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Optimization of Drug-Eluting Stents

Abstract : Drug-eluting stents (DES), which release anti-proliferative drugs into the arterial wall in a controlled manner, have drastically reduced the rate of in-stent restenosis and revolutionized the treatment of atherosclerosis. However, late stent thrombosis remains a safety concern of DES, mainly due to delayed healing of the wound inflicted during DES implantation. We present a framework to optimize DES design such that restenosis is inhibited without affecting the healing process. To this end, we have developed a computational model of blood flow and drug transport in stented arteries which provides a metric for quantifying DES performance. The model takes into account the multi-layered structure of the arterial wall and incorporates a reversible binding model to describe drug interaction with the cells of the arterial wall. The model is coupled to a novel optimization algorithm that minimizes the DES performance metric to identify optimal DES designs. We show that optimizing the period of drug release from DES and the initial drug concentration within the coating has a drastic effect on DES performance. Optimal paclitaxel-eluting stents release the drug either within a few hours or slowly within a year at concentrations considerably lower than current DES. Optimal sirolimus-eluting stents require a slow drug release. Optimal strut shapes for DES are elongated and can be streamlined only if the drug release occurs quickly. The results offer explanations for the performance of recent DES designs, demonstrate the potential for large improvements in DES design relative to the current state of commercial devices, and define guidelines for implementing these improvements
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https://pastel.archives-ouvertes.fr/pastel-00858100
Contributor : Franz Bozsak <>
Submitted on : Wednesday, September 4, 2013 - 4:06:16 PM
Last modification on : Wednesday, March 27, 2019 - 4:39:25 PM
Document(s) archivé(s) le : Thursday, April 6, 2017 - 3:20:22 PM

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  • HAL Id : pastel-00858100, version 1

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Franz Bozsak. Optimization of Drug-Eluting Stents. Cardiology and cardiovascular system. Ecole Polytechnique X, 2013. English. ⟨pastel-00858100⟩

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