Patient-specific finite element analysis of carotid artery stenting: a focus on vessel modeling

• Published in: International journal for numerical methods in biomedical engineering 2013-06, Vol.29 (6), p.645-664
• Main Authors: Auricchio, F., Conti, M., Ferrara, A., Morganti, S., Reali, A.
• Format: Article
• Language: English
• Subjects: Aged; Angiography; Blood vessels; Carotid arteries; Carotid Arteries - anatomy & histology; Carotid Arteries - pathology; carotid artery stenting (CAS); Computer Simulation; Constitutive relationships; Female; Finite Element Analysis; Finite element method; finiteelement analysis (FEA); Humans; Image Processing, Computer-Assisted - methods; Mathematical analysis; Mathematical models; Models, Cardiovascular; patient-specific modeling; Precision Medicine - instrumentation; Precision Medicine - methods; Prosthesis Design; Stents; Straightening; Surgical implants; Tomography, X-Ray Computed
• ISSN: 2040-7939; 2040-7947
• DOI: 10.1002/cnm.2511

SUMMARYFinite element analysis is nowadays a well‐assessed technique to investigate the impact of stenting on vessel wall and, given the rapid progression of both medical imaging techniques and computational methods, the challenge of using the simulation of carotid artery stenting as procedure planning tool to support the clinical practice can be approached. Within this context, the present study investigates the impact of carotid stent apposition on carotid artery anatomy by means of patient‐specific finite element analysis. In particular, we focus on the influence of the vessel constitutive model on the prediction of carotid artery wall tensional state of lumen gain and of vessel straightening. For this purpose, we consider, for a given stent design and CA anatomy, two constitutive models for the CA wall, that is, a hyperelastic isotropic versus a fiber‐reinforced hyperelastic anisotropic model. Despite both models producing similar patterns with respect to stress distribution, the anisotropic model predicts a higher vessel straightening and a more evident discontinuity of the lumen area near the stent ends as observed in the clinical practice. Although still affected by several simplifications, the present study can be considered as further step toward a realistic simulation of carotid artery stenting.Copyright © 2012 John Wiley & Sons, Ltd. The study investigates the impact of carotid stent apposition on vascular anatomy by patient‐specific finite element analysis. In particular, we consider, for a given stent design and artery model, two constitutive models for the vessel wall, that is, a hyperelastic isotropic versus a fiber‐reinforced hyperelastic anisotropic model. Despite both models predicting a similar stress distribution, the anisotropic model predicts a higher vessel straightening and a more evident discontinuity of the lumen near the stent ends, as observed in the clinical practice.