Controlling the rate of penetration of a therapeutic drug into the wall of an artery by means of a pressurized balloon

Stark, John R.; Gorman, John M; Sparrow, E. M.; Abraham, John; Kohler, Rob

doi:10.4236/jbise.2013.65067

Cited by 12 publications

(6 citation statements)

References 17 publications

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“…1,16,21,23,24,28,35,50,51 These studies are important, not only for the relationship between flow and pressure within a diseased artery, but they also have implications for other transport process through arterial walls. 7,8,19,[30][31][32]64,77 Furthermore, the presence of plaque or arterial hardening changes the compliance of the vessel wall which also affects blood flow and pressure (aside from the influence of the occlusions). A wealth of literature has investigated this flow-structure interaction.…”

Section: Introductionmentioning

confidence: 99%

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

Plourde

Vallez

Sun

et al. 2016

Cardiovasc Eng Tech

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Simulations were made of the pressure and velocity fields throughout an artery before and after removal of plaque using orbital atherectomy plus adjunctive balloon angioplasty or stenting. The calculations were carried out with an unsteady computational fluid dynamic solver that allows the fluid to naturally transition to turbulence. The results of the atherectomy procedure leads to an increased flow through the stenotic zone with a coincident decrease in pressure drop across the stenosis. The measured effect of atherectomy and adjunctive treatment showed decrease the systolic pressure drop by a factor of 2.3. Waveforms obtained from a measurements were input into a numerical simulation of blood flow through geometry obtained from medical imaging. From the numerical simulations, a detailed investigation of the sources of pressure loss was obtained. It is found that the major sources of pressure drop are related to the acceleration of blood through heavily occluded cross sections and the imperfect flow recovery downstream. This finding suggests that targeting only the most occluded parts of a stenosis would benefit the hemodynamics. The calculated change in systolic pressure drop through the lesion was a factor of 2.4, in excellent agreement with the measured improvement. The systolic and cardiac-cycle-average pressure results were compared with measurements made in a multi-patient study treated with orbital atherectomy and adjunctive treatment. The agreements between the measured and calculated systolic pressure drop before and after the treatment were within 3%. This excellent agreement adds further confidence to the results. This research demonstrates the use of orbital atherectomy to facilitate balloon expansion to restore blood flow and how pressure measurements can be utilized to optimize revascularization of occluded peripheral vessels.

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Section: Introductionmentioning

confidence: 99%

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

Plourde

Vallez

Sun

et al. 2016

Cardiovasc Eng Tech

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“…The most common of these PCIs is the insertion of a small mesh-like device called a stent [1], to act as a scaffold and widen the lumen. Some of the methods of reducing restenosis include directly coating the stent with a drug (the so-called drug-eluting stent) and, more recently, by inflating a drug-coated balloon at the required site [2,3]. Modelling the transport of drug from the device through the arterial wall is extremely challenging given the multitude of factors that influence drug distribution.…”

Section: Introductionmentioning

confidence: 99%

Does anisotropy promote spatial uniformity of stent-delivered drug distribution in arterial tissue?

McGinty

Wheel

McKee

et al. 2015

International Journal of Heat and Mass Transfer

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In this article we investigate the role of anisotropic diffusion on the resulting arterial wall drug distribution following stent-based delivery. The arterial wall is known to exhibit anisotropic diffusive properties, yet many authors neglect this, and it is unclear what effect this simplification has on the resulting arterial wall drug concentrations. Firstly, we explore the justification for neglecting the curvature of the cylindrical arterial wall in favour of using a Cartesian coordinate system. We then proceed to consider three separate transport regimes (convection dominated, diffusion dominated, reaction dominated) based on the range of parameter values available in the literature. By comparing the results of a simple one-dimensional model with those of a fully three-dimensional numerical model, we demonstrate, perhaps surprisingly, that the anisotropic diffusion can promote the spatial uniformity of drug concentrations, and furthermore, that the simple analytical one-dimensional model is an excellent predictor of the three-dimensional numerical results. However, the level of uniformity and the time taken to reach a uniform concentration profile depends on the particular regime considered. Furthermore, the more uniform the profile, the better the agreement between the one-dimensional and three-dimensional models. We discuss the potential implications in clinical practice and in stent design

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“…As exhibited in Figures 9 and 14, the distribution from the multi-lumen geometry lies closer to the artery wall and thereby enhances blood-artery wall mass transfer. This enhancement is important for mass transfer into arterial tissue [13][14][15][16][17][18][19][20].…”

Section: Multi-lumen Resultsmentioning

confidence: 99%

Drug dispersion for single- and multi-lumen catheters

Schwalbach¹,

Plourde²,

Abraham³

et al. 2013

JBiSE

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This study presents a comparison of the drug dispersion capability of various catheters which can be used to inject medication or stem cells into the arterial system. The study was carried out by the use of numerical simulation so that various geometric and physical operating parameters could be investigated. The blood was modeled with a power-law viscosity and the medication had two levels of viscosity to represent upper and lower bounds expected in practice. Two different medication flowrates were also incorporated into the study. Finally, the impact of an inflated balloon upstream of the injection was studied. The artery was simply modeled as a straight circular tube with the catheters concentrically positioned. It was found that in some cases, dispersion was improved by use of a multi-lumen device, particularly when an upstream balloon was employed to regulate blood flow and drug residence time. In other cases, the dispersion from the single-lumen device was superior. Another finding was that the multi-lumen device had a reduced hydraulic resistance to blood flow, compared to the single-lumen device when an upstream balloon was inflated.

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Controlling the rate of penetration of a therapeutic drug into the wall of an artery by means of a pressurized balloon

Cited by 12 publications

References 17 publications

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

Does anisotropy promote spatial uniformity of stent-delivered drug distribution in arterial tissue?

Drug dispersion for single- and multi-lumen catheters

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