Effects of inflation pressures on mechanical environment in carotid after stent implantation by numerical simulation

Objective: To investigate the effects of inflation pressures on mechanical environment in pathological carotid after stent implantation. Methods: The carotid artery models with lipid and calcified plaques were constructed based on high-resolution MRI images. The artery-stent interaction model was then developed with the finite element software. Based on the models, the Von Mises stress distributions on the vascular wall and plaques under 3 different inflation pressures (909, 1 212 and 1 515 kPa) were simulated. Results: High inflation pressure would induce large Von Mises stress on the artery-stent interface. Moreover, the stress on the lipid plaque increased significantly with the increase of inflation pressure. However, the differences in stress distributions on the calcified plaque were very small under different inflation pressure. Conclusions: Higher inflation pressure may severely threaten the lipid plaque and artery-stent interface after stenting, and lead to the failure of stent. This research finding may provide clinical guidance for selecting proper inflation pressure for arterial stent deployment, and making assessment of plaque stability after stent implantation.