Computational fluid dynamics simulations including oxygen mass transport in stented coronaries

In-stent restenosis (ISR) is a hyperplastic tissue response following percutaneous cardiac intervention for occlusive arterial disease such as atherosclerosis. Associations have been reported between maladaptive responses to healing in the form of neointimal hyperplasia (NIH) and regions of reduced and reversed flow. In vitro studies provide evidence that the extent of NIH may be related to partial endothelial denudation following stent expansion and decreased oxygen mass transfer which may result in regions of arterial wall hypoxia. Current studies investigate the potential to augment oxygen mass transport through innovative helical stent designs in vivo and in silico. The use of computational fluid dynamics (CFD) allows quantitative study of the complex environment of the fluid and mass transport within idealised and patient-specific stented vessels. However, the computational design used so far were ideal helical stent geometries for comparison with in vivo results. The present study has been performed to investigate oxygen mass transport in a realistic configuration of the stented coronary vessel, which is characterized by asymmetries and non-uniform geometry. To this end, a porcine right coronary artery (RCA) has been analyzed, whose in vivo geometry was reconstructed by combining data from micro-CT (stent) and by finite element analysis (vascular wall). The availability of corresponding histological images allows a direct correlation with CFD and mass transport results.