球囊扩张式血管支架介入对弯曲血管的生物力学损伤研究
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摘要
构建了球囊扩张式血管支架介入系统的非线性有限元模型,考虑了血管斑块类型对其本构模型的影响,分析了A型与B型血管支架在血管狭窄率-24%、40%、50%,曲率半径-6 mm、10 mm、20 mm,狭窄血管的壁面应力分布规律,研究了血管支架构型、狭窄血管几何参数和血管生物力学损伤的关系。数值分析结果表明,血管壁面应力随着狭窄率的增加而显著升高,随着血管曲率半径的增加而下降相对平缓;但是,扩张加载阶段的血管壁面应力显著高于卸载阶段,易于引起血管斑块的脆性断裂引起血管生物力学损伤。由于A型血管支架相对于B型血管支架具有纵向柔顺性更优的联接筋构型,导致A型血管支架引起的血管壁面应力低于B型支架,因而降低了A型血管支架对于血管的生物力学损伤。
The schematic nonlinear finite element model of intervened vascular stent is developed to investigate the relationship between stent design, arterial geometry and injures induced by implantation of a balloon expandable vascular stent into a stenosed artery. The influence of plaque composition in its constitutive model is also considered. The arterial wall stress distribution and magnitude are obtained and analyzed during A-stent and B-stent intervened to a curved vessel with varying restenosis rate of-24%, 40% and 50%, and curvature radius of-6 mm, 10 mm and 20 mm. The numerical results show that the arterial wall stress remarkably increases with increasing restenosis rate, while it decreases slowly with increasing curvature radius of the curved vessel. However, the arterial wall stress is much higher during expanding the stent than that during unloading the stent. Consequently, the resulting high arterial wall stress during expanding the stent can lead to plaque or arterial rupture and subject them to biomechanical injure. In addition, the stresses induced within plaque tissues and arteries by A-stent implantation is less than those by B-stent implantation because the former equipped with moreflexible links exhibits larger longitudinal flexibility than the latter. These findings suggest a lower risk of arterial biomechanical injury for A-stent as compared with B-stent.
The schematic nonlinear finite element model of intervened vascular stent is developed to investigate the relationship between stent design, arterial geometry and injures induced by implantation of a balloon expandable vascular stent into a stenosed artery. The influence of plaque composition in its constitutive model is also considered. The arterial wall stress distribution and magnitude are obtained and analyzed during A-stent and B-stent intervened to a curved vessel with varying restenosis rate of-24%, 40% and 50%, and curvature radius of-6 mm, 10 mm and 20 mm. The numerical results show that the arterial wall stress remarkably increases with increasing restenosis rate, while it decreases slowly with increasing curvature radius of the curved vessel. However, the arterial wall stress is much higher during expanding the stent than that during unloading the stent. Consequently, the resulting high arterial wall stress during expanding the stent can lead to plaque or arterial rupture and subject them to biomechanical injure. In addition, the stresses induced within plaque tissues and arteries by A-stent implantation is less than those by B-stent implantation because the former equipped with moreflexible links exhibits larger longitudinal flexibility than the latter. These findings suggest a lower risk of arterial biomechanical injury for A-stent as compared with B-stent.
引文
[1]Fereidoonnezhad B,Naghdabadi R,Sohrabpour S,Holzapfel G A.A mechanobiological model for damageinduced growth in arterial tissue with application to in-stent restenosis[J].Journal of the Mechanics and Physics of Solids,2017,101:311-327.
[2]Tahir H,Bonacasas C,Narracott A J,et al.Endothelial repair process and its relevance to longitudinal neointimal tissue patterns:comparing histology with in silico modelling[J].Journal of the Royal Society Interface,2014,11(94):20140022.
[3]David Martin,Fergal Boyle.Computational structural modeling of coronary stent deployment:a review[J].Computer Methods in Biomechanics and Biomechanical Engineering,2011,14(4):331-348.
[4]李萍萍,张若京.具有周期结构的血管支架有限元分析[J].工程力学,2012,29(9):369-374.Li Pingping,Zhang Ruojing.Finite element analysis of stent with periodic structure[J].Engineering Mechanics,2012,29(9):369-374.(in Chinese)
[5]赵丹阳,顿锁,田慧卿,等.生物可降解聚合物血管支架膨胀性能有限元分析[J].大连理工大学学报,2014,54(1):54-59.Zhao Danyang,Dun Suo,Tian Huiqing,et al.Finite element analysis of expansion performance biodegradable polymer stents[J].Journal of Dalian University of Technology,2014,54(1):54-59.(in Chinese)
[6]邢海瑞,朱明,崔跃,等.Ti-Ni合金血管支架的有限元分析及疲劳性能研究[J].稀有金属,2016,40(10):976-981.Xing Hairui,Zhu Ming,Cui Yue,et al.Finite element analysis and fatigue properties of Ti-Ni vascular stent[J].Chinese Journal of Rare Metals,2016,40(10):976-981.(in Chinese)
[7]Dong Bin Kim,Hyuk Choi,Sang Min Joo,et al.Acomparative reliability and performance study of different stent designs in terms of mechanical properties:foreshortening,recoil,radical force,and flexibility[J].Artificial Organs,2013,37(4):368-379.
[8]江旭东,滕晓艳,史冬岩,等.冠脉血管支架介入耦合系统力学行为数值模拟研究[J].工程力学,2016,33(8):231-237.Jiang Xudong,Teng Xiaoyan,Shi Dongyan,et al.Mechanical analysis on treatment of vetebral stenosis by stents with different links[J].Engineering Mechanics,2016,33(8):231-237.(in Chinese)
[9]Sanjay Pant,Neil W,Bressloff,et al.The influence of strut-connectors in stented vessels:a comparison of pulsatile flow through five coronary stents[J].Annals of Biomedical Engineering,2010,38(5):1893-1907.
[10]Qiao A,Zhang Z.Numerical simulation of vertebral artery stenosis treated with different stents[J].Journal of Biomechanical Engineering,2014,136(4):1274-1283.
[11]Misagh Imani,Ali M Goudaarzi,Davood D Ganji,et al.The comprehensive finite element model for stenting:the influence of stent design on the outcome after coronary stent placement[J].Journal of Theoretical and Applied Mechanics,2013,51(3):639-648.
[12]Ling Wei,Qiang Chen,Zhiyong Li.Study on the impact of straight stents on arteries with different curvatures[J].Journal of Mechanics in Medicine and Biology,2016,16(7):1-14.
[13]Zhao S,Gu L,Froemming S R.Finite element analysis of the implantation of a self-expanding stent:impact of lesion calcification[J].Journal of Medical Devices,2012,6(2):211-214.
[14]Alireza Karimi,Mahdi Navidbakhsh,Reza Razaghi.Afinite study of balloon expandable stent for plaque and arterial vulnerability assessment[J].Journal of Applied Physics,2014,116(4):044701.
[15]高云亮,缪卫东,冯昭伟,等.几何参数对Ti-Ni合金血管支架支撑性能的影响[J].稀有金属,2017,41(8):936-942.Gao Yunliang,Miao Weidong,Feng Shaowei,et al.Ti-Ni alloy vascular stents’supporting performance with different design geometric parameters[J].Chinese Journal of Rare Metals,2017,41(8):936-942.(in Chinese)
[16]Hongxia Li,Xicheng Wang.Design optimization of balloon-expandable coronary stent[J].Structural Multidisciplinary Optimization,2013,48(4):837-847.
[17]Liu Q.Concept design of cardiovascular stents based on load identification[J].Journal of the Institution of Engineers,2015,96(2):99-105.
[18]Muhammad Farhan Khan,David Brackett,Ian Ashcroft,et al.A novel approach to design lesion-specific stents for minimum recoil[J].Journal of Medical Devices,2017,11(3):1-10.
[2]Tahir H,Bonacasas C,Narracott A J,et al.Endothelial repair process and its relevance to longitudinal neointimal tissue patterns:comparing histology with in silico modelling[J].Journal of the Royal Society Interface,2014,11(94):20140022.
[3]David Martin,Fergal Boyle.Computational structural modeling of coronary stent deployment:a review[J].Computer Methods in Biomechanics and Biomechanical Engineering,2011,14(4):331-348.
[4]李萍萍,张若京.具有周期结构的血管支架有限元分析[J].工程力学,2012,29(9):369-374.Li Pingping,Zhang Ruojing.Finite element analysis of stent with periodic structure[J].Engineering Mechanics,2012,29(9):369-374.(in Chinese)
[5]赵丹阳,顿锁,田慧卿,等.生物可降解聚合物血管支架膨胀性能有限元分析[J].大连理工大学学报,2014,54(1):54-59.Zhao Danyang,Dun Suo,Tian Huiqing,et al.Finite element analysis of expansion performance biodegradable polymer stents[J].Journal of Dalian University of Technology,2014,54(1):54-59.(in Chinese)
[6]邢海瑞,朱明,崔跃,等.Ti-Ni合金血管支架的有限元分析及疲劳性能研究[J].稀有金属,2016,40(10):976-981.Xing Hairui,Zhu Ming,Cui Yue,et al.Finite element analysis and fatigue properties of Ti-Ni vascular stent[J].Chinese Journal of Rare Metals,2016,40(10):976-981.(in Chinese)
[7]Dong Bin Kim,Hyuk Choi,Sang Min Joo,et al.Acomparative reliability and performance study of different stent designs in terms of mechanical properties:foreshortening,recoil,radical force,and flexibility[J].Artificial Organs,2013,37(4):368-379.
[8]江旭东,滕晓艳,史冬岩,等.冠脉血管支架介入耦合系统力学行为数值模拟研究[J].工程力学,2016,33(8):231-237.Jiang Xudong,Teng Xiaoyan,Shi Dongyan,et al.Mechanical analysis on treatment of vetebral stenosis by stents with different links[J].Engineering Mechanics,2016,33(8):231-237.(in Chinese)
[9]Sanjay Pant,Neil W,Bressloff,et al.The influence of strut-connectors in stented vessels:a comparison of pulsatile flow through five coronary stents[J].Annals of Biomedical Engineering,2010,38(5):1893-1907.
[10]Qiao A,Zhang Z.Numerical simulation of vertebral artery stenosis treated with different stents[J].Journal of Biomechanical Engineering,2014,136(4):1274-1283.
[11]Misagh Imani,Ali M Goudaarzi,Davood D Ganji,et al.The comprehensive finite element model for stenting:the influence of stent design on the outcome after coronary stent placement[J].Journal of Theoretical and Applied Mechanics,2013,51(3):639-648.
[12]Ling Wei,Qiang Chen,Zhiyong Li.Study on the impact of straight stents on arteries with different curvatures[J].Journal of Mechanics in Medicine and Biology,2016,16(7):1-14.
[13]Zhao S,Gu L,Froemming S R.Finite element analysis of the implantation of a self-expanding stent:impact of lesion calcification[J].Journal of Medical Devices,2012,6(2):211-214.
[14]Alireza Karimi,Mahdi Navidbakhsh,Reza Razaghi.Afinite study of balloon expandable stent for plaque and arterial vulnerability assessment[J].Journal of Applied Physics,2014,116(4):044701.
[15]高云亮,缪卫东,冯昭伟,等.几何参数对Ti-Ni合金血管支架支撑性能的影响[J].稀有金属,2017,41(8):936-942.Gao Yunliang,Miao Weidong,Feng Shaowei,et al.Ti-Ni alloy vascular stents’supporting performance with different design geometric parameters[J].Chinese Journal of Rare Metals,2017,41(8):936-942.(in Chinese)
[16]Hongxia Li,Xicheng Wang.Design optimization of balloon-expandable coronary stent[J].Structural Multidisciplinary Optimization,2013,48(4):837-847.
[17]Liu Q.Concept design of cardiovascular stents based on load identification[J].Journal of the Institution of Engineers,2015,96(2):99-105.
[18]Muhammad Farhan Khan,David Brackett,Ian Ashcroft,et al.A novel approach to design lesion-specific stents for minimum recoil[J].Journal of Medical Devices,2017,11(3):1-10.