Computational modeling of low-density lipoprotein accumulation at the carotid artery bifurcation after stenting.
carotid artery stenting
low-density lipoprotein
stent design
Journal
International journal for numerical methods in biomedical engineering
ISSN: 2040-7947
Titre abrégé: Int J Numer Method Biomed Eng
Pays: England
ID NLM: 101530293
Informations de publication
Date de publication:
20 Sep 2023
20 Sep 2023
Historique:
revised:
10
07
2023
received:
11
10
2022
accepted:
04
09
2023
medline:
21
9
2023
pubmed:
21
9
2023
entrez:
20
9
2023
Statut:
aheadofprint
Résumé
Restenosis typically occurs in regions of low and oscillating wall shear stress, which also favor the accumulation of atherogenic macromolecules such as low-density lipoprotein (LDL). This study aims to evaluate LDL transport and accumulation at the carotid artery bifurcation following carotid artery stenting (CAS) by means of computational simulation. The computational model consists of coupled blood flow and LDL transport, with the latter being modeled as a dilute substance dissolved in the blood and transported by the flow through a convection-diffusion transport equation. The endothelial layer was assumed to be permeable to LDL, and the hydraulic conductivity of LDL was shear-dependent. Anatomically realistic geometric models of the carotid bifurcation were built based on pre- and post-stent computed tomography (CT) scans. The influence of stent design was investigated by virtually deploying two different types of stents (open- and closed-cell stents) into the same carotid bifurcation model. Predicted LDL concentrations were compared between the post-stent carotid models and the relatively normal contralateral model reconstructed from patient-specific CT images. Our results show elevated LDL concentration in the distal section of the stent in all post-stent models, where LDL concentration is 20 times higher than that in the contralateral carotid. Compared with the open-cell stents, the closed-cell stents have larger areas exposed to high LDL concentration, suggesting an increased risk of stent restenosis. This computational approach is readily applicable to multiple patient studies and, once fully validated against follow-up data, it can help elucidate the role of stent strut design in the development of in-stent restenosis after CAS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3772Subventions
Organisme : Fundamental Research Grant Scheme (FRGS)
ID : RDU210109
Organisme : Fundamental Research Grant Scheme (FRGS)
ID : FRGS/1/2021/TK0/UMP/02/8
Organisme : Imperial College London for the PhD scholarship
Informations de copyright
© 2023 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.
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