Staff View: Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation

Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation

A computational approach is used to investigate potential risk factors for distal stent graft-induced new entry (dSINE) in aortic dissection (AD) patients. Patient-specific simulations were performed based on computed tomography images acquired from six AD patients (three dSINE and three non-dSINE)...

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Main Authors:	Tan, Wei Ting, Liew, Yih Miin, Mokhtarudin, Mohd Jamil Mohamed, Pirola, Selene, Ab Naim, Wan Naimah Wan, Hashim, Shahrul Amry, Xu, Xiao Yun, Lim, Einly
Format:	Article
Published:	ASME 2021
Subjects:	QC Physics TA Engineering (General). Civil engineering (General)
Online Access:	http://eprints.um.edu.my/33906/
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spelling	my.um.eprints.339062022-07-22T04:44:07Z http://eprints.um.edu.my/33906/ Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation Tan, Wei Ting Liew, Yih Miin Mokhtarudin, Mohd Jamil Mohamed Pirola, Selene Ab Naim, Wan Naimah Wan Hashim, Shahrul Amry Xu, Xiao Yun Lim, Einly QC Physics TA Engineering (General). Civil engineering (General) A computational approach is used to investigate potential risk factors for distal stent graft-induced new entry (dSINE) in aortic dissection (AD) patients. Patient-specific simulations were performed based on computed tomography images acquired from six AD patients (three dSINE and three non-dSINE) to analyze the correlation between anatomical characteristics and stress/strain distributions. Sensitivity analysis was carried out using idealized models to independently assess the effect of stent graft length, stent tortuosity and wedge apposition angle at the landing zone on key biomechanical variables. Mismatch of biomechanical properties between the stented and nonstented regions led to high stress at the distal stent graft-vessel interface in all patients, as well as shear strain in the neighboring region, which coincides with the location of tear formation. Stress was observed to increase with the increase of stent tortuosity (from 263 kPa at a tortuosity angle of 50 deg to 313 kPa at 30 deg). It was further amplified by stent graft landing at the inflection point of a curve. Malapposition of the stent graft led to an asymmetrical segment within the aorta, therefore changing the location and magnitude of the maximum von Mises stress substantially (up to +25.9% with a +25 deg change in the distal wedge apposition angle). In conclusion, stent tortuosity and wedge apposition angle serve as important risk predictors for dSINE formation in AD patients. ASME 2021-08-01 Article PeerReviewed Tan, Wei Ting and Liew, Yih Miin and Mokhtarudin, Mohd Jamil Mohamed and Pirola, Selene and Ab Naim, Wan Naimah Wan and Hashim, Shahrul Amry and Xu, Xiao Yun and Lim, Einly (2021) Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation. Journal of Biomechanical Engineering-Transactions of the ASME, 143 (8). ISSN 0148-0731, DOI https://doi.org/10.1115/1.4050642 <https://doi.org/10.1115/1.4050642>. 10.1115/1.4050642
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	QC Physics TA Engineering (General). Civil engineering (General)
spellingShingle	QC Physics TA Engineering (General). Civil engineering (General) Tan, Wei Ting Liew, Yih Miin Mokhtarudin, Mohd Jamil Mohamed Pirola, Selene Ab Naim, Wan Naimah Wan Hashim, Shahrul Amry Xu, Xiao Yun Lim, Einly Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
description	A computational approach is used to investigate potential risk factors for distal stent graft-induced new entry (dSINE) in aortic dissection (AD) patients. Patient-specific simulations were performed based on computed tomography images acquired from six AD patients (three dSINE and three non-dSINE) to analyze the correlation between anatomical characteristics and stress/strain distributions. Sensitivity analysis was carried out using idealized models to independently assess the effect of stent graft length, stent tortuosity and wedge apposition angle at the landing zone on key biomechanical variables. Mismatch of biomechanical properties between the stented and nonstented regions led to high stress at the distal stent graft-vessel interface in all patients, as well as shear strain in the neighboring region, which coincides with the location of tear formation. Stress was observed to increase with the increase of stent tortuosity (from 263 kPa at a tortuosity angle of 50 deg to 313 kPa at 30 deg). It was further amplified by stent graft landing at the inflection point of a curve. Malapposition of the stent graft led to an asymmetrical segment within the aorta, therefore changing the location and magnitude of the maximum von Mises stress substantially (up to +25.9% with a +25 deg change in the distal wedge apposition angle). In conclusion, stent tortuosity and wedge apposition angle serve as important risk predictors for dSINE formation in AD patients.
format	Article
author	Tan, Wei Ting Liew, Yih Miin Mokhtarudin, Mohd Jamil Mohamed Pirola, Selene Ab Naim, Wan Naimah Wan Hashim, Shahrul Amry Xu, Xiao Yun Lim, Einly
author_facet	Tan, Wei Ting Liew, Yih Miin Mokhtarudin, Mohd Jamil Mohamed Pirola, Selene Ab Naim, Wan Naimah Wan Hashim, Shahrul Amry Xu, Xiao Yun Lim, Einly
author_sort	Tan, Wei Ting
title	Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
title_short	Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
title_full	Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
title_fullStr	Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
title_full_unstemmed	Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation
title_sort	effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:possible link with new entry formation through biomechanical simulation
publisher	ASME
publishDate	2021
url	http://eprints.um.edu.my/33906/
_version_	1739828481552809984
score	13.211869

Effect of vessel tortuosity on stress concentration at the distal stent-vessel interface:Possible link with new entry formation through biomechanical simulation

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