Enhancement of Peripheral Stents Reliability: Developing Interactive Procedure Planning by Means of Numerical Simulations and Clinical Software Development

Around 20% of the population over 60-years-old have peripheral arterial disease. Symptoms can cause major lifestyle limitation through pain on walking (intermittent claudication). Progressive disease can also lead to critical limb ischemia, which is the major cause of amputation for adults. The implant of a stent is the endovascular therapy of election for the treatment of peripheral arterial disease. This, however, can increase the risk of fatigue fracture of the implanted device, under in vivo loading conditions. RT3S (real time simulations for safer vascular stenting) is a scientific project involving both universities and private companies, for a funded budget of more than $4.5 million (www.rt3s.eu). The project aims at providing physicians with interactive clinical software for an enhanced pre-operative planning of femoral artery stenting including a prediction of in vivo stent fracture risk, computed by means of numerical simulations. Software-developing companies developed an interactive application allowing physicians to upload the patient's clinical images and plan the stenting procedure, estimating the device fatigue fracture risk, for a specific case of stent and anatomical geometry/boundary conditions. Thanks to the application of innovative response surface techniques, results obtained with the numerical model (requiring 8-day running time) can be exploited quasi real time by the software user. Outcomes of the project will be also exploited for designing activities of next-generation stent devices.