Modelling the Effects of Stenting in the Femoropopliteal Artery
Ní Ghriallais, Ríona
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The femoropopliteal artery is a complex and challenging environment for stent placement. It is subject to large deformations due to the impact of physiological loading from surrounding muscles. It is also subject to changing haemodynamic conditions due to its curved and tortuous geometry. Stenting has many significant impacts on the vessel including altering its deformation characteristics due to stiffness changes to portions of the artery, and damage to the vessel wall due to cell denudation and tearing of arterial tissue. Despite extensive investigations of stent-artery interactions using finite element simulations, in vitro and in vivo experiments, the links between the effects of stenting in terms of local stresses, global deformation characteristic changes and biological responses, and their interdependence has yet to be comprehensively assessed. The objective of this thesis is to examine the effects of stenting in the femoropopliteal artery by investigating the mechanical and biological effects of stent-artery interactions. Finite element models are used to determine stent-artery interactions local to the stented region as a result of stent deployment and physiological loading. Deformation characteristics of the artery as a result of knee bending and changes to these deformation characteristics as a result of stent placement are also investigated. In addition, an in vitro model is used to evaluate stent-artery interactions of curved stented vessels in a cellular and biological context. The investigations presented in this work highlight the importance of taking both ¿local¿ and ¿global¿ finite element models simultaneously, allowing thorough assessment of the consequences of stenting in terms of the mechanical effect to vessel tissue. In a biological context, the investigations presented in this work allow the effects of stent placement and vessel curvature on the vascular endothelium to be assessed.