Impact of Malapposed and Overlapping Stents on Hemodynamics: A 2D Parametric Computational Fluid Dynamics Study

Manuel Lagache, Ricardo Coppel, Gérard Finet, François Derimay, Roderic I. Pettigrew, Jacques Ohayon and Mauro Malvè
Additional contact information
Manuel Lagache: Laboratory SYMME, Savoie Mont-Blanc University, 73000 Chambéry, France
Ricardo Coppel: Laboratory SYMME, Savoie Mont-Blanc University, 73000 Chambéry, France
Gérard Finet: Department of Hemodynamics and Interventional Cardiology, Hospices Civils de Lyon and Claude Bernard University Lyon 1, INSERM Unit 886, 69622 Lyon, France
François Derimay: Department of Hemodynamics and Interventional Cardiology, Hospices Civils de Lyon and Claude Bernard University Lyon 1, INSERM Unit 886, 69622 Lyon, France
Roderic I. Pettigrew: CEO, Engineering Health (EnHealth) and Executive Dean, Engineering Medicine (EnMed), Texas A&M University and Houston Methodist Hospital, Houston, TX 77030, USA
Jacques Ohayon: Laboratory SYMME, Savoie Mont-Blanc University, 73000 Chambéry, France
Mauro Malvè: Department of Engineering, Public University of Navarra, 31006 Pamplona, Spain

Mathematics, 2021, vol. 9, issue 8, 1-19

Abstract: Despite significant progress, malapposed or overlapped stents are a complication that affects daily percutaneous coronary intervention (PCI) procedures. These malapposed stents affect blood flow and create a micro re-circulatory environment. These disturbances are often associated with a change in Wall Shear Stress (WSS), Time-averaged WSS (TAWSS), relative residence time (RRT) and oscillatory character of WSS and disrupt the delicate balance of vascular biology, providing a possible source of thrombosis and restenosis. In this study, 2D axisymmetric parametric computational fluid dynamics (CFD) simulations were performed to systematically analyze the hemodynamic effects of malapposition and stent overlap for two types of stents (drug-eluting stent and a bioresorbable stent). The results of the modeling are mainly analyzed using streamlines, TAWSS, oscillatory shear index (OSI) and RRT. The risks of restenosis and thrombus are evaluated according to commonly accepted thresholds for TAWSS and OSI. The small malapposition distances (MD) cause both low TAWSS and high OSI, which are potential adverse outcomes. The region of low OSI decrease with MD. Overlap configurations produce areas with low WSS and high OSI. The affected lengths are relatively insensitive to the overlap distance. The effects of strut size are even more sensitive and adverse for overlap configurations compared to a well-applied stent.

Keywords: hemodynamics; overlap; malapposition; stent; stenosis; thrombosis (search for similar items in EconPapers)
JEL-codes: C (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/2227-7390/9/8/795/pdf (application/pdf)
https://www.mdpi.com/2227-7390/9/8/795/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jmathe:v:9:y:2021:i:8:p:795-:d:531513

Access Statistics for this article

Mathematics is currently edited by Ms. Emma He

More articles in Mathematics from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().