1. Percutaneous coronary intervention (PCI)
Coronary artery stenting
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Dr Neil W. Bressloff

2. Coronary Artery Disease
Coronary Artery Disease (CAD) is a condition caused by the accumulation of plaque (usually atheromatous or fibrous plaque) on the inner walls of the artery.
Coronary Arteries(1)
Plaque in a coronary artery(2)
Angiogram showing stenotic region(3)
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Antonio Colombo and Goran Stankovic. Colombo’s Tips & Tricks with Drug-Eluting Stents. Taylor and Francis Group, 2005.

3. Stents as a treatment to CAD
Stents are a most common treatment for CAD
They are tubular structures (often meshes) which are inserted in the stenotic region through a balloon catheter and then expanded through plastic deformation.
Stents are primarily inserted to provide a scaffolding feature.
Drug eluting stents (DES) are coated with an anti-proliferative drug.
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National heart lung and blood institute (nlhbi).
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Stenting procedure(1)

4. Key challenge with using stents
Restenosis - reduction in lumen size as a result of formation of the neointima within 12 months of the stent-implant
Thrombosis - formation of a blood clot, thrombus, inside a blood vessel.
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Restenosis(1)
Thrombosis(2)
Rossella Balossino. A computational study of minimally-invasive devices for the treatment of coronary disease. PhD thesis, Politecnico di Milano.
David Faxon. Restenosis: a guide to therapy. Informa Health Care, illustrated edition, 2001.

5. Geometry Construction
Representative models of the ART stent and Bx VELOCITY are constructed using Rhinoceros 4.0
ART stent – Flat model
Bx VELOCITY – Flat model
ART stent
Bx VELOCITY stent

6. Meshing Tool used for meshing and CFD runs: Star CCM+ 3.06.006 Cells
1,097,951
Interior faces
6,023,874
Vertices
4,850,151
Cells
1,076,793
Interior faces
6,177,303
Vertices
5,010,556

7. Velocity profiles- the ART stent

8. Velocity profiles – Bx VELOCITY stent

9. Haemodynamics and drug release NIR stent
CD-Adapco 2010 calendar

10. Stent Expansion CYPHER stent

11. Drug elution BVS stent (in expanded state)

12. Flexibility BVS B stent (Abbott Vascular)

13. Multi-objective design
Balloon expansion; structural integrity
Haemodynamics: re-endothelialisation
Optimal design: patient specific
Systematic design search and optimisation:
Towards a novel, fully biodegradable
drug eluting coronary stent
Recover and maintain healthy blood flow
but then disappear
Drug elution:
control of
restenosis
Flexibility