Curtin Antonia E, Zhou Leming
Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America; Department of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
PLoS One. 2014 Apr 14;9(4):e94411. doi: 10.1371/journal.pone.0094411. eCollection 2014.
While animal models are widely used to investigate the development of restenosis in blood vessels following an intervention, computational models offer another means for investigating this phenomenon. A computational model of the response of a treated vessel would allow investigators to assess the effects of altering certain vessel- and stent-related variables. The authors aimed to develop a novel computational model of restenosis development following an angioplasty and bare-metal stent implantation in an atherosclerotic vessel using agent-based modeling techniques. The presented model is intended to demonstrate the body's response to the intervention and to explore how different vessel geometries or stent arrangements may affect restenosis development.
The model was created on a two-dimensional grid space. It utilizes the post-procedural vessel lumen diameter and stent information as its input parameters. The simulation starting point of the model is an atherosclerotic vessel after an angioplasty and stent implantation procedure. The model subsequently generates the final lumen diameter, percent change in lumen cross-sectional area, time to lumen diameter stabilization, and local concentrations of inflammatory cytokines upon simulation completion. Simulation results were directly compared with the results from serial imaging studies and cytokine levels studies in atherosclerotic patients from the relevant literature.
The final lumen diameter results were all within one standard deviation of the mean lumen diameters reported in the comparison studies. The overlapping-stent simulations yielded results that matched published trends. The cytokine levels remained within the range of physiological levels throughout the simulations.
We developed a novel computational model that successfully simulated the development of restenosis in a blood vessel following an angioplasty and bare-metal stent deployment based on the characteristics of the vessel cross-section and stent. A further development of this model could ultimately be used as a predictive tool to depict patient outcomes and inform treatment options.
虽然动物模型被广泛用于研究血管介入后再狭窄的发展，但计算模型为研究这一现象提供了另一种手段。经治疗血管反应的计算模型将使研究人员能够评估改变某些血管和支架相关变量的影响。作者旨在使用基于智能体的建模技术，开发一种新型的计算模型，用于模拟动脉粥样硬化血管在血管成形术和裸金属支架植入后再狭窄的发展过程。所提出的模型旨在展示机体对干预的反应，并探索不同的血管几何形状或支架排列如何影响再狭窄的发展。
该模型在二维网格空间上创建。它利用术后血管腔直径和支架信息作为输入参数。模型的模拟起点是血管成形术和支架植入术后的动脉粥样硬化血管。模型随后在模拟完成时生成最终管腔直径、管腔横截面积的变化百分比、管腔直径稳定所需时间以及炎症细胞因子的局部浓度。将模拟结果与相关文献中动脉粥样硬化患者的系列成像研究结果和细胞因子水平研究结果直接进行比较。
最终管腔直径结果均在比较研究中报告的平均管腔直径的一个标准差范围内。重叠支架模拟产生的结果与已发表的趋势相符。在整个模拟过程中，细胞因子水平保持在生理水平范围内。
我们开发了一种新型计算模型，该模型基于血管横截面和支架的特征，成功模拟了血管成形术和裸金属支架植入后血管再狭窄的发展过程。该模型的进一步发展最终可作为一种预测工具，用于描述患者的预后并为治疗方案提供参考。
