A fully coupled framework for in silico investigation of in-stent restenosis

Abstract

Finite element analysis (FEA) can be implemented along with Agent-based model (ABM) to investigate the biomechanical and mechanobiological mechanisms of pathophysiological processes. However, traditional ABM-FEA approaches are often partially coupled and lack the feedback responses from biological analysis. To overcome this problem, a fully coupled ABM-FEA framework is developed in this paper by linking the macro-scale and cell-scale modules bi-directionally. Numerical studies of the in-stent restenosis process are conducted using the proposed approach and comparisons are made between the two types of frameworks. A reduction in lumen loss rate, which is possibly caused by the time-varying stresses, is observed in the fully coupled simulations. The re-endothelialisation process is also simulated under different frameworks and the simulation results show strong inhibition of endothelial cells to vascular restenosis. The proposed method is proved to be effective to explain the biomechanical-mechanobiological coupling characteristics of the restenosis problem and can be utilized for stent design and optimization.

Keywords:

• Agent-based model
• finite element
• mechanobiology
• in-stent restenosis
• biomechanics

Disclosure statement

No potential conflict of interest is reported by the authors.

Additional information

Funding

This work is supported by Shenzhen Fundamental Research Funds (Grant Nos. JCYJ20160608153218487 and JCYJ20160428144135222), in part by Shenzhen Key Laboratory Project (Grant No. ZDSYS201707271637577), Shenzhen Peacock Plan (Grant No. KQTD2016113010571019) and National Natural Science Foundation of China (Grant Nos. U1613224 and U1713218).