Abstract
Implantation of drug-eluting stents in curved blood vessels may cause changes in hemodynamics and drug distribution, and even provoke in-stent restenosis. Due to the complexity of building three-dimensional (3-D) curved stent model, few studies have gone through such numerical simulations. In this study, three virtual stent models with different bending angles (0°, 30° and 90°) were developed to numerically investigate the distribution of wall shear stress (WSS) and drug concentration. The results showed that (1) the low-WSS regions in the inner bend of the stent models increased with the bending angles; (2) the drug concentration differed between the inner and outer bends of the stents but irrespective to the changes of bending angle; (3) the pattern of drug concentration for the curved stents found similar to that of the straight stents, and the phenomenon, ‘proximal part low and distal part high’ in the drug concentration showed in both the straight and curved stents. The increase in bending angles from 30° to 90° had little effect on the WSS and drug concentration; however, the largest effect of the curved stents was the remarkable difference of drug concentration between the inner and outer bends of the stents—about 20 %. Hence, it is feasible that quick analysis focused on the straight stents instead of the curved stents.
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References
Acharya G, Park K (2006) Mechanisms of controlled drug release from drug-eluting stents. Adv Drug Deliv Rev 58:387–401
Balakrishnan B, Tzafriri AR, Seifert P (2005) Strut position, blood flow, and drug deposition implications for single and overlapping drug-eluting stents. Circulation 111(22):2958–2965
Balossino R, Gervaso F, Migliavacca F, Dubini G (2008) Effects of different stent designs on local hemodynamics in stented arteries. J Biomech 41:1053–1061
Benard N, Perrault R, Coisne D (2006) Computational approach to estimating the effects of blood properties on changes in intra-stent flow. Ann Biomed Eng 34(8):1259–1271
Bozsak F, Chomaz JM, Barakat AI (2014) Modeling the transport of drugs eluted from stents: physical phenomena driving drug distribution in the arterial wall. Biomech Model Mechanobiol 13(2):327–347
Brinda B, Dooley JF (2007) Intravascular drug release kinetics dictate arterial drug deposition, retention and distribution. J Control Release 12(3):100–108
Buchanan JR, Kleinstreuer C, Hyun S (2003) Hemodynamics simulation and identification of susceptible sites of atherosclerotic lesion formation in a model abdominal aorta. J Biomech 36(8):1185–1196
Bulusu KV, Plesniak MW (2013) Secondary flow morphologies due to model stent-induced perturbations in a 180° curved tube during systolic deceleration. Exp Fluids 54(3):1–13
Caro CG, Pedley RJ (1978) The mechanics of the circulation. Oxford University Press, New York
Chen J, Ni Z, Gu X (2009) Survey of coronary stents development for restenosis prevention. Chin J Med Instrum 33(6):429–434
Chen Y, Jiang W, Chen X, Zheng T, Wang Q, Fan Y (2013) Numerical simulation on the effects of drug-eluting stents with different links on hemodynamics and drug concentration distribution. J Mech Med Biol 13:04
Chen Y, Yan F, Jiang WT, Wang QY, Fan YB (2014) Numerical study on effects of drug-coating position of drug-eluting stents on drug concentration. J Med Biol Eng 34:05
Chen Y, Xiong Y, Jiang W (2015) Numerical simulation on the effects of drug eluting stents at different Reynolds numbers on hemodynamic and drug concentration distribution. Biomed Eng Online 14(Suppl 1):S16
Dehlaghi V, Shadpoor MT, Najarian S (2008) Analysis of wall shear stress in stented coronary artery using 3D computational fluid dynamics modeling. J Mater Process Technol 197(1):174–181
Evegren P, Fuchs L, Revstedt J (2010) On the secondary flow through bifurcating pipes. Phys Fluids 22:103601
Glenn AL, Bulusu KV, Shu F (2012) Secondary flow structures under stent-induced perturbations for cardiovascular flow in a curved artery model. Int J Heat Fluid Flow 35:76–83
Kastrati A, Mehilli J, Dirschinger J, Pache J, Ulm K, Schuhlen H, Seyfarth M, Schmitt C, Blasini R, Neumann FJ, Schomig A (2001) Restenosis after coronary placement of various stent types. Am J Cardiol 87:34–39
Kleinstreuer C, Hyun S, Buchanan JR Jr, Longest PW, Archie JP Jr, Truskey GA (2001) Hemodynamic parameters and early intimal thickening in branching blood vessels. Crit Rev Biomed Eng 29:1–64
Kumar V, Cotran RS, Robbins SL (1992) Basic pathology. WB Saunders, Philadelphia
LaDisa JF Jr, Guler I, Olson LE (2003) Three-dimensional computational fluid dynamics modelling of alterations in coronary wall shear stress produced by stent implantation. Ann Biomed Eng 31:972–980
LaDisa JFJ, Olson LE, Molthen RC, Hettrick DA, Pratt PF, Hardel MD, Kersten JR, Warltier DC, Pagel PS (2005) Alterations in wall shear stress predict sites of neointimal hyperplasia after stent implantation in rabbit iliac arteries. Am J Physiol Heart Circ Physiol 288:2465–2475
Liistro F, Bolognese L (2003) Drug-eluting stents. Heart Drug 3:203–213
Mandal AP, Sarifuddin, Mandal PK (2015) An unsteady analysis of arterial drug transport from half-embedded drug-eluting stent. Appl Math Comput 266:968–981
Morlacchi S, Migliavacca F (2013) Modeling stented coronary arteries: where we are, where to go. Ann Biomed Eng 41:1428–1444. doi:10.1007/s10439-012-0681-6
Morlacchi S, Keller B, Arcangeli P, Balzan M, Migliavacca F, Dubini G et al (2011) Hemodynamics and in-stent restenosis: micro-ct images, histology, and computer simulations. Ann Biomed Eng 39:2615–2626. doi:10.1007/s10439-011-0355-9
Olgac U, Kurtcuoglu V, Saur SC, Poulikakos D (2008) Identification of atherosclerotic lesionprone sites through patient-specific simulation of low-density lipoprotein accumulation. Med Image Comput Comput Assist Interv 11:774–781
Peiffer V, Sherwin SJ, Weinberg PD (2013) Does low and oscillatory wall shear stress correlate spatially with early atherosclerosis? A systematic review. Cardiovasc Res 99:242–250
Serruys PW, Sianos G, Abizaid A (2005) The effect of variable dose and release kinetics on neointimal hyperplasia using a novel paclitaxel-eluting stent platform: the paclitaxel in-stent controlled elution study (PISCES). J Am Coll Cardiol 46:253–260
Suh J, Park DW, Lee JY et al (2010) The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC Cardiovasc Interv 3(4):383–389
Sun A, Wang Z, Fan Z et al (2015) Influence of proximal drug eluting stent (DES) on distal bare metal stent (BMS) in multi-stent implantation strategies in coronary arteries. Med Eng Phys 37:840–844
Wentzel JJ, Krams R, Schuurbiers JCH (2001) Relationship between neointimal thickness and shear stress after Wallstent implantation in human coronary arteries. Circulation 103(13):1740–1745
Yang C, Burt HM (2006) Drug-eluting stents: factors governing local pharmacokinetics. Adv Drug Deliv Rev 58:402–411
Zhan H, Zhang X, Dai C (2002) Influence of secondary flow in water-only cyclone on its separation mechanism. Min Metall Eng 2:017
Acknowledgments
This project was supported by Grants-in-Aid from the National Natural Science Research Foundation of China (Nos. 61190123, 51205262, 10872138) and Key Technique Research and Development Programs of Science and Technology Department of Sichuan Province (No. 2013gz0139).
Author contributions
YC and YX contributed in the model development and analysis and wrote most of the manuscript. WJ contributed to the whole study frame and wrote parts of the manuscript. FY supplied the data and revised the manuscript. QW, YF, and MSW thoroughly reviewed the manuscript.
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Other than the Grants listed in the acknowledgement section, the authors declared that they have no competing interests.
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Yu Chen and Yan Xiong contributed equally in this project and are considered as the co-first authors.
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Chen, Y., Xiong, Y., Jiang, W. et al. Numerical simulation on the effects of drug-eluting stents with different bending angles on hemodynamics and drug distribution. Med Biol Eng Comput 54, 1859–1870 (2016). https://doi.org/10.1007/s11517-016-1488-7
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DOI: https://doi.org/10.1007/s11517-016-1488-7