+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn

+ Translate
+ Recently Requested

Application of a mechanobiological simulation technique to stents used clinically



Application of a mechanobiological simulation technique to stents used clinically



Journal of Biomechanics 46(5): 918-924



Many cardiovascular diseases are characterised by the restriction of blood flow through arteries. Stents can be expanded within arteries to remove such restrictions; however, tissue in-growth into the stent can lead to restenosis. In order to predict the long-term efficacy of stenting, a mechanobiological model of the arterial tissue reaction to stress is required. In this study, a computational model of arterial tissue response to stenting is applied to three clinically relevant stent designs. We ask the question whether such a mechanobiological model can differentiate between stents used clinically, and we compare these predictions to a purely mechanical analysis. In doing so, we are testing the hypothesis that a mechanobiological model of arterial tissue response to injury could predict the long-term outcomes of stent design. Finite element analysis of the expansion of three different stent types was performed in an idealised, 3D artery. Injury was calculated in the arterial tissue using a remaining-life damage mechanics approach. The inflammatory response to this initial injury was modelled using equations governing variables which represented tissue-degrading species and growth factors. Three levels of inflammation response were modelled to account for inter-patient variability. A lattice-based model of smooth muscle cell behaviour was implemented, treating cells as discrete agents governed by local rules. The simulations predicted differences between stent designs similar to those found in vivo. It showed that the volume of neointima produced could be quantified, providing a quantitative comparison of stents. In contrast, the differences between stents based on stress alone were highly dependent on the choice of comparison criteria. These results show that the choice of stress criteria for stent comparisons is critical. This study shows that mechanobiological modelling may provide a valuable tool in stent design, allowing predictions of their long-term efficacy. The level of inflammation was shown to affect the sensitivity of the model to stent design. If this finding was verified in patients, this could suggest that high-inflammation patients may require alternative treatments to stenting.

(PDF emailed within 0-6 h: $19.90)

Accession: 051607358

Download citation: RISBibTeXText

PMID: 23398970

DOI: 10.1016/j.jbiomech.2012.12.014



Related references

Computational simulation methodologies for mechanobiological modelling: a cell-centred approach to neointima development in stents. Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences 368(1921): 2919-2935, 2010

Simulation of tissue differentiation in a scaffold as a function of porosity, Young's modulus and dissolution rate: application of mechanobiological models in tissue engineering. Biomaterials 28(36): 5544-5554, 2007

Three-dimensional simulation of mandibular distraction osteogenesis: mechanobiological analysis. Annals of Biomedical Engineering 39(1): 35-43, 2011

Incidence and predictors of clinically driven target lesion revascularization from bare-metal stents to drug-eluting stents. Catheterization and Cardiovascular Interventions 70(2): 184-184, 2007

Assessment of mechanobiological models for the numerical simulation of tissue differentiation around immediately loaded implants. Computer Methods in Biomechanics and Biomedical Engineering 6(5-6): 277-288, 2003

Evaluation of bone remodeling around single dental implants of different lengths: a mechanobiological numerical simulation and validation using clinical data. Computer Methods in Biomechanics and Biomedical Engineering 19(7): 699-706, 2016

In silico prediction of the mechanobiological response of arterial tissue: application to angioplasty and stenting. Journal of Biomechanical Engineering 133(8): 081001-081001, 2012

Sirolimus-eluting stents for bifurcation lesions Comparison to standard bare stents using the T-stenting technique. Circulation 106(19 Supplement): II-519, November 5, 2002

Use of a branch wire to anchor stents for exact placement proximal to bifurcation stents: the reverse Szabo technique. Catheterization and Cardiovascular Interventions 67(6): 904-907, 2006

In-situ investigation of stress conditions during expansion of bare metal stents and PLLA-coated stents using the XRD sin(2)ψ-technique. Journal of the Mechanical Behavior of Biomedical Materials 49: 23-29, 2016

Randomized study of the crush technique versus provisional side-branch stenting in true coronary bifurcations: the CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) Study. Circulation 119(1): 71-78, 2009

The technique and application of magnetostatic simulation system. Pages 436-438 1986, 1986

Letter by Movahed regarding article, "Randomized Study of the Crush Technique Versus Provisional Side-Branch Stenting in True Coronary Bifurcations: The CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) Study". Circulation 120(8): E63; Author Reply E64-E63; Author Reply E64, 2009

Thermal histories and overthrusting; application of numerical simulation technique. Organic Geochemistry 16(1-3): 267-285, 1990

A cytogenetic study of nonpolymalformed patients with mental retardation of clinically undefined etiology: application of a high resolution banding technique. Acta Medica Okayama 43(2): 105-114, 1989