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Τίτλος: The role of vascular calcification in inducing fatigue and fracture of coronary stents
Συγγραφείς: Halwani, Dina O. 
Anayiotos, Andreas 
Major Field of Science: Engineering and Technology
Field Category: Medical Engineering
Λέξεις-κλειδιά: Calcification;In-stent restenosis;Overlapping stents;Fatigue;Stent fracture
Ημερομηνία Έκδοσης: 26-Σεπ-2011
Πηγή: Journal of Biomedical Materials Research - Part B Applied Biomaterials, 2012, vol.100 B, no. 1, pp. 292-304
Volume: 100 B
Issue: 1
Start page: 292
End page: 304
Περιοδικό: Journal of Biomedical Materials Research Part B: Applied Biomaterials 
Περίληψη: Traditional approaches for in-vitro pulsatile and fatigue testing of endovascular stents do not take into consideration the pathologies of the stented vessel and their associated biomechanical effects. One important pathology is calcification, which may be capable of inducing changes in the vessel wall leading to inhomogeneous distribution of stresses combined with wall motion during the cardiac cycle. These local property changes in the region adjacent to stents could directly influence in-vivo stent performance. Seven cases containing a total of 18 stents were obtained from autopsy. Radiographs were evaluated and vessels were sectioned for histology and stent topographical analysis. Stents were retrieved by chemical removal of surrounding tissue and surfaces were evaluated using 3D digital optical and scanning electron microscopy for biomechanical abrasion and fracture features. Pathologic complications such as restenosis and thrombus formation were assessed from histological sections. Direct evidence of fracture was found in 6 of the 7 cases (in 12 out of 18 stents; 9 drug eluting and 3 bare metal). The degree of stent alterations was variable, where separation of segments due to fracture occurred mostly in drug-eluting stents. All fracture surfaces were representative of a high cycle fatigue mechanism. These fractures occurred in complex lesions involving the presence of diffuse calcification alone, or in combination with vessel angulations and multiple overlapping stents. Morphologic analysis of tissue at or near some fracture sites showed evidence of thrombus formation and/or neointimal tissue growth.
URI: https://hdl.handle.net/20.500.14279/4366
ISSN: 15524981
DOI: 10.1002/jbm.b.31911
Rights: © Wiley
Type: Article
Affiliation: University of Alabama at Birmingham 
Cyprus University of Technology 
Publication Type: Peer Reviewed
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