Hemodynamic perturbations due to the presence of stents

Superficial femoral artery stenting: Impact of stent design and overlapping on the local hemodynamics

“…It is well known that the presence of the stent struts within an artery results in unfavorable local hemodynamic conditions [27], potentially promoting inflammatory-related responses such as neointimal hyperplasia especially during the first weeks after stent deployment, which can result in ISR [18,28]. Indeed, a cascade of events based on inflammation and cellular proliferation is commenced within 1-3 days after stenting, with known remodeling phase exponentially increasing starting from the third week after stent implantation [18,29].…”

“…As previously demonstrated, the physiology of the arterial wall is modulated by low and oscillatory wall shear stress (WSS), which specifically up-regulate the pro-inflammatory vascular responses through mechano-transduction pathways [12,13]. In the case of stenting, in the immediate post-implantation period the stent struts cause local flow disturbances with flow separation and recirculation zones downstream of the struts [14]. Overall, lower WSS values characterize the stented region as compared to a non-treated healthy segment [14].…”

“…In the case of stenting, in the immediate post-implantation period the stent struts cause local flow disturbances with flow separation and recirculation zones downstream of the struts [14]. Overall, lower WSS values characterize the stented region as compared to a non-treated healthy segment [14]. Focusing on femoral arteries, recent works have demonstrated that WSS, investigated through computational fluid dynamics (CFD) simulations and quantified through different WSS-based descriptors, contributes to the onset and progression of ISR in human stented SFAs [15][16][17].…”

Semi-Automatic Reconstruction of Patient-Specific Stented Coronaries based on Data Assimilation and Computer Aided Design

“…Since flow patterns measures are difficult in vivo, numerical modeling, in particular Computational Fluid Dynamics (CFD), is a valuable tool for quantification [11]. The step-like geometry introduced by the stent in the flow stream majorly affects the local hemodynamics, not to mention the perturbation induced by the floating ("malapposed") stent struts [10]. Accurate quantification of this interplay may help to understand in-stent restenosis and thrombosis.…”

Multiscale Computational Modeling of Vascular Adaptation: A Systems Biology Approach Using Agent-Based Models

“…At the molecular level, PDE systems (e.g., advection-diffusion-reaction equations) are broadly implemented in the vascular field to describe the transport of molecular species (e.g., low density lipoproteins, inflammatory cytokines and other pro-atherogenic species ( Silva et al, 2020 )). In addition to transport phenomena, equation-based models are adopted to evaluate the mechanical behavior or the fluid dynamics at tissue/organ scale (e.g., to quantify stresses and strains in the arterial wall or the hemodynamic variables following endovascular procedures as percutaneous transluminal angioplasty (PTA) with/without stenting ( Chiastra et al, 2021a ; Chiastra et al, 2021b ; Colombo et al, 2021a ; Colombo et al, 2021b )). Usually, given the complex geometry of the vascular segments, numerical methods, such as finite difference method, finite element method (FEM) or finite volume method, are needed to solve PDE systems associated to solid mechanics or fluid dynamics problems ( Walpole et al, 2013 ).…”