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冠状动脉药物洗脱支架的数值模拟

Numerical modeling of coronary drug eluting stents.

作者信息

Mongrain Rosaire, Leask Richard, Brunette Jean, Faik Iam, Bulman-Feleming Neil, Nguyen T

机构信息

McGill University, McGill, Canada.

出版信息

Stud Health Technol Inform. 2005;113:443-58.

Abstract

One of the principal therapies considered for the control of in-stent restenosis is the use of drug loaded polymer-coated stents for local delivery. We present two-dimensional and three-dimensional numerical models to study local delivery of drug eluting stents. The impact of various stent and flow parameters on the concentration distribution in the wall are investigated including the effect of the strut size, coating thickness, strut inter-distance and strut embedment in the vascular wall, blood flowing speed and the respective diffusion coefficients in the blood, wall and polymer. We also present criteria to assess the drug delivery efficiency based of the concept of the therapeutic window which aims at an spatial homogeneous concentration distribution and we introduce the variables to assess the amount of drug delivered in the wall. The results suggest that advection have a much stronger effect compared to diffusion in the blood media and that drug diffusivity in the arterial wall and in the polymer coating significantly affects the drug distribution. It is also shown that fully-embedded struts provide better spatial drug concentration uniformity after a short period of time and the half-embedded struts have a better temporal uniformity.

摘要

控制支架内再狭窄所考虑的主要治疗方法之一是使用载药聚合物涂层支架进行局部给药。我们提出二维和三维数值模型来研究药物洗脱支架的局部给药。研究了各种支架和血流参数对血管壁内浓度分布的影响,包括支柱尺寸、涂层厚度、支柱间距以及支柱在血管壁中的嵌入情况、血流速度以及血液、血管壁和聚合物中的各自扩散系数。我们还基于治疗窗的概念提出了评估药物递送效率的标准,该标准旨在实现空间均匀的浓度分布,并引入变量来评估在血管壁中递送的药物量。结果表明,在血液介质中,平流比扩散的影响要强得多,并且药物在动脉壁和聚合物涂层中的扩散系数显著影响药物分布。还表明,完全嵌入的支柱在短时间后能提供更好的空间药物浓度均匀性,而半嵌入的支柱具有更好的时间均匀性。

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