Effects of pharmacokinetics on arteries with in-stent restenosis in a fluid-solid framework
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Drug-eluting stents, though successful in addressing coronary artery disease, can give rise to undesired outcomes such as endothelial denudation that may trigger inflammation, leading to uncontrolled tissue growth known as in-stent restenosis. This study seeks to comprehensively examine these effects through a fluid-structure interaction model, evaluating drug distribution influenced by blood flow dynamics in the lumen and in the arterial wall. Navier-Stokes equations and a Newtonian constitutive model are used to simulate blood flow in stented arteries. Modeling drug elution and deposition on the vessel wall involves an advection-diffusion equation for the fluid with corresponding boundary conditions, coupled with steady averaged blood flow to establish the convective field. The transport and interaction of the drug in the vessel wall are modeled through advection-reaction equations, with coupling at the arterial wall-lumen interface to consider downstream drug deposition. Governing equations for wall species are integrated with a continuum mechanical description of volumetric growth. We test our approach with a simplified ring-stent and validate the model on a patient-based geometry. Utilizing a staggered approach, we employ the two finite element method solvers FEAP and XNS to exchange information at the interface boundary condition with the final objective to create an in silico tool that assists interventional cardiologists in optimizing parameters for drug-eluting stent implantation.
