Acute Stent-Induced Endothelial Denudation: Biomechanical Predictors of Vascular Injury

Conway, Claire; Nezami, Farhad R.; Rogers, Campbell; Groothuis, Adam; Squire, James C.; Edelman, Elazer R.

doi:10.3389/fcvm.2021.733605

Title: Acute Stent-Induced Endothelial Denudation: Biomechanical Predictors of Vascular Injury

Journal Article · Fri Oct 15 00:00:00 EDT 2021 · Frontiers in Cardiovascular Medicine

DOI:https://doi.org/10.3389/fcvm.2021.733605· OSTI ID:1825951

Conway, Claire; Nezami, Farhad R.; Rogers, Campbell; Groothuis, Adam; Squire, James C.; Edelman, Elazer R.

Recent concern for local drug delivery and withdrawal of the first Food and Drug Administration-approved bioresorbable scaffold emphasizes the need to optimize the relationships between stent design and drug release with imposed arterial injury and observed pharmacodynamics. In this study, we examine the hypothesis that vascular injury is predictable from stent design and that the expanding force of stent deployment results in increased circumferential stress in the arterial tissue, which may explain acute injury poststent deployment. Using both numerical simulations and ex vivo experiments on three different stent designs (slotted tube, corrugated ring, and delta wing), arterial injury due to device deployment was examined. Furthermore, using numerical simulations, the consequence of changing stent strut radial thickness on arterial wall shear stress and arterial circumferential stress distributions was examined. Regions with predicted arterial circumferential stress exceeding a threshold of 49.5 kPa compared favorably with observed ex vivo endothelial denudation for the three considered stent designs. In addition, increasing strut thickness was predicted to result in more areas of denudation and larger areas exposed to low wall shear stress. We conclude that the acute arterial injury, observed immediately following stent expansion, is caused by high circumferential hoop stresses in the interstrut region, and denuded area profiles are dependent on unit cell geometric features. Such findings when coupled with where drugs move might explain the drug–device interactions.

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Sponsoring Organization:: USDOE

OSTI ID:: 1825951

Journal Information:: Frontiers in Cardiovascular Medicine, Journal Name: Frontiers in Cardiovascular Medicine Vol. 8; ISSN 2297-055X

Publisher:: Frontiers Media SACopyright Statement

Country of Publication:: Switzerland

Language:: English

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