A Novel Tram Stent Method in the Treatment of Coronary Bifurcation Lesions - Finite Element Study

PLoS One. 2016 Mar 3;11(3):e0149838. doi: 10.1371/journal.pone.0149838. eCollection 2016.

Abstract

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.

MeSH terms

  • Angioplasty, Balloon, Coronary
  • Chromium / therapeutic use
  • Cobalt / therapeutic use
  • Coronary Angiography
  • Coronary Stenosis / pathology
  • Coronary Stenosis / surgery
  • Coronary Stenosis / therapy*
  • Coronary Vessels / physiopathology
  • Coronary Vessels / surgery
  • Finite Element Analysis*
  • Heart / physiopathology*
  • Humans
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Chromium
  • Cobalt

Grants and funding

The authors received no specific funding for this work. Authors Gianluca De Santis and Mathieu De Beule are employed by FEops bvba. FEops bvba provided support in the form of salaries for authors Gianluca De Santis and Mathieu De Beule, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.