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Numerical Simulation of Restenosis in a Stented Coronary Artery

Authors: Weronika Kurowska-Nouyrigat, Jacek Szumbarski

Abstract:

Nowadays, cardiac disease is one of the most common cause of death. Each year almost one million of angioplasty interventions and stents implantations are made all over the world. Unfortunately, in 20-30% of cases neointimal proliferations leads to restenosis occurring within the following period of 3-6 months. Three major factors are believed to contribute mostly to the edge restenosis: (a) mechanical damage of the artery-s wall caused by the stent implantation, (b) interaction between the stent and the blood constituents and (c) endothelial growth stimulation by small (lower that 1.5 Pa) and oscillating wall shear stress. Assuming that this last actor is particularly important, a numerical model of restenosis basing on wall shear stress distribution in the stented artery was elaborated. A numerical simulations of the development of in-stent restenosis have been performed and realistic geometric patterns of a progressing lumen reduction have been obtained

Keywords: Coronary artery disease, coronary blood flow, instent restenosis.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1075200

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[1] Biassiouny H.S. et al.: Hemodynamic stress amd experimental aortoiliac artherosclerosis. Jour. of Vascular Surgery 19 (1994), p. 426-434.
[2] Oshinski J.N. et al.: Determination of wall shear stress in the aorta with the use of MR phase velocity mapping. J. Magnetic Resonance Imag. 5 (1995), p. 640-647.
[3] Malek A.M. et al.: Endotheliul expression of thrombomodulin is reversibly regulated by fluid shear stress. Circulation Research 74 (1994), p. 852-860.
[4] Benard N. et al.: Experimental study of laminar blood flow through an artery treated by a stent implantation: characterization of intra-stent wall shear stress. J. of Biomechanics 26 (2003), p. 991-998.
[5] Wentzel J.J. et al.: Shear stress, vascular remodeling and neointimal formation. J. of Biomechanics 36 (2003), p. 681-688.
[6] Ohashi T., Sato M.: Remodelling of vascular endothelial cells exposed to fluid shear stress: experimental and numerical approaches. Fluid Dynamics Research 31 (2005), p. 40-59.
[7] Sanmartin M. et al.: Influence of Shear Stress on In-Stent Restenosis: In Vivo Study Using 3D Reconstruction and Computational Fluid Dynamics. Review Esp. Cardiol. 59 (1), p. 20-27, 2006.
[8] Garcia J. et al.: Study of the evolution of the shear stress on the restenosis after coronary angioplasty. J. of Biomechanics 39 (2006), p. 799-805.
[9] Delhagi V. et al.: Analysis of wall shear stress in stented coronary artery using 3D computational fluid dynamics modeling. J. Materials Processing Technology 197 (2008) , p. 174-181.
[10] Doriot P.A., Dorsaz P.A., Verin V.: A morphological-mechanical explanation of edge restenosis in lesions treated with vascular brachytherapy. Cardiovascular Radiation Medicine 4 (2003), p. 108-115
[11] Wentzel J.J. et al.: Coronary stent implantation changes 3D vessel geometry and 3D shear stress distribution. J. of Biomechanics 33 (2000), p. 1287-1295.