2016
DOI: 10.1016/j.jconrel.2016.07.023
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Drug deposition in coronary arteries with overlapping drug-eluting stents

Abstract: Drug-eluting stents are accepted as mainstream endovascular therapy, yet concerns for their safety may be under-appreciated. While failure from restenosis has dropped to below 5%, the risk of stent thrombosis and associated mortality remain relatively high. Further optimization of drug release is required to minimize thrombosis risk while maintaining therapeutic dose. The complex three-dimensional geometry of deployed stents together with the combination of diffusive and advective drug transport render an intu… Show more

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Cited by 27 publications
(12 citation statements)
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“…In contrast to the vast literature considering computational modeling of the drug eluting stents (e.g. [ 28 , 31 33 ]), where drug delivery is typically sustained over a period of weeks, the number of published studies considering computational modeling of DCBs (and specifically for diseased SFAs) is extremely low [ 15 18 ]. Given the limited time of contact between the DCB external surface and the arterial wall, an adequate understanding of drug transport and retention in a realistic arterial model and of the impact of procedural aspects becomes of extreme importance for the success of DCB treatment for diseased SFAs [ 34 ].…”
Section: Discussionmentioning
confidence: 99%
“…In contrast to the vast literature considering computational modeling of the drug eluting stents (e.g. [ 28 , 31 33 ]), where drug delivery is typically sustained over a period of weeks, the number of published studies considering computational modeling of DCBs (and specifically for diseased SFAs) is extremely low [ 15 18 ]. Given the limited time of contact between the DCB external surface and the arterial wall, an adequate understanding of drug transport and retention in a realistic arterial model and of the impact of procedural aspects becomes of extreme importance for the success of DCB treatment for diseased SFAs [ 34 ].…”
Section: Discussionmentioning
confidence: 99%
“…Blood was simulated as an incompressible fluid, with a density of 1,060 kg/m (3), which expresses non-Newtonian behavior with shear-dependent dynamic viscosity according to the Carreau model (41,42). Blood was assumed to enter the artery with the rate of 0.95 ml/s, similar to typical flow rate of coronaries at the ostium, and the artery outlet was set to 70 mm Hg relative pressure (43). To minimize the uncertainties introduced by boundary conditions, inlet and outlet were extended to induce fully developed flow at the former, and minimum back flow at the latter.…”
Section: Wall Shear Stress Analysismentioning
confidence: 99%
“…In a more applied approach, computational modeling has been recognized by manufacturers and regulatory officials as an economical, yet reliable tool to advance the device design with optimized efficacy. As a case in point, drug-eluting stent development and evaluation has benefited tremendously from computational models in optimizing strut geometry, pharmacokinetics and pharmacodynamics of released drug, and procedural routines of implantation [77], [78]. Hemodynamic metrics of disrupted flow such as WSS, as well, has been extensively studied using computer models and correlated to atherogenesis and clinical events such as restenosis.…”
Section: Computational Modelingmentioning
confidence: 99%