Deployment Behavior of Stent in Tapered Vessels With Multiple Stenoses: Effect of Different Implantation Planning Systems

Abstract

In-stent restenosis (ISR), which is a common complication after stent intervention, affects the long-term outcome of stent intervention. Suitable implantation planning will effectively reduce the incidence of ISR. The aim of this study is to investigate the effect of different implantation planning on the mechanical behavior of stents in tapered vessels with multiple stenoses and select a better implantation planning. The finite element method (FEM) was used in this study. A different planning was designed as follows: (a) using a cylindrical balloon to deploy cylindrical stent (plan CC), (b) using the tapered balloon to deploy cylindrical stent (plan TC) and (c) using the tapered balloon to deploy tapered stent (plan TT). When the stent was expanded to the maximum diameter, the position of maximum vascular stress all appeared at distal plaque in three implantation plans. After balloon was deflated, the vascular stress in plan TC was the minimum. Using tapered balloon to deploy cylindrical stent has advantages in the tapered vessels with multiple stenoses and could reduce the probability of ISR. Moreover, this method could assess the mechanical properties of stent deployment in multiple stenoses and then select a better implantation planning.