Over-expansion capacity and stent design model: An update with contemporary DES platforms Jaryl Ng, Nicolas Foin, Hui Ying Ang, Jiang Ming Fam, Sayan.

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Over-expansion capacity and stent design model: An update with contemporary DES platforms Jaryl Ng, Nicolas Foin, Hui Ying Ang, Jiang Ming Fam, Sayan Sen, Sukhjinder Nijjer, Ricardo Petraco, Carlo Di Mario, Justin Davies, Philip Wong International Journal of Cardiology Volume 221, Pages 171-179 (October 2016) DOI: 10.1016/j.ijcard.2016.06.097 Copyright © 2016 The Authors Terms and Conditions

Fig. 1 Methods of Measurements: Minimal Lumen Diameter (MLD) is measured from the side view at the edge and 5mm distal from the overexpanded edge (A). Cell opening diameter, including a cell opening diameter at the stent transition (B) and crown angle (C) are also measured from the side view. From the cross-sectional view, the Stent Luminal Diameter on 2 perpendicular axis (D) and the minimal stent lumen Area (E) are also measured. International Journal of Cardiology 2016 221, 171-179DOI: (10.1016/j.ijcard.2016.06.097) Copyright © 2016 The Authors Terms and Conditions

Fig. 2 Largest workhorse designs for each stent platform: Each of the picture shows the longitudinal image as well as the cross sectional image of the largest workhorse design of each platform after over expansion to 6.0mm. International Journal of Cardiology 2016 221, 171-179DOI: (10.1016/j.ijcard.2016.06.097) Copyright © 2016 The Authors Terms and Conditions

Fig. 3 Cell opening measurements at nominal pressure (NP) deployment and at over expansion (OE): Cell opening values are the average values across 6 measurements. Comparable cell opening values between the platforms and designs are observed at nominal diameter. Overexpansion increased cell opening by more than two folds, which is likely to affect scaffolding and drug delivery. International Journal of Cardiology 2016 221, 171-179DOI: (10.1016/j.ijcard.2016.06.097) Copyright © 2016 The Authors Terms and Conditions

Fig. 4 Crown Angle measurements at Nominal Pressure (NP) deployment and at Over Expansion (OE): The crown angles are measured between adjacent struts that do not have a connector between them. Although at nominal diameter crown angles usually ranged from 63 to 95°, this was increased after overexpansion to over 122°, indicative of how much straightening was present in the crowns after overexpansion. International Journal of Cardiology 2016 221, 171-179DOI: (10.1016/j.ijcard.2016.06.097) Copyright © 2016 The Authors Terms and Conditions

Fig. 5 SEM analysis of DESs after nominal pressure (left) deployment and overexpansion (right): Stents shown in the table are the largest workhorse design for each platform. All stents were first post dilated using a 5mm NC balloon followed by overexpansion with a 6.0mm SC balloon. Overexpansion causes visible straightening of the stent struts. Most coating resisted well despite oversizing with only minor cracks on the coating appearing in the crowns when deformation was the most severe. International Journal of Cardiology 2016 221, 171-179DOI: (10.1016/j.ijcard.2016.06.097) Copyright © 2016 The Authors Terms and Conditions