School of Health Science and Engineering, University of Shanghai for Science and Technology, 516 Jungong Road, Shanghai, 200093, China.
Biomech Model Mechanobiol. 2022 Oct;21(5):1549-1560. doi: 10.1007/s10237-022-01605-1. Epub 2022 Jul 22.
Percutaneous coronary intervention (PCI) has become the primary treatment for patients with coronary heart disease because of its minimally invasive nature and high efficiency. Anatomical studies have shown that most coronary vessels gradually shrink, and the vessels gradually become thinner from the proximal to the distal end. In this paper, the effects of different stent expansion methods on the mechanical and hemodynamic behaviors of coronary vessels and stents were studied. To perform a structural-mechanical analysis of stent implantation, the coronary vessels with branching vessels and the coronary vessels with large bending curvature are selected. The two characteristic structures are implanted in equal diameter expansion mode and conical expansion mode, and the stress and mechanical behaviors of the coronary vessels and stents are analyzed. The results of the structural-mechanical analysis showed that the mechanical behaviors and fatigue performance of the cobalt-chromium alloy stent were good, and the different expansion modes of the stent had little effect on the fatigue performance of the stent. However, the equal diameter expansion mode increased distal coronary artery stress and the risk of vascular injury. The computational fluid dynamics analysis results showed that different stent expansion methods had varied effects on coronary vessel hemodynamics and that the wall shear stress distribution of conical stent expansion is more uniform compared with equal diameter expansion. Additionally, the vortex phenomenon is not apparent, the blood flow velocity is slightly increased, the hydrodynamic environment is more reasonable, and the risk of coronary artery injury is reduced.
经皮冠状动脉介入治疗（PCI）因其微创性和高效性已成为冠心病患者的主要治疗方法。解剖学研究表明，大多数冠状动脉逐渐收缩，血管从近端到远端逐渐变细。本文研究了不同支架扩张方法对冠状动脉和支架的力学和血液动力学行为的影响。为了对支架植入进行结构力学分析，选择了具有分支血管的冠状动脉和具有大弯曲曲率的冠状动脉。将这两种特征结构以等径扩张模式和锥形扩张模式植入，并分析了冠状动脉和支架的应力和力学行为。结构力学分析的结果表明，钴铬合金支架的力学性能和疲劳性能良好，支架的不同扩张模式对支架的疲劳性能影响不大。然而，等径扩张模式增加了远端冠状动脉的应力和血管损伤的风险。计算流体动力学分析结果表明，不同的支架扩张方法对冠状动脉血流动力学有不同的影响，锥形支架扩张的壁面切应力分布比等径扩张更均匀。此外，没有明显的漩涡现象，血流速度略有增加，水动力环境更加合理，冠状动脉损伤的风险降低。
