No abstract

Coronary artery disease can be treated by implanting a stent into the blocked region of an artery, thus enabling blood perfusion to distal vessels. Minimally invasive procedures of this nature often result in damage to the arterial tissue culminating in the re-blocking of the vessel. In an effort to alleviate this phenomenon, known as restenosis, drug eluting stents were developed. They are similar in composition to a bare metal stent but encompass a coating with therapeutic agents designed to reduce the overly aggressive healing response that contributes to restenosis. There are many variables that can influence the effectiveness of these therapeutic drugs being transported from the stent coating to and within the artery wall, many of which have been analysed and documented by researchers. However, the physical deformation of the artery substructure due to stent expansion, and its influence on a drugs ability to diffuse evenly within the artery wall have been lacking in published work to date. The paper highlights previous approaches adopted by researchers and proposes the addition of porous artery wall deformation to increase model accuracy.

The development of restenosis within the coronary arteries after a stenting procedure has been addressed with the development of the drug eluting stent device. However, in recent times the superiority of the drug eluting stent over bare metal stents has been brought into question. A lack of knowledge regarding the behavior of drug transport from the drug eluting devices contributes to this uncertainty. Questions arise as to whether drug eluting stents deliver sufficient amounts of therapeutic agents into the artery wall to suppress restenosis. Published investigations in this area have focused primarily on trends associated with how variations in stenting conditions affect mass transport behavior. However, experimentally validated numerical models that simulate mass transport within the artery wall are lacking. A novel experimental model was developed to validate computational predictions of species diffusion into a porous medium and an investigation into how stent strut compression influences mass transport was conducted. The study revealed that increased compressive forces on a porous media reduced the ability of species to diffuse through that media, and in relation to drug eluting stents will contribute to a reduction in therapeutic levels of drugs within the wall.

No abstract

Strain gauge plethysmography (SGP) is a non-invasive method used in the detection of deep venous thrombosis (DVT). The technique is based on the measurement of calf volume changes in response to venous occlusion by a thigh cuff, the volume changes reflecting the rates of arterial inflow and venous outflow. A numerical model of the blood circulation within the limb and the response of this to a SGP test has been derived, based on treating the different parts of the circulatory system in the leg as resistance and capacitance elements. The simulation results were compared with clinical studies and support the ability of SGP to detect non-occlusive clots of more than 50-60% of the lumen, as well detecting calf vein occlusion. The non-linear behaviour of the venous compliance with intra-luminal pressure appears to be a particularly important factor within the model. In addition, increases in venous tone due to post-operative venospasm were shown to be a potential source of false positive results.