A Mathematical Model and Computer Simulation Approach to Reendothelialization: Post Drug-Eluting Stent

Abstract

Implantation of the drug-eluting stent, following a myocardial infarction, can be a very invasive surgery. Mechanical injury to the coronary artery causes partial or full denudation of the endothelial cell monolayer. Antimitogenic drugs released from the stent inhibit the regrowth of endothelial cells, possibly resulting in stent thrombosis caused by migration and proliferation of smooth muscle cells into the lumen. Our goal was to model and simulate endothelial cell regrowth around a drug-eluting stent in efforts to determine factors that may reduce or possibly prevent stent thrombosis. A mathematical model was implemented to simulate the arterial drug concentration over time and establish a gradient of drug concentrations surrounding the stent due to fluid flow. Computer simulations with varying parameters were used to visualize endothelial cell interaction with the antimitogenic drug gradients and concentrations. The development of this mathematical model will help to identifying ideal drug release patterns from stents and test hypotheses for overcoming the deadly potential of late stent thrombosis associated with current generation drug-eluting stents.