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Geometry parameterization and multidisciplinary constrained optimization of coronary stents.

机译:冠状动脉支架的几何参数化和多学科约束优化。

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Coronary stents are tubular type scaffolds that are deployed, using an inflatable balloon on a catheter, most commonly to recover the lumen size of narrowed (diseased) arterial segments. A common differentiating factor between the numerous stents used in clinical practice today is their geometric design. An ideal stent should have high radial strength to provide good arterial support post-expansion, have high flexibility for easy manoeuvrability during deployment, cause minimal injury to the artery when being expanded and, for drug eluting stents, should provide adequate drug in the arterial tissue. Often, with any stent design, these objectives are in competition such that improvement in one objective is a result of trade-off in others. This study proposes a technique to parameterize stent geometry, by varying the shape of circumferential rings and the links, and assess performance by modelling the processes of balloon expansion and drug diffusion. Finite element analysis is used to expand each stent (through balloon inflation) into contact with a representative diseased coronary artery model, followed by a drug release simulation. Also, a separate model is constructed to measure stent flexibility. Since the computational simulation time for each design is very high (approximately 24?h), a Gaussian process modelling approach is used to analyse the design space corresponding to the proposed parameterization. Four objectives to assess recoil, stress distribution, drug distribution and flexibility are set up to perform optimization studies. In particular, single objective constrained optimization problems are set up to improve the design relative to the baseline geometry-i.e. to improve one objective without compromising the others. Improvements of 8, 6 and 15% are obtained individually for stress, drug and flexibility metrics, respectively. The relative influence of the design features on each objective is quantified in terms of main effects, thereby suggesting the design features which could be altered to improve stent performance. In particular, it is shown that large values of strut width combined with smaller axial lengths of circumferential rings are optimal in terms of minimizing average stresses and maximizing drug delivery. Furthermore, it is shown that a larger amplitude of the links with minimum curved regions is desirable for improved flexibility, average stresses and drug delivery.
机译:冠状动脉支架是管状类型的支架,其通过在导管上使用可充气的气球来展开,最常见的是恢复狭窄的(病变的)动脉节段的管腔大小。当今临床实践中使用的众多支架之间的共同差异因素是其几何设计。理想的支架应具有较高的径向强度,以在扩张后提供良好的动脉支撑,具有较高的柔韧性,以在展开过程中易于操作,在扩张时对动脉造成的损伤最小,并且对于药物洗脱支架,应在动脉组织中提供足够的药物。通常,在任何支架设计中,这些目标都是相互竞争的,因此一个目标的改进是其他目标之间权衡的结果。这项研究提出了一种通过改变圆周环和连接件的形状来参数化支架几何形状的技术,并通过对球囊扩张和药物扩散过程进行建模来评估性能。使用有限元分析将每个支架扩展(通过球囊膨胀)使其与代表性的患病冠状动脉模型接触,然后进行药物释放模拟。此外,构建了一个单独的模型来测量支架的柔韧性。由于每个设计的计算仿真时间都非常长(大约24?h),因此使用了高斯过程建模方法来分析与建议的参数化相对应的设计空间。建立了评估后坐力,压力分布,药物分布和柔韧性的四个目标,以进行优化研究。特别是,设置了单一目标约束的优化问题以相对于基线几何形状改进设计,即在不损害其他目标的前提下改善一个目标。分别在压力,药物和柔韧性指标方面分别提高了8%,6%和15%。根据主要效果量化设计特征对每个物镜的相对影响,从而提出可以更改以改善支架性能的设计特征。特别地,显示出,在最小化平均应力和最大化药物输送方面,大的支柱宽度值与较小的圆周环轴向长度相结合是最佳的。此外,示出了具有最小弯曲区域的链节的较大振幅对于改善的柔性,平均应力和药物输送是期望的。

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