Modeling of Damage Evolution in a Patient-Specific Stenosed Artery upon Stent Deployment

Computational models provide a powerful tool for pre-clinical assessment of medical devices and early evaluation of potential risks to the patient in terms of plaque fragmentation and in-stent restenosis (ISR). Using a suitable constitutive model for arterial tissue is key for the development of a reliable computational model. Although some inelastic phenomena such as stress softening and permanent deformation likely occur due to the supra-physiological loading of arterial tissue during the stenting procedure, hyperelastic constitutive models have been employed in most of the previously developed computational models. This study presents a finite element model for stent deployment into a patient-specific stenosed artery while inelastic arterial behaviors due to supra-physiological loading of the tissue have been considered. Specifically, the maximum stress in the plaque and the arterial layers which is the main cause of plaque fracture during stent deployment and the surgically-induced injury (damage) in the arterial wall, as the main cause of ISR., are presented. The results are compared with the commonly-used hyperelastic behavior for arterial layers. Furthermore, the effects of arterial material parameter variation, analogues to different patients, are investigated. A higher amount of damage is predicted for the artery which shows a higher stress in a specific strain.