Impact of Tissue Damage and Hemodynamics on Restenosis Following Percutaneous Transluminal Angioplasty: A Patient-Specific Multiscale Model.

Corti, Anna; Marradi, Matilde; Çelikbudak Orhon, Cemre; Boccafoschi, Francesca; Büchler, Philippe; Rodriguez Matas, Jose F; Chiastra, Claudio (2024). Impact of Tissue Damage and Hemodynamics on Restenosis Following Percutaneous Transluminal Angioplasty: A Patient-Specific Multiscale Model. Annals of biomedical engineering, 52(8), pp. 2203-2220. Springer 10.1007/s10439-024-03520-1

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Multiscale agent-based modeling frameworks have recently emerged as promising mechanobiological models to capture the interplay between biomechanical forces, cellular behavior, and molecular pathways underlying restenosis following percutaneous transluminal angioplasty (PTA). However, their applications are mainly limited to idealized scenarios. Herein, a multiscale agent-based modeling framework for investigating restenosis following PTA in a patient-specific superficial femoral artery (SFA) is proposed. The framework replicates the 2-month arterial wall remodeling in response to the PTA-induced injury and altered hemodynamics, by combining three modules: (i) the PTA module, consisting in a finite element structural mechanics simulation of PTA, featuring anisotropic hyperelastic material models coupled with a damage formulation for fibrous soft tissue and the element deletion strategy, providing the arterial wall damage and post-intervention configuration, (ii) the hemodynamics module, quantifying the post-intervention hemodynamics through computational fluid dynamics simulations, and (iii) the tissue remodeling module, based on an agent-based model of cellular dynamics. Two scenarios were explored, considering balloon expansion diameters of 5.2 and 6.2 mm. The framework captured PTA-induced arterial tissue lacerations and the post-PTA arterial wall remodeling. This remodeling process involved rapid cellular migration to the PTA-damaged regions, exacerbated cell proliferation and extracellular matrix production, resulting in lumen area reduction up to 1-month follow-up. After this initial reduction, the growth stabilized, due to the resolution of the inflammatory state and changes in hemodynamics. The similarity of the obtained results to clinical observations in treated SFAs suggests the potential of the framework for capturing patient-specific mechanobiological events occurring after PTA intervention.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Computational Bioengineering
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Musculoskeletal Biomechanics
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

UniBE Contributor:

Büchler, Philippe

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1573-9686

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

06 May 2024 10:29

Last Modified:

16 Jul 2024 00:13

Publisher DOI:

10.1007/s10439-024-03520-1

PubMed ID:

38702558

Uncontrolled Keywords:

Agent-based modeling (ABM) Arterial wall remodeling Computational fluid dynamics (CFD) Finite element analysis (FEA) Mechanobiology Peripheral artery disease (PAD)

BORIS DOI:

10.48350/196522

URI:

https://boris.unibe.ch/id/eprint/196522

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