Royal College of Surgeons in Ireland
2021_Conway_Acute-stent-induc-endothelial-denudation.pdf (1.68 MB)

Acute stent-induced endothelial denudation: biomechanical predictors of vascular injury

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journal contribution
posted on 2022-01-13, 17:24 authored by Claire ConwayClaire Conway, Farhad R Nezami, Campbell Rogers, Adam Groothuis, James C Squire, Elazer R Edelman
Recent concern for local drug delivery and withdrawal of the first Food and Drug Administration-approved bioresorbable scaffold emphasizes the need to optimize the relationships between stent design and drug release with imposed arterial injury and observed pharmacodynamics. In this study, we examine the hypothesis that vascular injury is predictable from stent design and that the expanding force of stent deployment results in increased circumferential stress in the arterial tissue, which may explain acute injury poststent deployment. Using both numerical simulations and ex vivo experiments on three different stent designs (slotted tube, corrugated ring, and delta wing), arterial injury due to device deployment was examined. Furthermore, using numerical simulations, the consequence of changing stent strut radial thickness on arterial wall shear stress and arterial circumferential stress distributions was examined. Regions with predicted arterial circumferential stress exceeding a threshold of 49.5 kPa compared favorably with observed ex vivo endothelial denudation for the three considered stent designs. In addition, increasing strut thickness was predicted to result in more areas of denudation and larger areas exposed to low wall shear stress. We conclude that the acute arterial injury, observed immediately following stent expansion, is caused by high circumferential hoop stresses in the interstrut region, and denuded area profiles are dependent on unit cell geometric features. Such findings when coupled with where drugs move might explain the drug-device interactions.


Post-market surveillance methodology for assessment of coronary stent fracture | Funder: Oak Ridge Associated Universities | Grant ID: ORISE



The original article is available at

Published Citation

Conway C. et al. Acute stent-induced endothelial denudation: biomechanical predictors of vascular injury. Front Cardiovasc Med. 2021;8:733605

Publication Date

15 October 2021

PubMed ID



  • Anatomy and Regenerative Medicine

Research Area

  • Vascular Biology
  • Biomaterials and Regenerative Medicine


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  • Published Version (Version of Record)