Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 51 |
| Number of Articles | 379 |
| Article View | 103,408 |
| PDF Download | 67,542 |
Review: Biomechanical impacts of vascular stents | ||
| Cardiovascular Biomedicine | ||
| Volume 5, Issue 1, September 2025, Pages 31-44 PDF (838.01 K) | ||
| Document Type: review article | ||
| DOI: 10.18502/cbj.v5i1.19450 | ||
| Authors | ||
| Mohammad Moradi* ; Hanieh Habibi Jirdehi | ||
| 1. Biomedical Engineering, Department of Biomedical Engineering, Faculty of Khajeh Nasir al Din Tusi Faculty, Tabriz University of Technology (Sahand), Sahand, Tabriz, Iran | ||
| Abstract | ||
| Objectives: Coronary stents are widely used as an effective intervention for coronary artery disease (CAD). This study investigates the biomechanical and hemodynamic consequences of stent implantation on arterial blood flow. While stenting improves myocardial perfusion and decreases vascular resistance, it can also lead to adverse effects, such as altered flow patterns, endothelial injury, and increased arterial stiffness. These factors may contribute to restenosis and other complications. This review summarizes biomechanical alterations caused by stenting and highlights recent strategies aimed at enhancing stent performance. To investigate the biomechanical and hemodynamic consequences of coronary stent implantation on arterial blood flow and to assess strategies aimed at mitigating related complications. | ||
| Keywords | ||
| Coronary stent; biomechanics; endothelial injury; blood flow dynamics; myocardial perfusion | ||
| References | ||
|
1.Ang HY, Bulluck H, Wong P, et al. Bioresorbable stents: Current and upcoming bioresorbable technologies. Int J Cardiol. 2017;228: 931-939.
2.Bangalore S, Toklu B, Patel N, et al. Newer-Generation Ultrathin Strut Drug-Eluting Stents Versus Older Second-Generation Thicker Strut Drug-Eluting Stents for Coronary Artery Disease. Circulation. 2018; 138(20): 2216-2226.
3.Blum M, Cao D, Mehran R. Device profile of the Resolute Onyx Zotarolimus eluting coronary stent system for the treatment of coronary artery disease: overview of its safety and efficacy. Expert Rev Med Device. 2020;17(4): 257-265.
4.Camenzind E, Steg PG, Wijns W. Stent thrombosis late after implantation of first-generation drug-eluting stents: a cause for concern. Circulation. 2007;115(11):1440-1455.
5.Chandran K, Rittgers S, Yoganathan A. Biofluid Mechanics. Taylor & Francis Group. 2006.
6.Chistiakov DA, Orekhov AN, Bobryshev YV. Effects of shear stress on endothelial cells: go with the flow. Acta physiol (Oxf). 2017;219(2):382-408.
7.En.wikipedia.org. Atherosclerosis. Wikipedia. 2022.
8.Gertz SD, Roberts WC. Hemodynamic shear force in rupture of coronary arterial atherosclerotic plaques. Am J Cardiol. 1990;66(19):1368–1372.
9.Grujicic M, Pandurangan B, Arakere A, et al. Fatigue-Life Computational Analysis for the Self-Expanding Endovascular Nitinol Stents. JMEP. 2012;21(11):2218-2230.
10.Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002;106(6):653–658.
11.Hall JE, Hall ME. Guyton and Hall Textbook of Medical Physiology. Elsevier Health Sciences. 2020.
12.Hoffmeister HM, Jur M, Ruf-Lehmann M, et al. Endothelial tissue-type plasminogen activator release in coronary heart disease: Transient reduction in endothelial fibrinolytic reserve in patients with unstable angina pectoris or acute myocardial infarction. J Am Coll Cardiol. 1998;31(3):547–551.
13.Kandzari DE, Mauri L, Koolen JJ, et al. Ultrathin, bioresorbable polymer sirolimus-eluting stents versus thin, durable polymer everolimus-eluting stents in patients undergoing coronary revascularisation (BIOFLOW V): a randomised trial. Lancet. 2017; 390(10105):1843-1852.
14.Kinlay S, Young MM, Sherrod R, et al. Long‐Term Outcomes and Duration of Dual Antiplatelet Therapy After Coronary Intervention With Second‐Generation Drug‐Eluting Stents: The Veterans Affairs Extended DAPT Study. J Am Heart Assoc. 2023;12(2):e027055.
15.Libby P, Ridker PM, Hansson GK, and Leducq Transatlantic Network on Atherothrombosis. Inflammation in Atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009;54(23):2129-38.
16.Marcus AJ, Broekman MJ, Drosopoulos JH, et al. Role of CD39 (NTPDase-1) in thromboregulation, cerebroprotection, and cardioprotection. Semin Thromb Hemost. 2005;31(2):234–246.
17.Marieb EN, Hoehn K. Human Anatomy & Physiology. Pearson Education. 2018.
18.Martini F, Nath J, Bartholomew E. Fundamentals of Anatomy and Physiology. 10th ed. Pearson Education Inc. 2015.
19.Massa KHC, Duarte YAO, Chiavegatto Filho ADP. Analysis of the prevalence of cardiovascular diseases and associated factors among the elderly, 2000-2010. Cien Saude Colet. 2019;24(1):105-14.
20.Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003;349(14):1315-23.
21.Navarese EP, Kowalewski M , Kandzari D, et al. First-generation versus second-generation drug-eluting stents in current clinical practice: updated evidence from a comprehensive meta-analysis of randomised clinical trials comprising 31,379 patients. Open Heart. 2014;1(1): e000064.
22.Ng J, Foin N, Ang HY, et al. Over-expansion capacity and stent design model: An update with contemporary DES platforms. Int J Cardiol. 2016;221:171-179.
23.Pericevic I, Lally C, Toner D, et al. The influence of plaque composition on underlying arterial wall stress during stent expansion: the case for lesion-specific stents. Med Eng Phys. 2009;31(4):428-33.
24.Peters B, Ewert P, Berger F. The role of stents in the treatment of congenital heart disease: Current status and future perspectives. Ann Pediatr Cardiol. 2009;2(1):3-23.
25.Räber L, Magro M, Stefanini GG, et al. Very Late Coronary Stent Thrombosis of a Newer-Generation Everolimus-Eluting Stent Compared With Early-Generation Drug-Eluting Stents: a Prospective Cohort Study. Circulation. 2012;125(9): 1110-1121.
26.Ribeiro ALP, Duncan BB, Brant LCC, et al. Cardiovascular health in Brazil: Trends and Perspectives. Circulation. 2016;133(4):422-33.
27.Ribeiro NS, Folgado J, Rodrigues HC. Surrogate‐based multi‐objective design optimization of a coronary stent: Altering geometry toward improved biomechanical performance. Int J Numer Method Biomed Eng. 2021;37(6): e3453.
28.Ribeiro NS, Folgado J, Rodrigues HC. Surrogate-based visualization and sensitivity analysis of coronary stent performance: A study on the influence of geometric design. Int J Numer Method Biomed Eng. 2018; 34(10): e3125.
29.Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to prevent vascular events in men and women with Elevated C-Reactive Protein. N Engl J Med. 2008; 359(21):2195-207.
30.Rikhtegar F, Wyss C, Stok KS, et al. Hemodynamics in coronary arteries with overlapping stents. J Biomech. 2014; 47(2):505-11.
31.Rong JX, Rangaswamy S, Shen L, et al. Arterial injury caused by cholesterol oxidation products leads to endothelial dysfunction and arterial wall cholesterol accumulation. Arterioscler Thromb Vasc Biol. 1998; 18(12):1885–1894.
32.Serruys PW, de Jaegere P, Kiemeneij F, et al. A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease. N Engl J Med. 1994; 331(8):489-495.
33.Sigwart U, Puel J, Mirkovitch V, et al. Intravascular Stents to Prevent Occlusion and Re-Stenosis after Transluminal Angioplasty. N Engl J Med. 1987;316(12):701-706.
34.Silverthorn DU. Human Physiology: An Integrated Approach. Pearson Education. 2020.
35.Soulis JV, Fytanidis DK, Seralidou KV, et al. Wall shear stress oscillation and its gradient in the normal left coronary artery tree bifurcations. Hippokratia. 2014;18 (1):12-6.
36.Stary HC, Chandler AB, Glagov S, et al. A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1994;89(5):24,62-78.
37.Stone GW, Ellis SG, Cox DA, et al. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med. 2004;350(3):221-31.
38.Strauss BH, Tanguay JF, Picard F, et al. Coronary Stenting: Reflections on a 35-Year Journey. Can J Cardiol. 2022;38(10 Suppl1): S17-S29.
39.Sumi T, Yamashita A, Matsuda S, et al. Disturbed blood flow induces erosive injury to smooth muscle cell-rich neointima and promotes thrombus formation in rabbit femoral arteries. J Thromb Haemost. 2010;8(6):1394–1402.
40.Tenekecioglu E, Farooq V, Bourantas CV, et al. Bioresorbable scaffolds: a new paradigm in percutaneous coronary intervention. BMC Cardiovasc Disord. 2016; 16:38.
41.Thondapu V, Bourantas CV, Foin N, et al. Biomechanical stress in the coronary atherosclerosis: emerging insights from computational modelling. Eur Heart J. 2017; 38(2): 81-92.
42.Torki MM, Hassanajili S, Jalisi MM, Design optimizations of PLA stent structure by FEM and investigating its function in a simulated plaque artery. Mathematics and Computers in Simulation. 2020;169 :103-116.
43.Tortora GJ, Derrickson BH. Principles of Anatomy and Physiology. John Wiley & Sons. 2018.
44.Virmani R, Kolodgie FD, Burke AP, et al. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol. 2000;20(5):126275.
45.Wentzel JJ, Krams R, Schuurbiers JC, et al. Relationship between neointimal thickness and shear stress after Wallstent implantation in human coronary arteries. Circulation. 2001; 103(13):1740-5.
46. Widmaier EP, Raff H, Strang KT. Vander's Human Physiology: The Mechanisms of Body Function. McGraw-Hill Education. 2018. | ||
|
Statistics Article View: 17 PDF Download: 21 |
||