Optimize Stent Design by Additive Manufacturing: A Biomechanical and Hemodynamic Approach

Stenting has been used in peripheral arterial disease (PAD), the narrowing of peripheral arteries, to restore normal blood flow with promising clinical outcomes. NiTi shape memory alloy with its unique super elasticity has improved the femoropopliteal artery stenting. However, the complex biomechanical and hemodynamic environment in the femoropopliteal artery presents unique challenges for stent implantation. This artery undergoes significant deformation from bending, torsion, and compression during limb flexion, which can cause stent fatigue, deformation, and fracture that affects both structural integrity and clinical outcomes. Therefore, the design and geometry of stent is critical to improve performance. Additive manufacturing offers new possibilities for optimizing stent design to better accommodate arterial motion, reduce mechanical stresses, and minimize flow disturbances to ensure effective blood flow and minimize complications. Moreover, design, geometry, and cell configuration of the stent result in different flow patterns in stent, which can lead to thrombosis. Stent design impact on hemodynamic parameters need to be assessed to enhance blood flow in stented artery. This study aims to investigate the biomechanical and hemodynamic factors influencing stent performance in the popliteal artery to characterize stent design to adapt the highly mechanically active nature of the artery and reduce the mismatch between artery and stent. By benefiting from additive manufacturing through design accuracy and design freedom, patient specific and customized stent with optimized geometry and design are assessed to address issues such as stent flexibility, durability, and flow dynamics.