Unveiling LDL dynamics post-stent intervention: a deep dive into transport and accumulation.

Abstract

The endovascular stent implantation is a significant and efficacious cardiovascular interventional treatment. However, the underlying mechanisms behind in-stent neoarteriosclerosis and restenosis following the intervention remain unclear. Our hypothesis posits that stent implantation may impact the transportation of low-density lipoproteins (LDL) within the host artery, thereby disrupting its concentration distribution and leading to adverse clinical events. To validate this hypothesis, we conducted a numerical investigation to examine the influence of stenting on LDL distribution, utilizing a lumen-wall model based on the coronary artery. The findings of the study suggest that the introduction of an implanted stent can disrupt blood flow and result in an abnormal accumulation of lipids on the inner surface of the arterial wall, particularly in the vicinity of the strut protrusion. Additionally, improper stent implantation, characterized by thick struts, reduced spacing between struts, and non-streamlined struts can exacerbate the local mechanical conditions of the host artery and contribute to a relatively high concentration of low-density lipoprotein (LDL) near the stent strut. In summary, the presence of a stent in the artery leads to an elevated LDL concentration both within the stented segment and downstream, potentially leading to adverse consequences.