Numerical simulation of arterial dissection during balloon angioplasty of atherosclerotic coronary arteries

JOURNAL OF BIOMECHANICS

卷:47

Article

Badel, Pierre¹  Avril, Stephane¹  Sutton, Michael A.²  Lessner, Susan M.³ 

[1] Ecole Natl Super Mines, CNRS, CIS EMSE, LGF,UMR5307, F-42023 St Etienne, France

[2] Univ S Carolina, Dept Mech Engn, Columbia, SC 29208 USA

[3] Univ S Carolina, Sch Med, Dept Cell Biol & Anat, Columbia, SC 29208 USA

关键词: Balloon angioplasty;    Coronary artery;    Arterial dissection;    Cohesive zone;    Finite element model;    Plaque fracture;   

DOI  :  10.1016/j.jbiomech.2014.01.009

来源: Elsevier

【 摘 要 】

Balloon angioplasty is a standard clinical treatment for symptomatic coronary artery disease. In this procedure, controlled damage is applied intraluminally to the wall of a stenotic artery. Dissection of the coronary artery is a commonly observed clinical complication of angioplasty; however, not all dissections can be detected angioscopically. This work focuses on studying the dissection mechanisms triggered during the early stages of angioplasty in an atherosclerotic coronary artery, addressing the problem by means of a parametric study based on a simplified finite element model and cohesive interface modeling. Our results emphasize the presence of several damage mechanisms, at different locations, that are triggered near the very beginning of the process and evolve competitively, depending on both geometry and material properties of the atherosclerotic vessel. Small-scale damage was evidenced, which would not be detectable by angiography or intravascular ultrasound, but could potentially be sufficient to stimulate smooth muscle cell activation, promoting late-onset complications such as restenosis. (C) 2014 Elsevier Ltd. All rights reserved.

【 授权许可】

Free