期刊
JOURNAL OF THE ROYAL SOCIETY INTERFACE
卷 18, 期 178, 页码 -出版社
ROYAL SOC
DOI: 10.1098/rsif.2021.0068
关键词
restenosis; balloon angioplasty; finite-element modelling; homogenized constrained mixture theory; vascular remodelling
资金
- Research Foundation-Flanders (FWO) [11A6519N, G088020N]
By replicating the mechanical stimulus and mechanobiological effects in biomechanical simulations, predictive finite-element models can help predict long-term outcomes of treatments for restenosis, increase understanding of restenosis formation, and optimize treatment strategies. The comparison of model results with clinical and experimental data demonstrates its relevance and ability to predict different remodeling responses and the importance of biomechanical understanding in restenosis formation.
Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model's clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.
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