A Next-Generation Mathematical Model for Drug-Eluting Stents

A Next-Generation Mathematical Model for Drug-Eluting Stents
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下一代药物洗脱支架数学模型

DOI:
10.1137/20m1365144
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发表时间:
2021
影响因子:
1.9
通讯作者:
Bukač, Martina
Bukač, Martina
中科院分区:
数学4区
文献类型:
--
作者:
Čanić, Sunčica;Wang, Yifan;Bukač, Martina

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我们提出了一个Navier-Stokes-Biot流体-结构相互作用(FSI)模型来研究不可压缩的粘性牛顿流体与渗透率依赖于孔径体积变化的多孔弹性介质之间的相互作用。FSI模型被耦合到一组定义在移动区域上的对流-反应-扩散方程,以便我们可以研究药物洗脱支架中的血流、支架内的冠状动脉和药物吸收的时间依赖的药代动力学之间的相互作用。在有限元离散的背景下,用整体方法对所提出的问题进行了数值实现。采用Nitsche方法对运动流体-孔弹性结构界面上的耦合条件之一进行了数值模拟。给出了稳定性分析,给出了格式无条件稳定的Nitsche罚参数的条件。通过三维模拟,考虑了五种几何形状不同的金属支架平台,以及两种不同的药代动力学,以显示支架几何形状和涂层类型对生物力学环境、局部血流动力学以及药物在血管壁和动脉腔内的浓度的影响。研究发现,支架置入改变了动脉壁的通透性和局部血流动力学,这可能是所谓的边缘效应的原因,即药物洗脱支架边缘附近再狭窄率的次优降低。据我们所知,这是药物洗脱支架的第一次研究,它考虑了流体-孔洞弹性结构与渗透率之间的相互作用,这取决于孔径的体积变化,并结合了定义在移动区域上的平流-反应-扩散模型。
We propose a Navier--Stokes--Biot fluid-structure interaction (FSI) model to study the interaction between an incompressible, viscous Newtonian fluid and a poroelastic medium with permeability depending on the volumetric change of pore size. The FSI model is coupled to a set of advection-reaction-diffusion equations defined on moving domains so that we may study the interaction between the blood flow, a stented coronary artery, and time-dependent pharmacokinetics of drug absorption in drug-eluting stents. A monolithic approach is used to implement the proposed problem numerically within the context of finite element discretization. Nitsche's method is employed to enforce one of the coupling conditions at the moving fluid-poroelastic structure interface. Stability analysis is presented, providing conditions on Nitsche's penalty parameter under which the scheme is unconditionally stable. Using 3D simulations, five geometrically different metallic stent platforms are considered with two different pharmacokinetics to show how stent geometry and type of coating impact the biomechanical environment, the local hemodynamics, and the concentration of the pharmacological agents within the vascular wall and artery lumen. It is found that stent implantation changes the permeability properties of the arterial wall, as well as local hemodynamics, which may be responsible for the so-called edge effect, i.e., suboptimal reduction in restenosis rates near the edges of drug-eluting stents. To the best of our knowledge, this is the first study of drug-eluting stents that takes into account fluid-poroelastic structure interaction with permeability depending on the volumetric change of the pore size, coupled to an advection-reaction-diffusion model defined on moving domains.
人类冠状动脉和小鼠头臂动脉的血管通透性测定。
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DOI: 10.1016/j.cma.2019.03.034
发表时间: 2019-06-15
影响因子: 7.2
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