COMSOL Multiphysics 5.1. Results CFD analysis demonstrated low endothelial shear stress (ESS) involving 9.4 and 63.6% surface area of the central stent graft and bare metal stent, respectively. Recirculation zones were identified adjacent to the bare metal stent struts, while none were identified in the central stent graft. However, the stent graft demonstrated malapposition of the proximal stent graft edge with low velocity flow between the PTFE lining and arterial wall, which was associated with longitudinally and radially oriented recirculation zones and low ESS. Conclusion Computational hemodynamic analysis demonstrates that peripheral artery stent grafts have a superior central hemodynamic profile compared to bare metal stents. Stents grafts, however, suffer from malapposition at the proximal stent edge which is likely a major contributor to edge stenosis.

Original languageEnglish (US)
Pages (from-to)729-735
Number of pages7
JournalDiagnostic and Interventional Imaging
Volume98
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

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Stents
Pathologic Constriction
Arteries
Hemodynamics
Transplants
Metals
Hydrodynamics
Polytetrafluoroethylene
Swine
Tomography

Keywords

  • Edge stenosis
  • Experimental studies
  • Hemodynamics
  • Peripheral artery
  • Stent graft

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Al-Hakim, R., Lee, E. W., Kee, S. T., Seals, K., Varghese, B., Chien, A., ... McWilliams, J. (2017). Hemodynamic analysis of edge stenosis in peripheral artery stent grafts. Diagnostic and Interventional Imaging, 98(10), 729-735. https://doi.org/10.1016/j.diii.2017.01.011

Hemodynamic analysis of edge stenosis in peripheral artery stent grafts. / Al-Hakim, Ramsey; Lee, E. W.; Kee, S. T.; Seals, K.; Varghese, B.; Chien, A.; Quirk, M.; McWilliams, J.

In: Diagnostic and Interventional Imaging, Vol. 98, No. 10, 01.10.2017, p. 729-735.

Research output: Contribution to journalArticle

Al-Hakim, R, Lee, EW, Kee, ST, Seals, K, Varghese, B, Chien, A, Quirk, M & McWilliams, J 2017, 'Hemodynamic analysis of edge stenosis in peripheral artery stent grafts', Diagnostic and Interventional Imaging, vol. 98, no. 10, pp. 729-735. https://doi.org/10.1016/j.diii.2017.01.011
Al-Hakim, Ramsey ; Lee, E. W. ; Kee, S. T. ; Seals, K. ; Varghese, B. ; Chien, A. ; Quirk, M. ; McWilliams, J. / Hemodynamic analysis of edge stenosis in peripheral artery stent grafts. In: Diagnostic and Interventional Imaging. 2017 ; Vol. 98, No. 10. pp. 729-735.
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