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Factors that affect mass transport from drug eluting stents into the artery wall.doc

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Factors that affect mass transport from drug eluting stents into the artery wall

O’Connelletal.BioMedicalEngineeringOnLine2010,9:15 /content/9/1/15 REVIEW OpenAccess Factorsthataffectmasstransportfromdrug elutingstentsintothearterywall BarryMO’Connell,TimMMcGloughlin,MichaelTWalsh* *Correspondence:michael. Abstract walsh@ul.ie CentreforAppliedBiomedical EngineeringResearch(CABER), DepartmentofMechanicaland AeronauticalEngineeringandthe MaterialsandSurfaceScience Institute,UniversityofLimerick, Limerick,Ireland Coronaryarterydiseasecanbetreatedbyimplantingastentintotheblockedregion ofanartery,thusenablingbloodperfusiontodistalvessels.Minimallyinvasiveproce- duresofthisnatureoftenresultindamagetothearterialtissueculminatinginthe re-blockingofthevessel.Inanefforttoalleviatethisphenomenon,knownasreste- nosis,drugelutingstentsweredeveloped.Theyaresimilarincompositiontoabare metalstentbutencompassacoatingwiththerapeuticagentsdesignedtoreduce theoverlyaggressivehealingresponsethatcontributestorestenosis.Therearemany variablesthatcaninfluencetheeffectivenessofthesetherapeuticdrugsbeingtrans- portedfromthestentcoatingtoandwithinthearterywall,manyofwhichhave beenanalysedanddocumentedbyresearchers.However,thephysicaldeformation ofthearterysubstructureduetostentexpansion,anditsinfluenceonadrugsability todiffuseevenlywithinthearterywallhavebeenlackinginpublishedworktodate. Thepaperhighlightspreviousapproachesadoptedbyresearchersandproposesthe additionofporousarterywalldeformationtoincreasemodelaccuracy. Introduction Atherosclerosisisadegenerative diseasethat affects coronary,carotidandotherper- ipheral arteries in the body. Disease formation can occur as early as childhood with thedevelopmentoffattystreakswithinthearterywall.Astheagingprocessprogresses thesefattystreaksaccumulatebecominglargerlipiddepositswithinthearteryandare detrimental to the smooth operation of the vasculature. Occlusions ensuing from aggressive plaque progression can often culminate in an ischemic attack, such as an apoplecticattackoramyocardialinfarction[1-3].Thereareanumberofinterv