Simulation of vessel tissue remodeling with residual stress: an application to in-stent restenosis

We present a numerical procedure to model the artery wall remodeling stimulated by stenting considering varying degree of residual stresses. This framework sets up biological remodeling with the existence of residual stress. Previous studies suggest that the residual stress originates from the growth and remodeling of the premature tissue. Meanwhile, it is known that tissue remodeling can happen under mechanical loading. However, none of the existing research studies the impact of residual stress on the mechanical-driven growth of biomaterials. To fill this gap, we build a numerical framework that couples the residual stress with a growth model, and examine its impact on tissue remodeling. The proposed approach is applied to in-stent restenosis, where the tissue remodeling process is modeled with finite element method, and the residual stress is generated geometrically using open angle method. The result shows that residual stress reverses the radial distribution of stress concentration, which is ameliorated by tissue remodeling. The thickening of vessel wall tends to increase with residual stress, which links to more severe in-stent restenosis. The results demonstrate the important interplay between residual stress and tissue remodeling. The findings suggest that residual stress should be considered in the future simulation of tissue remodeling.