Novel design of drug delivery in stented arteries: A numerical comparative study

Abstract

Implantation of drug eluting stents following percutaneous transluminal angioplasty has revealed a well established technique for treating occlusions caused by the atherosclerotic plaque. However, due to the risk of vascular re-occlusion, other alternative therapeutic strategies of drug delivery are currently being investigated. Polymeric endoluminal pave stenting is an emerging technology for preventing blood erosion and for optimizing drug release. The classical and novel methodologies are compared through a mathematical model able to predict the evolution of the drug concentration in a cross-section of the wall. Though limited to an idealized configuration, the present model is shown to catch most of the relevant aspects of the drug dynamics in a delivery system. Results of numerical simulations shows that a bi-layer gel paved stenting guarantees a uniform drug elution and a prolonged perfusion of the tissues, and remains a promising and effective technique in drug delivery.

Drug release from coronary eluting stents: A multidomain approach

“…Several computational approaches formulated on one-dimensional (Lovich and Edelman, 1996;Costantini et al, 2008), bi-dimensional Zunino, 2004;Grassi et al, 2009), or three-dimensional domains with simplified geometry (Hose et al, 2004) or derived from a simulated stent expansion (Migliavacca et al, 2007), have been recently proposed. In these studies the arterial wall is generally modelled as a homogenous porous medium, including drug advection due to the plasma filtration through the tissue.…”

“…In-stent restenosis represents the main limiting factor of percutaneous treatments for coronary artery diseases and the most promising treatment against such an event is based on the local delivery of pharmacological compounds to injured blood vessels, currently achieved by drug-eluting stents (DESs, van der Hoeven et al, 2005) or by the endoluminal gel paving technique (Slepian and Hubbell, 1997;Davia et al, 2009;Grassi et al, 2009).…”

A multi-layer porous wall model for coronary drug-eluting stents

“…In the last years, a number of mathematical models have been developed to address the fundamental problem of the mass release from DES through the arterial wall [4][5][6]. Unconventional approaches of drug delivery, such as those based on the endoluminal gel paving technology, have been recently proposed [7]. In some work the combination of solid mechanics and fluid dynamics allows both mechanical expansion and DES elution properties to be investigated [8].…”

Simulating Drug-eluting Stents - Progress Made and the Way Forward

“…Two-dimensional models in simplified geometries were computed by (Hwang et al, 2001), (Grassi et al, 2009) and (Zunino, 2004) among others. A number of three-dimensional models have also been devised.…”