Arokiaraj Mark C, De Santis Gianluca, De Beule Matthieu, Palacios Igor F
Cardiology, Pondicherry Institute of Medical Sciences, Pondicherry, India.
FEops nv, Technologiepark 3, Ghent, Belgium.
PLoS One. 2016 Mar 3;11(3):e0149838. doi: 10.1371/journal.pone.0149838. eCollection 2016.
A novel stent was designed for the treatment of coronary bifurcation lesion, and it was investigated for its performance by finite element analysis. This study was performed in search of a novel method of treatment of bifurcation lesion with provisional stenting. A bifurcation model was created with the proximal vessel of 3.2 mm diameter, and the distal vessel after the side branch (2.3 mm) was 2.7 mm. A novel stent was designed with connection links that had a profile of a tram. Laser cutting and shape setting of the stent was performed, and thereafter it was crimped and deployed over a balloon. The contact pressure, stresses on the arterial wall, stresses on the stent, the maximal principal log strain of the main artery and the side-branch were studied. The study was performed in Abaqus, Simulia. The stresses on the main branch and the distal branch were minimally increased after deployment of this novel stent. The side branch was preserved, and the stresses on the side branch were lesser; and at the confluence of bifurcation on either side of the side branch origin the von-Mises stress was marginally increased. The stresses and strain at the bifurcation were significantly lesser than the stresses and strain of the currently existing techniques used in the treatment of bifurcation lesions though the study was primarily focused only on the utility of the new technology. There is a potential for a novel Tram-stent method in the treatment of coronary bifurcation lesions.
设计了一种用于治疗冠状动脉分叉病变的新型支架，并通过有限元分析对其性能进行了研究。本研究旨在寻找一种采用临时支架置入术治疗分叉病变的新方法。构建了一个分叉模型，近端血管直径为3.2毫米，侧支（2.3毫米）后的远端血管为2.7毫米。设计了一种带有呈电车轨道轮廓连接环的新型支架。对支架进行了激光切割和形状设定，然后将其压接并部署在球囊上。研究了接触压力、动脉壁上的应力、支架上的应力、主动脉和侧支的最大主对数应变。该研究在Simulia公司的Abaqus软件中进行。植入这种新型支架后，主支和远端分支上的应力增加极小。侧支得以保留，且侧支上的应力较小；在侧支起源两侧的分叉汇合处，冯·米塞斯应力略有增加。尽管该研究主要仅关注新技术的效用，但分叉处的应力和应变明显小于目前用于治疗分叉病变的现有技术的应力和应变。新型电车轨道式支架法在治疗冠状动脉分叉病变方面具有潜力。
