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Local hemodynamic environment is a determinant factor in drug delivery from a drug eluting stent (DES) to the target arterial tissue. By using a simplified model of a DES, we demonstrated that if a DES had a drug release mode of uniform rate the drug released from the stent will distribute non-uniformly along the stent due to the flowing blood, with a significantly higher drug concentration at the distal part of the stent than that at the proximal one. This may explain why a DES could retard neointimal formation and vascular remodeling in downstream coronary segments. To solve this problem, we thereafter optimized the drug release mode of the DES as an exponential function. The simulation results showed that the optimized drug release mode could lead to a fairly uniform drug concentration distribution along the stent. Therefore, the present study suggested that to achieve a more effective result, optimization of drug eluting strategy (drug release mode) for the DES would be essential. [ABSTRACT FROM AUTHOR]

To elucidate the difference between Newtonian and shear thinning non-Newtonian assumptions of blood in the analysis of DES drug delivery, we numerically simulated the local flow pattern and the concentration distribution of the drug at the lumen-tissue interface for a structurally simplified DES deployed in a curved segment of an artery under pulsatile blood flow conditions. The numerical results showed that when compared with the Newtonian model, the Carreau (shear thinning) model could lead to some differences in the luminal surface drug concentration in certain areas along the outer wall of the curved vessel. In most areas of the vessel, however, there were no significant differences between the 2 models. Particularly, no significant difference between the two models was found in terms of the area-averaged luminal surface drug concentration. Therefore, we believe that the shear thinning property of blood may play little roles in DES drug delivery. Nevertheless, before we draw the conclusion that Newtonian assumption of blood can be used to replace its non-Newtonian one for the numerical simulation of drug transport in the DES implanted coronary artery, other more complex mechanical properties of blood such as its thixotropic behavior should be tested. [ABSTRACT FROM AUTHOR]

Background: Blood flow condition may have influence upon the hydraulic conductivity of venous graft (Lp,vein) in an arterial bypass, then affecting the accumulation of low-density lipoproteins (LDLs) within the graft wall. To probe this possibility, we first measured in vitro the filtration rates of swine lateral saphenous vein segments under different flow rates, and the correlation of Lp,vein with wall shear stress (WSS) was then obtained.Results: The experimental results showed that when WSS was very low, Lp,vein would increase drastically with WSS from 1.16 ± 0.15 × 10-11 m/s Pa at 0 dyn/cm2 to 2.17 ± 0.20 × 10-11 m/s Pa at 0.7 dyn/cm2, then became constant of approximately 2.33 × 10-11 m/s Pa as the WSS increased further. Based on the experimental results, we assumed three different cases of Lp,vein and numerically simulated the LDLs transport in an arterial bypass model with venous graft. Case A: Lp,vein = 2.33 × 10-11 m/s Pa; Case B: Lp,vein = 1.16 × 10-11 m/s Pa (static condition with WSS of 0); Case C: Lp,vein was shear dependent. The simulation showed that the deposition/accumulation of LDLs within the venous graft wall in Case A was greatly enhanced when compared with that in Case B. However, the LDL accumulation in the graft wall was similar for Case A and Case C.Conclusions: Our study, therefore, indicates that when the venous graft was implanted as a bypass graft, the Lp,vein might remain nearly constant along its whole length except for very few areas where the value of WSS was extremely low (less than 0.7 dyn/cm2) and the effects of Lp,vein modulated by blood flow on LDL transport may be neglected. [ABSTRACT FROM AUTHOR]