Mathematical modelling of the restenosis process after stent implantation
Mathematical modelling of the restenosis process after stent implantation
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DOI：
10.1098/rsif.2019.0313
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发表时间：
2019-08-01
影响因子：
3.9
通讯作者：
Pena, Estefania
中科院分区：
文献类型：
--
作者：
Escuer, Javier;Martinez, Miguel A.;Pena, Estefania
支架置入术已发展成为临床治疗晚期动脉粥样硬化病变的非常成功的技术。然而，支架内再狭窄的发展仍然是一个关键问题。在这项工作中，提出了一种新颖的二维连续数学模型来描述将支架插入冠状动脉后复杂的再狭窄过程。被认为在再狭窄发展中起关键作用的生物种类是生长因子、基质金属蛋白酶、细胞外基质、平滑肌细胞和内皮细胞。扩散反应方程用于模拟动脉壁中物质之间的质量平衡。文献中的实验数据已被用来估计模型参数。此外，还进行了敏感性分析，以研究模型参数变化对生物物种进化的影响。结果表明，该计算模型定性地捕获了受到非生理机械力作用的动脉内病变生长和愈合过程的关键特征。我们的结果表明，动脉壁反应是由损伤区域、平滑肌细胞增殖和胶原蛋白更新等因素驱动的。
The stenting procedure has evolved to become a highly successful technique for the clinical treatment of advanced atherosclerotic lesions in arteries. However, the development of in-stent restenosis remains a key problem. In this work, a novel two-dimensional continuum mathematical model is proposed to describe the complex restenosis process following the insertion of a stent into a coronary artery. The biological species considered to play a key role in restenosis development are growth factors, matrix metallo-proteinases, extracellular matrix, smooth muscle cells and endothelial cells. Diffusion-reaction equations are used for modelling the mass balance between species in the arterial wall. Experimental data from the literature have been used in order to estimate model parameters. Moreover, a sensitivity analysis has been performed to study the impact of varying the parameters of the model on the evolution of the biological species. The results demonstrate that this computational model qualitatively captures the key characteristics of the lesion growth and the healing process within an artery subjected to non-physiological mechanical forces. Our results suggest that the arterial wall response is driven by the damage area, smooth muscle cell proliferation and the collagen turnover among other factors.