Comparison of Near-Wall Hemodynamic Parameters in Stented Artery Models

Four commercially available stent designs (two balloon expandable—Bx Velocity and NIR, and two self-expanding—Wallstent and Aurora) were modeled to compare the near-wall flow characteristics of stented arteries using computational fluid dynamics simulations under pulsatile flow conditions. A flat rectangular stented vessel model was constructed and simulations were carried out using rigid walls and sinusoidal velocity input (nominal wall shear stress of $10±5dyn/cm2$⁠). Mesh independence was determined from convergence $(<10%)$ of the axial wall shear stress (WSS) along the length of the stented model. The flow disturbance was characterized and quantified by the distributions of axial and transverse WSS, WSS gradients, and flow separation parameters. Normalized time-averaged effective WSS during the flow cycle was the smallest for the Wallstent $(2.9dyn/cm2)$ compared with the others (⁠$5.8dyn/cm2$ for the Bx Velocity stent, $5.0dyn/cm2$ for the Aurora stent, and $5.3dyn/cm2$ for the NIR stent). Regions of low mean WSS $(<5dyn/cm2)$ and elevated WSS gradients $(>20dyn/cm3)$ were also the largest for the Wallstent compared with the others. WSS gradients were the largest near the struts and remained distinctly nonzero for most of the region between the struts for all stent designs. Fully recirculating regions (as determined by separation parameter) were the largest for the Bx Velocity stent compared with the others. The most hemodynamically favorable stents from our computational analysis were the Bx Velocity and NIR stents, which were slotted-tube balloon-expandable designs. Since clinical data indicate lower restenosis rates for the Bx Velocity and NIR stents compared with the Wallstent, our data suggest that near-wall hemodynamics may predict some aspects of in vivo performance. Further consideration of biomechanics, including solid mechanics, in stent design is warranted.