Journal of Biomechanics 34 (2001) 1065–1075

Mechanical properties of coronary stents determined by using finite

element analysis
Fre! de! rique Etavea, Ge! rard Finetb,c,*, Maurice Boivina, Jean-Claude Boyera,
Gilles Rioufolb,c, Gilbert Tholletd
a
Laboratory of Mechanics, INSA, Lyon, France
b
Department of Hemodynamics, Hospices Civils de Lyon, Claude Bernard University, Lyon, France
c
CREATIS Research Unit, CNRS, UMR 5515, INSERM, Lyon, France
d
GEMPPM, Laboratory of Scanning Electron Microscopy, INSA, Lyon, France
Accepted 14 February 2001

Abstract

The mechanical function of a stent deployed in a damaged artery is to provide a metallic tubular mesh structure. The purpose of
this study was to determine the exact mechanical characteristics of stents. In order to achieve this, we have used finite-element
analysis to model two different type of stents: tubular stents (TS) and coil stents (CS). The two stents chosen for this modeling
present the most extreme mechanical characteristics of the respective types. Seven mechanical properties were studied by
mathematical modeling with determination of: (1) stent deployment pressure, (2) the intrinsic elastic recoil of the material used, (3)
the resistance of the stent to external compressive forces, (4) the stent foreshortening, (5) the stent coverage area, (6) the stent
flexibility, and (7) the stress maps. The pressure required for deployment of CS was significantly lower than that required for TS,
over 2.8 times greater pressure was required for the tubular model. The elastic recoil of TS is higher than CS (5.4% and 2.6%,
respectively). TS could be deformed by 10% at compressive pressures of between 0.7 and 1.3 atm whereas CS was only deformed at
0.2 and 0.7 atm. The degree of shortening observed increases with deployment diameter for TS. CS lengthen during deployment. The
metal coverage area is two times greater for TS than for CS. The ratio between the stiffness of TS and that of CS varies from 2060 to
2858 depending on the direction in which the force is applied. TS are very rigid and CS are significantly more flexible. Stress
mapping shows stress to be localized at link nodes. This series of finite-element analyses illustrates and quantifies the main
mechanical characteristics of two different commonly used stents. In interventional cardiology, we need to understand their
mechanisms of implantation and action. # 2001 Elsevier Science Ltd. All rights reserved.

Keywords: Stent; Angioplasty; Finite-element analysis; Mechanics; Simulation

1. Introduction and biocompatibility. Biofunctionality defines this

The mechanical function of a stent deployed in
a damaged artery is to provide, over the long-term,
a smooth, metallic tubular mesh structure that fits
any existing arterial curvature and that efficiently
opposes compressive arterial forces (Sigwart, 1997).
The performance of any biomedical material is con-
trolled by two sets of characteristics: biofunctionality
*Correspondence address. Service d’H!emodynamique, Hopital
Cardiologique, B.P Lyon-Monchat, 69394 Lyon Cedex 03, France.
Tel.: +33-4-72-35-74-18; fax: +33-4-72-35-72-91.
E-mail address: gerard.finet@creatis.univ-lyon1.fr (G. Finet).
ability of the device to perform the required function.
The clinical value of stents has been widely evaluated
and two main advantages have been identified: (1)
restenosis rates are reduced due to better initial luminal
patency (Serruys and Kutryk, 1998); and (2) athero-
sclerotic vessel walls are rendered more mechanically
stable (with a reduced risk of occlusion, cracking of
plaque, and dissection) (Haude et al., 1991; Fishman
et al., 1991; Herrmann et al., 1992). In Europe, there are
at least 38 different types of stent currently being
#
marketed (Balcon et al., 1997; Serruys and Kutryk,
1998): 4 of these are self-expanding and the other 34 are
balloon-expandable. The mechanical characteristics of

0021-9290/01/$ - see front matter # 2001 Elsevier Science Ltd. All rights reserved.
PII: S 0 0 2 1 - 9 2 9 0 ( 0 1 ) 0 0 0 2 6 - 4
1066 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075

stents are poorly understood by interventional cardiol- 2. Methods

ogists and this has given rise to a number of
misconceptions that are at the root of various con-
troversies. Mechanical properties vary significantly and
it is impossible to determine these, either from first
principles or by extrapolation.
The purpose of this study was to determine the exact
mechanical characteristics of stents. In order to achieve
this, we have used finite element analysis to model
two different stents, each of which is most representative
of its type, i.e., one tubular and one coil-type stent.
The two stents chosen for this modeling present
the most extreme mechanical characteristics of the
respective types.
2.1. Model stents
We selected two stents for modeling that correspond
to the extremes of this wide spectrum: the most
representative member of the family of tubular stents
(TS) (Palmaz-Schatz1 stent made by Johnson and
Johnson Company, Warren, NJ, USA) and the most
typical coil stent (Freedom1 stent made by Global
Therapeutics Inc., Broomfield, CO, USA) (Fig. 1).
(i) The tubular stent: The tubular stent we modeled
consisted of a slotted tube of about 8 mm in length
(Palmaz-Schatz PS 1541 model). This hollow tube is

Fig. 1. Stent modeling.Tubular stent modeling. (a) Scanning electron micrograph (
43) of a Palmaz-SchatzTM stent, (b) modeled stent struts, (c) a
tubular stent modeled and visualized without thickness (thickness is taken into account in all calculations). TS1: a ¼ 0:3 mm, b ¼ 0:22 mm,
c ¼ 1:7 mm, d ¼ 0:14 mm, e (thickness)=0.1 mm, f ¼ 0:22 mm, D mounted (mean)=1.37 mm. TS2 (modified TS1}strut width): a ¼ 0:35 mm,
b ¼ 0:35 mm, c ¼ 1:57 mm, d ¼ 0:28 mm, e (thickness)=0.2 mm, f ¼ 0:34 mm, D mounted (mean)=1.37 mm.Coil stent modeling. (a0 ) Scanning
electron micrograph (
18) of a FreedomTM stent, (b0 ) modeled stent struts, (c0 ) a coil stent modeled by mean wire path and visualized without
thickness (thickness is taken into account in all calculations). CS1: h ¼ 3:2 mm, D ¼ 2 mm, d wire=0.16 mm, D (mean)=2.34 mm, d mounted
(mean)=1.37 mm. CS2 (modified CS1}the height of sinusoids is twice that of CS1): h ¼ 6:4 mm, D ¼ 2 mm, d wire=0.16 mm, D (mean)=2.34 mm,
D mounted (mean)=1.37 mm.
 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075 1067

made up of six identical units with each unit comprising
two solid metal struts and two openwork struts (TS1). A
second tubular stent (TS2) was modeled that had the
same overall geometry but its struts were approximatly
twice as large.
(ii) The coil stent: The selected coil stent was in the
form of a single helical round wire (Freedom1 model).
We modeled two coil stents (CS) (CS1 and CS2), the
second had the same shape but the height (h) of its
model’s sinusoid was twice that of the first. The wire of
both these stents wrapped around the cylinder 10 times.
The purpose of designing two stents of different
lengths from each of the two families (as shown in
Figs. 1 and 2) was to investigate the impact of these
dimensions on the stents’ mechanical properties. The
three-dimensional mesh remained the same (Fig. 2).
2.1.1. Modeling software
Modeling was performed using Abaqus1 finite
element software (Hibbitt, Karlsson & Sorensen, Inc.,
Rhode Island, USA). Since this program does not have
an automatic grid generation, all the nodes and their
coordinates were programmed using Visual Basic soft-
ware (Windows1, Microsoft Corporation, Redmond,
WA, USA). The BCs applied to the model corespond to
radial shifts. These shifts are made on all the nodes of
the structure for CS and on part only for TS so as to
limit flexion effects. The model was piloted with such
shifts. The aim of the calculation was to determine the
forces arising from a given shift.
2.1.2. Materials
Manufacturers provide no details as to the character-
istics of the material used; there is thus no established
value. The material used for this modeling was 316L
stainless steel (Z3CND17-12}Chroma 17%, Nickel
12%, from the AFNOR mark) (Degallaix et al., 1992).
A standard stress/strain curve for an annealed material
was used by the Abaqus1 software. The general
mechanical properties of this material are: modulus of
elasticity E ¼ 190 MPa, Poisson coefficient n ¼ 0:3.
2.1.3. Modeling methodology
One of the salient features of Abacus software is that it
can be adapted to deal with the mechanical parameters
of interest. Three different types of program were set up
to model the behavior of stents during implantation for a
range of different stent deployment diameters. It is these

Fig. 2. Geometrical visualization of the different mesh structures of each of the two stent types modeled: TS and CS and the variants proposed for
each type (TS1 and TS2, CS1 and CS2). These variations illuminate the impact of these dimensions on the stent’s mechanical properties.
1068 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075

three different types of program which were used to
calculate the mechanical parameters of interest.
(a) To model stent deployment, the calculation involves
submitting each of the stent’s nodes to a positive
radial displacement. Eight different calculations
were carried out to model deployment of the stent
from its crimped position to a variety of different
deployment diameters (from 2 to 5.5 mm by
increasing steps of 0.5 mm).
(b) To model stent compression, the calculation in-
volves submitting each of the nodes of the variously
deployed stents (the range of different diameters in
the programs in a) to a negative radial displacement.
Four different calculations were performed for each
deployment diameter which gave reductions in the
ultimate deployed diameter of between 5% and
25% in incremental steps of 5%.
(c) To model conformability, the stent was positioned
on 2 supports (located on a single generatrix) with a

Fig. 3. Representation of the various kinds of displacement of balloons and stents. (a) Balloon alone: radial displacement of a balloon corresponds to
its inflation. The relationship between diameter and inflation pressure for any balloon is supplied by the manufacturer and every balloon has a
nominal pressure (usually 6 atm) corresponding to a certain inflated diameter. (b) Stent alone: radial displacements of a stent. Both mechanical
components involved}SDP and IER}can be determined by finite element analysis. The SDP cannot be determined on a bench. (c) Stent crimped on
a balloon: inflation allows deployment of the balloon and the stent: this is the balloon inflation pressure (loading). After deflation of the balloon
(unloading), the stent undergoes IER which reduces its diameter from the inflated maximum. Subsequently, the stent is subject to further
compression by the force exerted by the arterial walls but the magnitude of this biomechanical factor is unknown. Then, the stent reaches its final
deployment diameter. The recoil measured angiographically corresponds to the sum of the two factors which tend to reduce the diameter of the stent
from its inflated maximum, i.e., the IER plus compression exerted by the diseased arterial walls.
 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
negative, radial force applied to the opposite
generatrix.
2.1.4. Modeling parameters
Seven mechanical properties were studied by mathe-
matical modeling, the first three properties concerne the
stent implantation (Fig. 3):
(1) the pressure necessary for stent deployment (i.e., the
pressure required to achieve plastic deformation of
the material used) beginning at the diameter of the
crimped stent (pressure expressed in atmosphere
with 1 atm=760 mmHg),
(2) determination of the intrinsic elastic recoil (IER)
due to elastic deformation of the material used. This
recoil is expressed in terms of a relative reduction in
the diameter of the stent (%, DD=D
100) follow-
ing deflation of the balloon,
(3) determination of the resistance of the stent to
external compressive forces (exerted in vivo by the
atherosclerotic artery). This resistance is arbitrarily
defined as the pressure (in atm) required to reduce
the stent diameter by 10% just after its deployment
and its intrinsic elastic recoil.
(4) determination of the stent foreshortening. Percen-
tage shortening can be calculated from the long-
itudinal displacements of the nodes at either end of
any particular stent at the end of the running of
programs in (a).
(5) determination of the stent coverage area defined
as the ratio between the area of the stent’s
external metal surface and the area of the
arterial cylinder covered by the stent (%), which
Fig. 4. Geometrical visualization of the different stent deformabilities.
1069
represents the fraction of the surface of a segment
of stented artery actually occupied by metal
for the various deployment diameters.
(6) determination of the stent flexibility. Stent stiffness
can be calculated from the results given by the
program in (c) (Fig. 4). This program gives the
maximum radial displacement of the stent subjected
to force F. Stiffness is given by dividing F by this
value.
(7) determination of stress and residual strain maps for
the stents at a diameter of 3 mm.
3. Results
3.1. Stent deployment pressure
Calculation of Stent deployment pressure (SDP) can
be defined as the pressure applied to a stent to deploy it
to the required diameter (Fig. 5). The pressure required
for deployment of CS was significantly lower than that
required for TS (e.g., to reach a diameter of 3.5 mm,
TS1=2.10 atm and CS1=0.71 atm; thus, over 2.8 times
greater pressure was required for the tubular model).
With the CS1 stent, a unique phenomenon was observed
when the deployment diameter exceeded 4.5 mm: the
pressure suddenly began to increase, reaching 8 atm at a
diameter of 5 mm. The length of one turn of the wire was
about 5.3 mm which is, of course, lower than the
maximum inflation diameter. Therefore, at large infla-
tion diameters, traction forces are exerted by the wire
which explains why a sudden increase in pressure is
necessary for deployment. Therefore, diameters of 5 and
5.5 mm should not be taken into account when dealing
1070 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
Fig. 5. SDP for stents of between 2 and 5.5 mm. (a) TS and (b) CS.
Dashed lines are explained in the Section 3.
with the stress/strain curve of this type of stent. The CS2
stent (the wire of which is twice as long as that of the
CS1 stent) should not undergo such an increase in
inflation pressure. Moreover, the stent struts also
significantly affect this mechanical property: TS2 has
thicker struts and the deployment pressure required is
6.5 times greater than those required for TS1. CS2, with
sinusoid height twice longer that CS2, has a deployment
pressure 2.7 time smaller than CS1.
3.2. Elastic recoil
Once the stent had been deployed, pressure was
released to model deflation of the balloon. After release,
the diameter of the stent was observed to have shrunk
compared with the maximum observed at the end of
inflation. This reduction in size is referred to as its IER
and is a result of elastic and plastic deformation of the
material (Fig. 6). The TS1 stent seemed far more flexible
than the TS2 stent. The elastic recoil of TS1 varied
between 5.4% and 7% whereas that of TS2 was between
3.7% and 4.1%, i.e., a two-fold difference. This was to
be expected because TS1 is less thick than TS2 and
contains less metal and therefore shoud be more flexible.
The elastic recoil of stent CS1 varied between 2.6% and
6.3% whereas that of CS2 was much higher
(6.3–12.8%). This difference is based on the fact that
Fig. 6. IER for stents of between 2 and 5.5 mm. (a) TS and (b) CS.
the height of the CS1 sinusoids is one-half that of CS2.
Therefore, a longer wire element is far more flexible.
3.3. Determination of stent resistance to external
compressive pressure
This external compressive pressure is in the opposite
direction to the inflation pressure and its calculation
involves the amount of pressure to be applied to the
overall stent surface in order to deform it (Fig. 7), i.e.,
the arterial compressive pressure. Stent TS1 could be
deformed by 10% at compressive pressures of between
0.7 and 1.3 atm (depending on the deployment diameter)
whereas stent TS2 (which is twice as thick) was only
deformed to the same extent at 8.5–20 atm, thus, the
relationships were not linear. Lower pressures were
required for the CS, specifically, 0.7 atm for CS1 and
0.2 atm for CS2.
3.4. Stent shortening
TS1 undergoes shortening of between 0% and 11%,
and TS2 of between 0% and 8%. The degree of
shortening observed increases with deployment dia-
meter. CS lengthen during deployment: by a factor of
between 1% and 27% for CS1 and between 0% and 8%
for CS2. Lengthening increases with deployment dia-
meter.
 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
Fig. 7. The resistance of stent to external compressive pressure
(RECP) (the compressive pressure on the stent exerted by the artery).
(a) TS and (b) CS. The RECP is expressed as a function of initial
diameter (between 2 and 5.5 mm) for a given relative reduction of size
(DD=D ¼ 10%).
3.5. Stent metal coverage area
The metal coverage area (MCA) for a given stented
artery segment decreases as a function of deploy-
ment diameter (Fig. 8). The MCA differs widely between
the two types of stent, tubular and coil (TS1 and CS1),
being 24% and 8.75%, respectively. Moreover there
are also significant differences according to design
within both families, with 24% and 48% for TS1 and
TS2, and 8.75% and 17.5% for CS1 and CS2,
respectively.
3.6. Stent flexibility
The ratio between the stiffness of ST1 and that of CS1
varies from 2000 to 2800 depending on the direction in
which the force is applied. The ratio for TS2 and CS2
varies from 10,200 to 14,200. Halving the thickness of
TS (TS1 and TS2) profoundly modifies flexibility
because stiffness is divided by a factor of 5. On the
other hand, if the height of the sinusoids of CS (CS1 and
CS2) is increased, stiffness is halved. TS are very rigid
and CS are significantly more flexible.
1071
Fig. 8. The MCA of different stents in a stented arterial segment. (a)
TS and (b) CS.
3.7. Stent stress maps
After deformation of the stents modeled at 3 mm
diameter, stress mapping shows stress to be localized at
link nodes, with significant residual values for 316L
stainless steel ranging from 190 to 400 MPa (Fig. 9).
4. Discussion
The various types of stents currently on the market
have different intrinsic mechanical characteristics (Los-
sef et al., 1994; Flueckiger et al., 1994), but two major
types are recognized, the tubular and coil-type stents.
The deployment of most stents involves the inflation of a
balloon. The stent is mounted onto a balloon which is
then inflated to generate a radial force which results in
stent deployment. The balloon, the stent, and the vessel
wall all interact with one another and the quality of stent
deployment at a given diameter will depend on all three.
4.1. Mechanical role of the balloon
The pressure required to deform the balloon’s
material is equal to the difference between internal
(pint ) and external pressure (pext ), i.e., p ¼ pint  pext is
actually the inflation pressure therefore, pint ¼ p þ pext .
1072 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075

Fig. 9. Stress and residual strain maps of the stents modeled at 3 mm diameter.

A linear compliance curve provided by the balloon increments of 0.5 mm. For a given diameter, the
manufacturer can be used to relate the inflation pressure manufacturer indicates a pressure value referred to as
with the corresponding diameter for balloons, which the nominal balloon inflation pressure (NBP), where
usually increase in size upwards from 0.5 mm in NBP ¼ p. This is the pressure necessary to deform the
 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
balloon structure to obtain a given diameter (Jain et al.,
1986). NBP is measured in water without any opposing
force, i.e., pext¼ 0; therefore, pint ¼ NBP (usually 6 atm
but also 8, 9, and 10 atm). This is an intrinsic property of
any given balloon.
4.2. Stent mechanical considerations
Each stent is acted upon by a radial force during
deployment and, in coronary angioplasty, it is the
balloon on which the stent is crimped that will provide
this necessary force. Therefore the stent deployment
force is the force which must be applied to the stent in
order to deploy it to the correct diameter. This force
becomes a pressure when considering the surface of the
stent and the SDP is a variable which depends on both
the stent type and the correct diameter. Once a stent is
mounted on a balloon, the external pressure is no longer
zero and corresponds to the pressure required for stent
deployment, calculated on the basis of finite elements
pext ¼ SDP therefore pint ¼ NBP þ SDP. In other
words, the effective or total inflation pressure for the
balloon (pint ) is equal to the sum of the pressure required
to deform the balloon material (NBP) plus that required
for deployment of the stent (SDP).
The pressure required for stent deployment varies
between stents because it is dependent on the struts of
the wires, the specific material used, and the three-
dimensional configuration of the mesh. The struts of the
metal wires of each stent occur in the calculation of
deployment pressure SDP.
(i) For TS, limit analysis calculation gives the press-
ure theoretically necessary for deployment. The
following equation gives an approximation of this
theoretical pressure for TS SDPTSwith parallepiped
strut section
se ed 2
p¼ ; diameter. Variations are dependent on induced forces,
Dl 2
where se is the material’s elasticity limit, and e, d, D, and
l are the thickness, the width, the diameter of expanded
stent, and the length of the wire, respectively. Therefore,
in order to vary the deployment pressure necessary for a
tubular stent, it is more efficient to change the width of
the wires (a quantity which is raised to the power of 2
than their thickness). The TS2 modifications in dimen-
sion (explained in figure legend 1) increased the inflation
pressure by a factor of 5. In practice, for a deployment
diameter of 3.5 mm, the TS1 tubular stent necessitated a
deployment pressure of 2.1 atm whereas the thicker TS2
stent required a pressure of 13.5 atm.
(ii) CS are deployed owing to their plasticity by
applying a stretching force. Deformation occurs when
the opposing force is equal to the force due to the
elasticity limit se . Analytical calculations are impossible
for this type of stent and the SDPCS can only be
1073
expressed as a function of two parameters
 
1
P ¼ f r3 ; ;
l
where r is the wire radius and l the length of one link.
Doubling the height of the sinusoids of a coil stent
significantly reduced the SDPCS. For a deployment
diameter of 3.5 mm, the CS1 coil stent had a deployment
pressure of 0.71 atm whereas the CS2 stent had a
deployment pressure of 0.25 atm.
After balloon deflation, the stent shrinks due to the
elastic recoil of the material, i.e., the IER. Such IER is a
phenomenon that occurs as soon as the balloon is
deflated and, although it is an inherent property that
depends on the specific material and its mass, the change
in diameter differs between TS and CS because it is also
dependant on the three-dimensional mesh structure
(Barragan et al., 2000). Recoil manifests as a shrinking
following deflation of the balloon, the extent of which is
deterministic and therefore predictable (Haude et al.,
1993; White, 1997; De Jaegere et al., 1994). Stents thus
deployed exert no radial force on the artery and resist
any external compressive forces exerted by normal and/
or atherosclerotic vessel walls (Schrader and Beyar,
1998).
4.3. Biomechanical effects due to the artery
The capacity to resist compressive force is the
fundamental biomechanical characteristic of any stent
since it corresponds to the basic therapeutic aim (Rieu
et al., 1999). Resistance to collapse is significantly
different for TS and CS, being 1.5 fold higher for the
former: the diameters of TS and CS shrink by 10% at
pressures of 1.04 and 0.75 atm, respectively (i.e., 760 and
570 mmHg). This resistance to collapse is not a constant
for a given stent but depends on the deployment
either flexion or traction forces.
4.4. Adjusted balloon inflation pression (ABIP)
The ABIP for stent deployment to a given diameter
(to provide stenting at the same diameter as the artery,
stent/artery ratio=1) is therefore dependent both on
properties intrinsic to the stent and on properties of the
balloon on which the stent is mounted. ABIP is equal to
the sum of the three different pressure components
discussed above.
ABIP ¼ NBP þ SDP þ CERP;
where NBP is the nominal balloon inflation pressure,
SDP the stent deployment pressure determined by
numerical method, and CERP the compensatory elastic
recoil pressure. IER is predictable. Its effect can be
1074 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
counteracted by very precise over-inflation using man-
ufacturer’s balloon compliance table (CERP).
The level of balloon inflation pressure for optimal
stent deployment is a controversial issue (Hausleiter
et al., 1997; Goldberg et al., 1998; Glogar et al., 1997).
Our study precisely demonstrates that the ABIP can be
accurately determined for each stent, for each required
diameter, and for each balloon. ABIPs should be varied
according to the variety of stents. There is no single
ABIP (high or low) that will guarantee optimal stent
sizing; however, optimal ABIP can be accurately
determined for each stent, for each required diameter,
and for each balloon.
5. Practical implication
Based directly from our numerical model a new stent
has been designed and manufactured by HEXACATH
(Paris, France): HELISTENT1. This stent is now
commercially available in Europe. Its CE mark has
been obtained the 12th May 1999 under the TUV . Degallaix, S., Vogt, J.B., Foct, J., 1992. Influence de la tenue en azote
Rheinland-ID 9910735 01. The conceiving of this stent
confirms the ability of our numerical model for
predicting mechanichal properties of coronary stents.
6. Study limitation
Finite element digital simulation is a method using a
theoretical model, with all the limitations that entails.
The model uses a theoretic behavior for perfectly radial
and homogeneous balloon deployment, which reality
fails to reproduce exactly. The model ignores any
friction between balloon, stent and arterial wall. In the
calculations, arterial wall visco-elasticity is not taken
into account, being presently unknown.
7. Conclusion
This series of finite-element analyses illustrates and
quantifies the main mechanical characteristics of two
different commonly used stents. Familiarity with such
mechanical characteristics is important for cardiologists
who not only have a huge range of different stents from
different companies to choose from but who also need to
understand the mechanisms of implantation and the
action of these devices (Dumoulin and Cochelin, 2000).
8. Uncited Reference
Carrozza et al., 1996; Ruygrok and Serruys, 1996.
Acknowledgements
The authors greatly acknowledge R!egis Rieu, Paul
Barragan, and Vincent Garitey (Ecole Sup!erieure de
M!ecanique de Marseille}ESM2) for their helpfull
comments concerning stent mechanical properties and
experimental validations.
References
Balcon, R., Beyar, R., Chierchia, S., de Sheerder, I., Hugenholtz, P.G.,
Kiemeneij, F., Meier, B., Meyer, J., Monassier, J.P., Wijns, W.,
1997. Recommendations on stent manufacture, implantation and
utilization. European Heart Journal 18, 1536–1547.
Barragan, P., Rieu, R., Garitey, V., Roquebert, P., Sainsous, J.,
Silvestri, M., Bayet, G., 2000. Elastic recoil of coronary stents: a
comparative analysis. Catheter and Cardiovascular Intervention
50, 112–119.
Carrozza, J.P., Yock, P.G., Linnemeier, T.J., Robertson, L.K., Yock,
C.A., Schnabel, J.S., Lird, J.R., Baim, D.S., 1996. Serial expansion
of the ACS Multilink stent after 8, 12, and 16 Atm: a QCA and
IVUS pilot study. Circulation; Abstract 0509: I-88.
interstitiel sur le comportement en fatigue plastique oligocyclique
d’aciers inoxydables aust!enitiques. Rupture a" chaud}GIS pro-
ceedings.
De Jaegere, P., Serruys, P.W., van Es, G.A., 1994. Recoil following
Wiktor stent implantation for restenotic lesions of coronary
arteries. Catheter and Cardiovascular Diagnosis 32, 147–156.
Dumoulin, C., Cochelin, B., 2000. Mechanical behavior modeling of
balloon-expandable stents. Journal of Biomechanics 33, 1461–
1470.
Fishman, H.C., Savage, M.P., Leon, M.B., Schatz, R.A., Ellis, S.G.,
Cleman, M.W., Teirstein, P., Walker, C.M., Bailey, S., Hirshfeld,
J.W., Goldberg, S., 1991. Effect of intracoronary stenting on
intimal dissection after balloon angioplasty. Journal of the
American College Cadiologists 18, 14.
Flueckiger, F., Sternthal, H., Klein, G.E., Aschauer, M., Szolar, D.,
Kleinhappl, G., 1994. Strength, elasticity, and plasticity of
expandable metal stents: in vitro studies with three types of stress.
Journal of Vascular Intervention and Radiology 5, 745–750.
Glogar, D., Yang, P., Hassan, A., Heyer, G., Klein, W., Luha, O.,
.
Muhlberger, V., Maurer, E., Pachinger, O., Sochor, H., Sykora, J.,
Weber, H., Weidinger, F., 1997. Does high-pressure balloon post-
dilatation improve long-term results of Wiktor1 coil stent? Journal
of the American College Cardiologists; Abstract 1011-23:313A.
Goldberg, S.L., Di Mario, C., Hall, P., Colombo, A., 1998.
Comparison of aggressive versus nonaggressive balloon dilatation
for stent deployment on late loss and restenosis in native coronary
arteries. American Journal of Cardiology 81, 708–712.
Haude, M., Erbel, R., Hassan, I., Meyer, J., 1993. Quantitative
analysis of elastic recoil after balloon angioplasty and after
intracoronary implantation of balloon expandable Palmaz-Schatz.
American Journal of Cardiology 21, 26–34.
Haude, M., Erbel, R., Straub, U., Dietz, U., Schatz, R., Meyer, J.,
1991. Results of intracoronary stents for management of coronary
dissection after balloon angioplasty. American Journal of Cardiol-
ogy 67, 691–696.
.
Hausleiter, J., Schuhlen, H., Elezi, S., Walter, M., Hadamitzky, M.,
.
Dirschinger, J., Schomig, A., 1997. Impact of high inflation
pressures on six-month angiographic follow-up after coronary
stent placement. Journal of the American College Cardiologists;
Abstract 782-4:369A.
 F. Etave et al. / Journal of Biomechanics 34 (2001) 1065–1075
Herrmann, H.C., Buchbinder, M., Cleman, M.W., Fishman, H.C.,
Goldberg, S., Leon, M.B., Schatz, R.A., Teirstein, P., Walker,
C.M., Hirshfeld, J.W., 1992. Emergent use of balloon-expandable
coronary artery stenting for failed percutaneous transluminal
coronary angioplasty. Circulation 86, 812–819.
Jain, A., Demer, L.L., Raizner, A.E., Roberts, R., 1986. Effect of
inflation pressures on coronary angioplasty balloons. American
Journal of Cardiology 57, 26–28.
Lossef, S.V., Lutz, R.J., Mundorf, J., Atmth, K.H., 1994. Comparison
of mechanical deformation properties of metallic stents with use of
stress–strain analysis. Journal of Vascular Intervention and
Radiology 5, 341–349.
Rieu, R., Barragan, P., Masson, C., Fuseri, J., Garitey, V., Silvestri,
M., Roquebert, P., Sainsous, J., 1999. Radial force of coronary
1075
stents: a comparative analysis. Catheter and Cardiovascular
Intervention 46, 380–391.
Ruygrok, P.N., Serruys, P.W., 1996. Intra-coronary stenting. From
concept to custom. Circulation 94, 882–890.
Schrader, S.C., Beyar, R., 1998. Evaluation of the compressive
mechanical properties of endoluminal metal stents. Catheter and
Cardiovascular Diagnosis 44, 179–187.
Serruys, P.W., Kutryk, M.J.B., 1998. Handbook of Coronary Stents,
2nd Edition.. Martin Dunitz Ltd., London.
Sigwart, U., 1997. Stents: a mechanical solution for a biological
problem? European Heart Journal 18, 1068–1072.
White, C.J., 1997. Stent recoil: comparison of the Wiktor-GX coil and
the Palmaz-Schatz tubular coronary stent. Catheter and Cardio-
vascular Diagnosis 41, 1–3.