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Communication Dans Un Congrès Année : 2018

Cardiovascular devices: Mechanical characterization of coronary stents

Résumé

Background: Coronary stents participate to limit cardiovascular death but are associated with some complications. Matching stent biomechanical characteristics with specific coronary lesions could limit these complications. Objectives: Development of a standardized and global bench test protocol and evaluation of most currently used coronary stents to improve stent choice in cathlab. Materials: We evaluated biomechanical characteristics of coronary stents (AbsorbTM-ABBOTT (R) , Xience AlpineTM-ABBOTT (R), Resolute IntegrityTM-MEDTRONIC (R), Resolute OnyxTM-MEDTRONIC (R), OrsiroTM-BIOTRONIK (R), SynergyTM-BOSTON SCIENTIFIC (R), OptimaxTM-HEXACATH (R)) in an in vitro study: radial elastic recoil, foreshortening, crimped stent with balloon flexibility and deployed stent flexibility. We also evaluated maximal resistance, elastic strength limit and elastic deformation limit for radial and longitudinal compression. Stents were deployed in a saline solution at 37+/-0.5 °C. 9 stents were used to evaluate elastic recoil and foreshortening. Then, 3 among them were used to evaluate radial resistance between parallel plates, 3 were used to evaluate longitudinal resistance and 3 others were used to evaluate deployed stent bending stiffness. Before stent inflation 3 stents, among the 9 devices dedicated to biomechanical evaluation, were used to evaluate the uninflated stent with balloon bending stiffness. For a maximum comparability between stent models, we chose the most used stent size in our clinical practice (3.0 mm diameter and the nearest to 20 mm length). For these evaluations, all devices were inflated with them own balloon, at nominal pressure, according to manufacturer's recommendations. Nominal pressure was maintained for 30 seconds. We studied coating with field emission gun scanning electron microscope after POT-SIDE-POT (PSP) simulation to evaluate coating resistance to angioplasty. Bifurcation performances were evaluated by microcomputed tomography imaging of PSP stented silicon bifurcation models. Statistical analyses were performed using XLStats 2017 (Addinsoft). Results: Elastic recoil, deployed stent exibility and crimped stent flexibility were signicantly different between groups (all p < 0.0001); as were radial and longitudinal maximum resistance (p < 0.0001). SynergyTM, OrsiroTM and Xience AlpineTM had the lowest elastic recoil. SynergyTM and Resolute OnyxTM were the most exible. OptimaxTM had the highest radial and longitudinal resistance. Coating lesions after PSP were not signicantly different, excepted for OptimaxTM which had no coating lesion. In bifurcation model, side branch ostium coverage and malapposed strut ratio were signicantly different between groups (respectively, p = 0.01 and p = 0.004). Strut fractures were founded only in AbsorbTM. Conclusion: Currently used stents have very different biomechanical and bifurcation performance proles. Their choice had to be adapted to each coronary lesion particularity to improve coronary interventions results.
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Dates et versions

hal-02910316 , version 1 (01-08-2020)

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  • HAL Id : hal-02910316 , version 1

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Mickael Bonin, Jean-Marc Olive, Patrice Guerin, Fabienne Jordana. Cardiovascular devices: Mechanical characterization of coronary stents. 16th European Mechanics of Materials Conference, Mar 2018, Nantes, France. ⟨hal-02910316⟩
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