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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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The effect of plaque eccentricity on blood hemodynamics and drug release in a stented artery

José A Ferreira1, Lino Gonçalves2, Jahed Naghipoor3

  • 1CMUC, Department of Mathematics, University of Coimbra, Coimbra 3001-454, Portugal.

Medical Engineering & Physics
|August 17, 2018
PubMed

Insights

Mathematical modeling of drug-eluting stents (DES) helps identify high-risk zones for in-stent restenosis. This study simulates drug delivery to predict complications in coronary artery disease patients.

Area of Science:

  • Biomedical Engineering
  • Computational Fluid Dynamics
  • Cardiovascular Research

Background:

  • Coronary artery disease (CAD) is a leading global cause of mortality.
  • Drug-eluting stents (DES) are crucial for percutaneous coronary interventions (PCI) to reduce restenosis.
  • Despite DES advancements, restenosis rates remain a clinical challenge.

Purpose of the Study:

  • To develop a mathematical model for simulating local therapeutic agent delivery from DES.
  • To identify high-risk zones for in-stent restenosis based on plaque morphology and drug distribution.
  • To investigate the relationship between plaque eccentricity and restenosis risk.

Main Methods:

  • Mathematical modeling and numerical simulation of drug diffusion and convection within the arterial wall.
  • Incorporation of drug-polymer interactions, viscoelastic arterial properties, and plaque morphology.
  • Analysis of local hemodynamics and drug-tissue interactions.

Main Results:

  • The model successfully simulated drug diffusion from the stent coating into the arterial wall.
  • Identified specific zones with increased risk of in-stent restenosis, correlated with plaque eccentricity.
  • Addressed potential locations for thrombosis and plaque rupture.

Conclusions:

  • Mathematical modeling provides valuable insights into predicting in-stent restenosis risk.
  • Plaque eccentricity is a significant factor influencing restenosis and complication risks.
  • This approach aids in optimizing DES therapy for atherosclerotic coronary artery disease.

Keywords:
Drug distributionEccentricityIn-stent restenosisNumerical simulationWall shear stress

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