Transactions of the Korean Society of Mechanical Engineers B (대한기계학회논문집B)

The Korean Society of Mechanical Engineers (대한기계학회)
권호 표지
DOI QR코드

DOI QR Code

Numerical Study of Flow Pattern and Drug Deposition in Drug-Eluting Stent

약물분출 스텐트 주위 유동형태와 약물침전에 대한 수치해석

  • Seo, Tae-Won (Dept. of Mechanical and Automotive Engineering, Andong Nat'l Univ.)
  • 서태원 (국립안동대학교 기계자동차공학과)
  • Received : 2011.04.11
  • Accepted : 2011.06.01
  • Published : 2011.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

This study is performed to determine the drug concentration profiles of drug-eluting stents (DES) for an ideal circular ring stent and intertwined stent models for various Reynolds numbers (Re = 200, 400, and 800). The Navier.Stokes equations coupled with the advection-diffusion equation are solved numerically in order to determine how the flow patterns and drug deposition are affected in the in-stent and post-stent regions where flow separation and recirculation occur. The presence of DES within the arterial segment affects the local drug distribution in the flow field. As a result, the drug concentration for the intertwined stent is higher over the in-stent region in comparison with the ideal stents. For a given stent geometry, the local drug concentration in the in-stent region decreases with Reynolds number, while for a given Reynolds number, the local drug concentration is relatively insensitive to the stent geometry. The results show that drug concentration along the arterial wall is significantly higher within the in-stent and post-stent regions for the intertwined stent geometry than for the ideal stent geometries.

본 연구는 이상적인 원형 환(Ideal Circular Ring) 스텐트와 Intertwined 스텐트의 삽입에 의해 야기 되는 혈류유동 형태와 스텐트 표면에서 방출되는 약물의 농도분포를 조사하는 것이다. 본 연구를 통해 Intertwined 스텐트의 스텐트 사이 영역에서 약물농도는 원형 환 스텐트에 비해 더 많이 분포해 있는 것을 알 수 있었다. 주어진 스텐트의 형상에 대하여 스텐트 사이 영역에서의 국소적인 약물 농도분포는 레이놀즈 수가 증가함에 따라 감소하는 것으로 나타났다. 주어진 레이놀즈 수에 대하여는 약물 농도분포는 스텐트의 형상과는 비교적 무관함을 알 수 있다. 원형 환 스텐트보다 Intertwined스텐트가 스텐트사이 영역과 스텐트 하류영역에서혈관 벽면을 따른 약물 농도분포는 크게 나타나는 것을 볼 수 있다.

Keywords

References

  1. Chong, P.H. and Cheng, J.W., 2004, "Early Experiences and Clinical Implications of Drug-Eluting Stents: Part 1," The Annals of Pharmacotherapy 38: 661-669. https://doi.org/10.1345/aph.1D256
  2. Chong, P.H. and Cheng, J.W., 2004, "Early Experiences and Clinical Implications of Drug-Eluting Stents: Part 2," The Annals of Pharmacotherapy Vol. 38, pp. 845-852. https://doi.org/10.1345/aph.1D261
  3. Wentzel, J.J., Krams, R., Schuurbiers, C.H., Oomen, J.H., Kloet, J., van der Giessen, W.J., Serruys, P.W. and Slager, C.J., 2001, "Relationship Between Neointimal Thickness and Shear Stress After Wallstent Implantation in Human Coronary Arteries," Circulation Vol. 103 pp. 1740-1745. https://doi.org/10.1161/01.CIR.103.13.1740
  4. Luscher, T.F., Steffel, J., Eberli, F.R., Joner, M., Nakazawa, G., Tanner, F.C. and Virmani, R., .2007, "Drug-Eluting Stent and Coronary Thrombosis: Biological Mechanisms and Clinical Implications," Circulation Vol. 115, No. 8, pp. 1051-1058. https://doi.org/10.1161/CIRCULATIONAHA.106.675934
  5. Morice, M-C, Serruys, P.W., Sousa, J.E., Fajadet, J, .Hayashi, E.B., Perin, M., Colombo, A., Schuler, G., Barragan, P., Guagliumi, G., Molnar, F. and Falotico, R., 2002, "A Randomized Comparison of a Sirolimus-Eluting Stent with a Standard Stent for Coronary Revascularization," N. Engl. J. Med. Vol. 346, pp. 1773-1780. https://doi.org/10.1056/NEJMoa012843
  6. Moses, J.W., Leon, M.B., Popma, J.J., Fitzgerald, P.J., Holmes, D.R., O'Shaughnessy, C., Caputo, R.P., Keriakes, D.J., Williams, D.O., Teirstein, P.S., Jaeger, J.L. and Kuntz., R.E., 2003, "Sirolimus-Eluting Stents Versus Standard Stents in Patients with Stenosis in a Native Coronary Artery.," N. Engl. J. Med. Vol. 349, pp. 1315-1323. https://doi.org/10.1056/NEJMoa035071
  7. Ramcharitar, S., Gaster, A.L., Daemen, J. and Serruy, P., 2007, "Drug-Eluting Stents, Restenosis and Revascularization," Herz, No. 4 pp. 287-295.
  8. Bennett, M.R., 2003, "In-Stent Stenosis: Pathology and Implications for the Development of Drug Eluting Stents," Heart Vol. 89, pp. 218-224. https://doi.org/10.1136/heart.89.2.218
  9. Garasic, J.M., Edelman, E.R., Squire, J.C., Seifert, P., Williams, M.S. and Rogers, C., 2000, "Stent and Artery Geometry Determine Intimal Thickening Independent of Arterial Injury," Circulation Vol. 101, pp. 812-818. https://doi.org/10.1161/01.CIR.101.7.812
  10. Gojova, A. and Barakat, A.I., 2005, "Vascular endothelial wound closure under shear stress: role of membrane fluidity and flow-sensitive channels," J. Appl. Physiol. Vol. 98, pp. 2355-2362. https://doi.org/10.1152/japplphysiol.01136.2004
  11. Seo, T.W., Schachter, L.G. and Barakat, A.I., 2005, "Computational study of fluid mechanical disturbance induced by endovascular stents," Annals of Biomedical Eng., Vol. 33, No. 4, pp. 444-456 https://doi.org/10.1007/s10439-005-2499-y
  12. Seo, T.W., Kim, T.D., Barakat, A.I., 2005, "Stent Design Using Computational Fluid Dynamics," Trans. of the KSME (B), Vol. 29, No. 9, pp. 1042-1048. https://doi.org/10.3795/KSME-B.2005.29.9.1042
  13. Duraiswamy, N., Cesar, J.M., Schoephoerster, R.T. and Moore, JR. J.E., 2008, "Effects of Stent Geometry on Local Flow Dynamics and Resulting Platelet Deposition in an in Vitro Model," Biorheology, Vol. 45, No. 5, pp. 547-561.
  14. Mongrain, R., Faik, I., Leask, R.L., Cabau, J.R., Larose, E., Bertrand, O.F.. 2007, "Effects of Diffusion Coefficients and Struts Apposition Using Numerical Simulations for Drug Eluting Coronary Stents," J Biomech Eng., Vol. 129, pp. 733-742. https://doi.org/10.1115/1.2768381
  15. Kolachalama, V., Tzafriri, A.R., Arifin, D.Y. and Edelman, E.R., 2009, "Luminal Flowpatterns Dictate Arterial Drug Deposition in Stent-Based Delivery," J. Control. Release, Vol. 133, pp. 24-30. https://doi.org/10.1016/j.jconrel.2008.09.075
  16. Duraiswamy, N., Cesar, J.M., Schoephoerster, R.T. and Moore, F.R., 2008, "Effects of Stent Geometry on Local Flow Dynamics and Resulting Platelet Deposition in an in Vitro Model," Biorehology, Vol. 45, pp. 547-561.
  17. Seo, T.W. and Barakat, A.I., 2007, "Numerical Analysis on the Effect of Wall Shear Stress Around the Ring Drug-Eluting Stent," Trans. of the KSME (B), Vol. 31, pp. 21-28. https://doi.org/10.3795/KSME-B.2007.31.1.021
  18. Buriev, B., Kim, T. and Seo, T., 2009, "Fluid-Structure Interactions of Physiological Flow in Stenosed Artery," Korean-Australia Rheology J., Vol. 21, No. 1, pp. 39-46.