Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions

Abstract Left main (LM) coronary artery bifurcation stenting is a challenging topic due to the distinct anatomy and wall structure of LM. In this work, we investigated computationally and experimentally the mechanical performance of a novel everolimus-eluting stent (SYNERGY MEGATRON) purpose-built f...

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Autores principales:	Saurabhi Samant, Wei Wu, Shijia Zhao, Behram Khan, Mohammadali Sharzehee, Anastasios Panagopoulos, Janaki Makadia, Timothy Mickley, Andrew Bicek, Dennis Boismier, Yoshinobu Murasato, Yiannis S. Chatzizisis
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e8771b35f53349eba7de93eaaa480382
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spelling	oai:doaj.org-article:e8771b35f53349eba7de93eaaa4803822021-12-02T17:32:56ZComputational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions10.1038/s41598-021-87908-22045-2322https://doaj.org/article/e8771b35f53349eba7de93eaaa4803822021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87908-2https://doaj.org/toc/2045-2322Abstract Left main (LM) coronary artery bifurcation stenting is a challenging topic due to the distinct anatomy and wall structure of LM. In this work, we investigated computationally and experimentally the mechanical performance of a novel everolimus-eluting stent (SYNERGY MEGATRON) purpose-built for interventions to large proximal coronary segments, including LM. MEGATRON stent has been purposefully designed to sustain its structural integrity at higher expansion diameters and to provide optimal lumen coverage. Four patient-specific LM geometries were 3D reconstructed and stented computationally with finite element analysis in a well-validated computational stent simulation platform under different homogeneous and heterogeneous plaque conditions. Four different everolimus-eluting stent designs (9-peak prototype MEGATRON, 10-peak prototype MEGATRON, 12-peak MEGATRON, and SYNERGY) were deployed computationally in all bifurcation geometries at three different diameters (i.e., 3.5, 4.5, and 5.0 mm). The stent designs were also expanded experimentally from 3.5 to 5.0 mm (blind analysis). Stent morphometric and biomechanical indices were calculated in the computational and experimental studies. In the computational studies the 12-peak MEGATRON exhibited significantly greater expansion, better scaffolding, smaller vessel prolapse, and greater radial strength (expressed as normalized hoop force) than the 9-peak MEGATRON, 10-peak MEGATRON, or SYNERGY (p < 0.05). Larger stent expansion diameters had significantly better radial strength and worse scaffolding than smaller stent diameters (p < 0.001). Computational stenting showed comparable scaffolding and radial strength with experimental stenting. 12-peak MEGATRON exhibited better mechanical performance than the 9-peak MEGATRON, 10-peak MEGATRON, or SYNERGY. Patient-specific computational LM stenting simulations can accurately reproduce experimental stent testing, providing an attractive framework for cost- and time-effective stent research and development.Saurabhi SamantWei WuShijia ZhaoBehram KhanMohammadali SharzeheeAnastasios PanagopoulosJanaki MakadiaTimothy MickleyAndrew BicekDennis BoismierYoshinobu MurasatoYiannis S. ChatzizisisNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Saurabhi Samant Wei Wu Shijia Zhao Behram Khan Mohammadali Sharzehee Anastasios Panagopoulos Janaki Makadia Timothy Mickley Andrew Bicek Dennis Boismier Yoshinobu Murasato Yiannis S. Chatzizisis Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
description	Abstract Left main (LM) coronary artery bifurcation stenting is a challenging topic due to the distinct anatomy and wall structure of LM. In this work, we investigated computationally and experimentally the mechanical performance of a novel everolimus-eluting stent (SYNERGY MEGATRON) purpose-built for interventions to large proximal coronary segments, including LM. MEGATRON stent has been purposefully designed to sustain its structural integrity at higher expansion diameters and to provide optimal lumen coverage. Four patient-specific LM geometries were 3D reconstructed and stented computationally with finite element analysis in a well-validated computational stent simulation platform under different homogeneous and heterogeneous plaque conditions. Four different everolimus-eluting stent designs (9-peak prototype MEGATRON, 10-peak prototype MEGATRON, 12-peak MEGATRON, and SYNERGY) were deployed computationally in all bifurcation geometries at three different diameters (i.e., 3.5, 4.5, and 5.0 mm). The stent designs were also expanded experimentally from 3.5 to 5.0 mm (blind analysis). Stent morphometric and biomechanical indices were calculated in the computational and experimental studies. In the computational studies the 12-peak MEGATRON exhibited significantly greater expansion, better scaffolding, smaller vessel prolapse, and greater radial strength (expressed as normalized hoop force) than the 9-peak MEGATRON, 10-peak MEGATRON, or SYNERGY (p < 0.05). Larger stent expansion diameters had significantly better radial strength and worse scaffolding than smaller stent diameters (p < 0.001). Computational stenting showed comparable scaffolding and radial strength with experimental stenting. 12-peak MEGATRON exhibited better mechanical performance than the 9-peak MEGATRON, 10-peak MEGATRON, or SYNERGY. Patient-specific computational LM stenting simulations can accurately reproduce experimental stent testing, providing an attractive framework for cost- and time-effective stent research and development.
format	article
author	Saurabhi Samant Wei Wu Shijia Zhao Behram Khan Mohammadali Sharzehee Anastasios Panagopoulos Janaki Makadia Timothy Mickley Andrew Bicek Dennis Boismier Yoshinobu Murasato Yiannis S. Chatzizisis
author_facet	Saurabhi Samant Wei Wu Shijia Zhao Behram Khan Mohammadali Sharzehee Anastasios Panagopoulos Janaki Makadia Timothy Mickley Andrew Bicek Dennis Boismier Yoshinobu Murasato Yiannis S. Chatzizisis
author_sort	Saurabhi Samant
title	Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
title_short	Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
title_full	Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
title_fullStr	Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
title_full_unstemmed	Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
title_sort	computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e8771b35f53349eba7de93eaaa480382
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Computational and experimental mechanical performance of a new everolimus-eluting stent purpose-built for left main interventions

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