2020_Article_.pdf (3.64 MB)
Mechanistic evaluation of long-term in-stent restenosis based on models of tissue damage and growth
journal contribution
posted on 2019-12-17, 09:34 authored by Ran He, Liguo Zhao, Vadim SilberschmidtVadim Silberschmidt, Yang LiuYang LiuDevelopment and application of advanced mechanical models of soft tissues and their growth represent one of the main directions in modern mechanics of solids. Such models are increasingly used to deal with complex biomedical problems. Prediction of in-stent restenosis for patients treated with coronary stents remains a highly challenging task. Using a finite element method, this paper presents a mechanistic approach to evaluate the development of in-stent restenosis in an artery following stent implantation. Hyperelastic models with damage, verified with experimental results, are used to describe the level of tissue damage in arterial layers and plaque caused by such intervention. A tissue-growth model, associated with vessel damage, is adopted to describe the growth behaviour of a media layer after stent implantation. Narrowing of lumen diameter with time is used to quantify the development of in-stent restenosis in the vessel after stenting. It is demonstrated that stent designs and materials strongly affect the stenting-induced damage in the media layer and the subsequent development of in-stent restenosis. The larger the artery expansion achieved during balloon inflation the higher the damage introduced to the media layer, leading to an increased level of in-stent restenosis. In addition, the development of in-stent restenosis is directly correlated with the artery expansion during the stent deployment. The correlation is further used to predict the effect of a complex clinical procedure, such as stent overlapping, on the level of in-stent restenosis developed after percutaneous coronary intervention.
Funding
EPSRC UK (Grant number: EP/R001650/1; Title: Smart peripheral stents for the lower extremity - design, manufacturing and evaluation)
British Heart Foundation (Grant number: FS/15/21/31424; Title: Towards controlling the mechanical performance of polymeric bioresorbable vascular scaffold during biodegradation)
Royal Society of UK (Grant number: IE160066; Title: Evaluating the performance of additively manufactured endovascular scaffolds)
History
School
- Mechanical, Electrical and Manufacturing Engineering
Published in
Biomechanics and Modeling in MechanobiologyVolume
19Issue
5Pages
1425 - 1446Publisher
Springer (part of Springer Nature)Version
- VoR (Version of Record)
Rights holder
© The AuthorsPublisher statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Acceptance date
2019-12-17Publication date
2020-01-07Copyright date
2020ISSN
1617-7959eISSN
1617-7940Publisher version
Language
- en