Objective To investigate the mechanical response and hemodynamic characteristics of stenotic vessels under different AZ31 magnesium alloy stent strut configurations and plaque thickness conditions. It explores the influence of stent structural on vascular wall stress, wall shear stress, and the distribution of neointimal growth factors. Methods ABAQUS/Explicit was employed to simulate the compression, expansion, and rebound processes of the stents, yielding vascular wall stress distributions. Based on these results, a fluid domain model was reconstructed, and hemodynamic analysis was conducted using ANSYS Fluent. Results Following stent implantation, high vascular stresses were primarily concentrated in the struts and their adjacent regions. Under plaque-free conditions, the VIV stent exhibited the highest proportion of high AS regions (15.25%), while the VIO stent showed the lowest (14.66%). In the presence of plaque, vascular stress significantly decreased within the plaque area, with high-stress regions concentrating in plaque-free segments. Moreover, the overall proportion of high AS tended to decrease with increasing plaque thickness. Hemodynamic results demonstrated that stent implantation significantly reduced local WSS. Low TAWSS areas predominantly distributed within the stent-covered region, with the VIV stent exhibiting the largest proportion of low TAWSS area (10.71%) and the VIO stent the smallest (9.99%). Conclusion The structural design of stent struts and plaque morphology significantly influence the vascular biomechanical environment. This study provides biomechanical evidence for optimizing the structure of biodegradable magnesium alloy vascular stents and assessing the risk of neointimal hyperplasia.