Patient Specific Stent Malapposition in Challenging Anatomy: An FEA Methodology to Understand Numerically the Extent of Malapposition of Latest Generation Stents

Stent malapposition is a common feature of percutaneous coronary intervention (PCI) particularly in challenging anatomy, and is associated with complications such as stent thrombosis and restenosis. Such lesions can be characterized by long, eccentric, calcified and tortuous geometry. For the purpose of this work, a patient specific right coronary artery stenosis was reconstructed pre-PCI so that virtual FEA simulations of current generation stent could be conducted to model realistic “stenting” conditions. The results show that from the proposed simulation methodology, quantitative and qualitative outcomes can be provided with insight into the development of stent malapposition.