The Relation Between the Arterial Stress and Restenosis Rate After Coronary Stenting

Two commercially available stents (the Palmaz–Schatz (PS) and S670 stents) with reported high and low restenosis rates, respectively, have been investigated in this paper. Finite element models simulating the stent, plaque, and artery interactions in 3 mm stenosed right coronary arteries were developed. These models were used to determine the stress field in artery walls after stent implantation. The material properties of porcine arteries were measured and implemented in the numerical models. The stress concentration induced in the artery by the PS stent was found to be more than double that of the S670 stent. It demonstrated a good correlation with the reported restenosis rate. The effects of stent structures, compliance mismatch, plaque geometry, and level of stenosis were studied. Results suggested that stent designs and tissue properties cause alterations in vascular anatomy that adversely affect arterial stress distributions within the wall, which impact vessel responses such as restenosis. Appropriate modeling of stent, plaque, and artery interactions provided insights for evaluating alterations to the arterial mechanical environment, as well as biomechanical factors leading to restenosis.