skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


Title: Stent strut streamlining and thickness reduction promote endothelialization
Stent thrombosis (ST) carries a high risk of myocardial infarction and death. Lack of endothelial coverage is an important prognostic indicator of ST after stenting. While stent strut thickness is a critical factor in ST, a mechanistic understanding of its effect is limited and the role of haemodynamics is unclear. Endothelialization was tested using a wound-healing assay and five different stent strut models ranging in height between 50 and 150 µm for circular arc (CA) and rectangular (RT) geometries and a control without struts. Under static conditions, all stent strut surfaces were completely endothelialized. Reversing pulsatile disturbed flow caused full endothelialization, except for the stent strut surfaces of the 100 and 150 µm RT geometries, while fully antegrade pulsatile undisturbed flow with a higher mean wall shear stress caused only the control and the 50 µm CA geometries to be fully endothelialized. Modest streamlining and decrease in height of the stent struts improved endothelial coverage of the peri-strut and stent strut surfaces in a haemodynamics dependent manner. This study highlights the impact of the stent strut height (thickness) and geometry (shape) on the local haemodynamics, modulating reendothelialization after stenting, an important factor in reducing the risk of stent thrombosis.  more » « less
Award ID(s):
1842308
PAR ID:
10340507
Author(s) / Creator(s):
; ;
Date Published:
Journal Name:
Journal of The Royal Society Interface
Volume:
18
Issue:
181
ISSN:
1742-5662
Page Range / eLocation ID:
20210023
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; ; (, Biomechanics and Modeling in Mechanobiology)
    Vascular stenting is a common intervention for the treatment for atherosclerotic plaques. However, stenting still has a significant rate of restenosis caused by intimal hyperplasia formation. In this study, we evaluate whether stent overexpansion leads to Vasa Vasorum (VV) compression, which may contribute to vascular wall hypoxia and restenosis. An idealized multilayered fibroatheroma model including Vasa Vasorum was expanded by three coronary stent designs up to a 1.3:1 stent/artery luminal diameter ratio (exp1.1, exp1.2, exp1.3) using a finite element analysis approach. Following Poiseuille’s law for elliptical sections, the fold increase in flow resistance was calculated based on VV compression in the Intima (Int), Media (Med) and Adventitia (Adv). The VV beneath the plaque experiences the smallest degree of compression, while the opposite wall regions are highly affected by stent overexpansion. The highest compressions for Adv, Med and Int at exp1.1 are 60.7, 65.9, 72.3%, at exp1.2 are 62.1, 67.3, 73.5% and at expp1.3 are 63.2, 68.7, 74.8%. The consequent fold increase in resistance to flow for Adv, Med and Int at exp1.1 is 3.3, 4.4, 6.6, at exp1.2 is 3.5, 4.7, 7.2 and at exp1.3 is 3.8, 5.1, 7.9. Stent overexpansion induces significant VV compression, especially in the Intima and Media layers, in agreement with previously observed Media necrosis and loss in elasticity after stenting. The observed steep increase in flow resistance suggests the blood flow and associated oxygen delivery would drop up to five times in the Media and almost eight in the Intima, which may lead to intimal hyperplasia and restenosis 
    more » « less
  2. ; ; ; ; (, Journal of Computational Physics)
    We develop a novel mathematical and computational framework for geometric optimization of mesh-like devices such as stents, based on modeling mesh-like structures as networks of one-dimensional curved rods. To simplify calculations, the curved rods are approximated by piecewise straight rods. Constrained optimization problems for different cost functionals are stated and mathematically analyzed. The cost functionals considered include: (1) stents' compliance, (2) norm of displacement, (3) norm of contact moment (which is related to fatigue), and (4) multicriteria optimization in which stents are optimized to achieve maximal radial stiffness and minimal bending rigidity. The optimization parameters are stent's vertices, namely, the location of points where the stent struts meet. Existence of solutions to the mathematically posed optimization problems is obtained, and a numerical method based on the gradient descent algorithm is proposed to find the solutions. Three representative stents' geometries are numerically analyzed to show that the optimization algorithms provide tangible solutions. The stent geometries considered are those of Palmaz type stents, single zig-zag stent rings, and Express type stents. Interesting findings are obtained, including several new stent designs. Several optimized stents are presented, including an optimized Palmaz stent with a reduction in contact moment of 30%, and optimized Express and Palmaz stents with a reduction in compliance by more than 70%. 
    more » « less
  3. ; (, BioMedical Engineering OnLine)
    Abstract BackgroundPercutaneous coronary interventions (PCIs) within left main coronary arteries are high-risk procedures that require optimization of interactions between stent(s) and diseased vessels. Optical Coherence Tomography (OCT) is a widely accepted tool that enhances physicians’ ability to assess proper stent appositions during clinical procedures. The primary aim of this study was to develop complementary post-procedure imaging methodologies to better assess and interpret outcomes of left main PCI procedures, utilizing both reanimated and perfusion-fixed human hearts. MethodsPCIs were performed while obtaining OCT scans within the left main anatomies of six human hearts. Subsequently, each heart was scanned with a micro-CT scanner with optimized parameters to achieve resolutions up to 20 µm. Scans were reconstructed and imported into a DICOM segmentation software to generate computational models of implanted stents and associated coronary vessels. 2D images from OCT that were obtained during PCIs were compared to the 3D models generated from micro-CT reconstructions. In addition, the 3D models were utilized to create virtual reality scenes and enlarged 3D prints for development of “mixed reality” tools relative to bifurcation stenting within human left main coronary arteries. ResultsWe developed reproducible methodologies for post-implant analyses of coronary artery stenting procedures. In addition, we generated high-resolution 3D computational models, with ~ 20-micron resolutions, of PCIs performed within reanimated and perfusion-fixed heart specimens. ConclusionsGenerated computational models of left main PCIs performed in isolated human hearts can be used to obtain detailed measurements that provide further clinical insights on procedural outcomes. The 3D models from these procedures are useful for generating virtual reality scenes and 3D prints for physician training and education. 
    more » « less
  4. (, Journal of Engineering and Science in Medical Diagnostics and Therapy)
    Abstract Pulsatile pressure at an artery is a collection of harmonics of the heartbeat. This study examines harmonics of pulsatile pressure at different ages and its effect on other pulsatile parameters and waveform-based clinical indices. Based on a vibrating-string model of the arterial tree, wave velocity and characteristic impedance are related to arterial stiffness and radius. Blood velocity, wall shear stress (WSS), and driving force on the left ventricle (LV) are related to pulsatile pressure. Reflection magnitude and return time are related to input impedance. These relations are applied to pulsatile pressure and blood velocity at the ascending aorta (AA) and the carotid artery (CA) at different ages in a database to calculate harmonics of all the pulsatile parameters and reflection magnitude and return time at each harmonic. Harmonics of pulsatile pressure varies with aging and between the two arteries. Reflection magnitude and return time vary between harmonics. While wave reflection manifests the arterial tree (i.e., arterial stiffness and radius) and termination, harmonics of pulsatile pressure is a combination of the LV, the arterial tree, and termination. Harmonics of pulsatile pressure dictates harmonics of WSS and affects endothelial function. Harmonics of pulsatile pressure needs to serve as an independent clinical index indicative of the LV function and endothelial function. Reflection magnitude and return time of the 1st harmonic of pulsatile pressure serve as clinical indices indicative of arterial stiffness and radius. 
    more » « less
  5. ; ; ; ; (, The Analyst)
    The lymphatic vascular function is regulated by pulsatile shear stresses through signaling mediated by intracellular calcium [Ca 2+ ] i . Further, the intracellular calcium dynamics mediates signaling between lymphatic endothelial cells (LECs) and muscle cells (LMCs), including the lymphatic tone and contractility. Although calcium signaling has been characterized on LEC monolayers under uniform or step changes in shear stress, these dynamics have not been revealed in LMCs under physiologically-relevant co-culture conditions with LECs or under pulsatile flow. In this study, a cylindrical organ-on-chip platform of the lymphatic vessel (Lymphangion-Chip) consisting of a lumen formed with axially-aligned LECs co-cultured with transversally wrapped layers of LMCs was exposed to step changes or pulsatile shear stress, as often experienced in vivo physiologically or pathologically. Through real-time analysis of intracellular calcium [Ca 2+ ] i release, the device reveals the pulsatile shear-dependent biological coupling between LECs and LMCs. Upon step shear, both cell types undergo a relatively rapid rise in [Ca 2+ ] i followed by a gradual decay. Importantly, under pulsatile flow, analysis of the calcium signal also reveals a secondary sinusoid within the LECs and LMCs that is very close to the flow frequency. Finally, LMCs directly influence the LEC calcium dynamics both under step changes in shear and under pulsatile flow, demonstrating a coupling of LEC–LMC signaling. In conclusion, the Lymphangion-Chip is able to illustrate that intracellular calcium [Ca 2+ ] i in lymphatic vascular cells is dependent on pulsatile shear rate and therefore, serves as an analytical biomarker of mechanotransduction within LECs and LMCs, and functional consequences. 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email