Towards a full-scale model of carotid artery stenting: Virtual stent implantation and its hemodynamic impact

Carotid Artery Stenting (CAS) has emerged as a safe and cost-effective endovascular treatment for patients at high risk for endarterectomy, even though its efficacy remains a matter of debate. The success rate of CAS depends, among other factors, on the selection of the appropriate device. Most research focused on the performance of carotid stents per se (e.g. radial stiffness, flexibility), the stent-vessel interaction from a structural perspective (e.g. vessel stress, lumen gain), or the effect of the stent on the vessel flow from a fluid dynamic perspective. Nonetheless, investigating the stented-vessel hemodynamics requires both a structural analysis, to obtain the post-implantation domain, and a fluid dynamic analysis. In this paper, we provide a full-scale computational approach to predict stenting effectiveness in restoring the flow given a prosthesis and a patient-specific vessel. As a first step, a stent is virtually implanted in a mildly-stenosed artery using the Finite Element Method (FEM); then, the stented lumen is virtually perfused reproducing realistic blood-flow conditions using Computational Fluid Dynamics (CFD)