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1.
Arch. cardiol. Méx ; Arch. cardiol. Méx;86(3): 260-270, jul.-sep. 2016. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-838383

RESUMO

Resumen Objetivo Tras las evidencias acumuladas mediante el uso de técnicas de angioplastia con stents, surge la polémica sobre los factores que inciden en la respuesta final, ya que hay estudios que reportan reestenosis de la luz en el 30-40% alrededor de 6 meses luego de ser implantados, vinculándose como una de las causas al diseño del dispositivo. Este artículo propone la caracterización funcional de stents endovasculares, analizando su influencia mecánica en el sistema vascular y prediciendo los factores de trauma implícitos en el lecho de los vasos. Métodos Utilizando modelos computacionales de prótesis endovasculares tipo stents, mediante técnicas Finite Elements Analysis, se procedió al análisis estructural de dichos dispositivos con el fin de predecir el comportamiento mecánico y el trauma vascular. Para ello, las prótesis fueron consideradas estructuras tubulares compuestas por múltiples eslabones que están sometidos a cargas de presión, que se reflejan como concentradores de esfuerzos. Resultados El estudio permitió visualizar cómo se ajusta la geometría del stent a las diferentes cargas, obteniéndose una aproximación a la respuesta de interacción "sólido-sólido" entre el stent y la pared arterial. Así, se caracterizó el patrón de esfuerzos y se planteó un modelo conceptual que explica su incidencia mecánica en la interacción stent-vaso, para inferir en la funcionalidad del diseño del dispositivo. Conclusiones El modelo conceptual planteado permite determinar la relación entre las condiciones de interacción mecánicas del stent, y advierte sobre los efectos en lo que sería la operación del dispositivo en el ambiente vascular.


Abstract Objective The accumulated evidence on angioplasty techniques with stents has raised a controversy about the factors that influence the final vascular response. Indeed, several studies have shown there might be re-stenosis between 30% to 40% about 6 months after placement, relating to the design of the device as one of the main causes. This paper proposes the functional characterization of endovascular stents, analyzing its mechanical influence in the vascular system and predicting implicit traumatic factors in the vessel. Methods A structural analysis was made for several computational models of endovascular stents using Finite Element Analysis in order to predict the mechanical behavior and the vascular trauma. In this way, the stents were considered as tubular devices composed of multiple links under radial pressure loads, reflecting stress concentration effects. Results The analysis allowed to visualize how the geometry of stents is adjusted under several load conditions, in order to obtain the response of "solid-solid" interaction between the stent and the arterial wall. Thus, an analysis was performed in order to calculate stress, and a conceptual model that explains its mechanical impact on the stent-vessel interaction, was raised, to infer on the functionality from the design of the devices. Conclusions The proposed conceptual model allows to determine the relationship between the conditions of mechanical interaction of the stents, and warns about the effects in what would be the operation of the device on the vascular environment.


Assuntos
Humanos , Vasos Sanguíneos/lesões , Stents/efeitos adversos , Análise de Elementos Finitos , Modelos Cardiovasculares , Fenômenos Biomecânicos
2.
Arch Cardiol Mex ; 86(3): 260-70, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-27238950

RESUMO

OBJECTIVE: The accumulated evidence on angioplasty techniques with stents has raised a controversy about the factors that influence the final vascular response. Indeed, several studies have shown there might be re-stenosis between 30% to 40% about 6 months after placement, relating to the design of the device as one of the main causes. This paper proposes the functional characterization of endovascular stents, analyzing its mechanical influence in the vascular system and predicting implicit traumatic factors in the vessel. METHODS: A structural analysis was made for several computational models of endovascular stents using Finite Element Analysis in order to predict the mechanical behavior and the vascular trauma. In this way, the stents were considered as tubular devices composed of multiple links under radial pressure loads, reflecting stress concentration effects. RESULTS: The analysis allowed to visualize how the geometry of stents is adjusted under several load conditions, in order to obtain the response of "solid-solid" interaction between the stent and the arterial wall. Thus, an analysis was performed in order to calculate stress, and a conceptual model that explains its mechanical impact on the stent-vessel interaction, was raised, to infer on the functionality from the design of the devices. CONCLUSIONS: The proposed conceptual model allows to determine the relationship between the conditions of mechanical interaction of the stents, and warns about the effects in what would be the operation of the device on the vascular environment.


Assuntos
Vasos Sanguíneos/lesões , Análise de Elementos Finitos , Modelos Cardiovasculares , Stents/efeitos adversos , Fenômenos Biomecânicos , Humanos
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