Numerical modeling of a human stented trachea under different stent designs

Endotracheal stenting is a common treatment for tracheal disorders as stenosis, cronic cough or dispnoea episodes. However, medical treatment and surgery are still challenging due to the difficulties in overcoming potential prosthesis complications. In this work we analyze the response of the tracheal wall during breathing and coughing conditions under different stent implantations. A finite element model of a human trachea was developed and used to analyze tracheal deformability after prosthesis implantation under normal breathing and coughing using a fluid-structure interaction approach (FSI). The geometry of the trachea is obtained from computed tomography (CT) images of a healthy patient. A structured hexahedral-based grid for the tracheal wall and an unstructured tetrahedral-based mesh with coincident nodes for the fluid were used to perform the simulations with a finite element-based commercial software code. Tracheal wall is modeled as a fiber reinforced hyperelastic solid material in which the anisotropy due to the orientation of the fibers is taken into account. Deformations of the tracheal cartilage rings and of the muscle membrane, as well as the maximum principal stresses in the wall, are analyzed and compared with those of the healthy trachea in absence of prosthesis. The results showed that, the presence of the stent prevents tracheal muscle deflections especially during coughing. In addition, we proposed a methodology to evaluate, through numerical simulations, the predisposition of the stent to migrate.