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Effects of Endovascular Intervention on Vascular Smooth Muscle Cell Function
Published in Jiro Nagatomi, Eno Essien Ebong, Mechanobiology Handbook, 2018
Brad Winn, Bethany Acampora, Jiro Nagatomi, Martine LaBerge
In basic terms, a balloon angioplasty procedure is a forceful displacement of an atherosclerotic lesion serving to widen the vessel lumen to increase blood flow. In so doing, this causes stretching of the vessel wall, tears in the atherosclerotic plaques, and general damage to the vessel [28]. This in turn signals a complex cascade of elastic recoil, thrombosis, inflammation, intimal thickening, and vascular remodeling [28]. Elastic recoil and negative remodeling are the primary causative factors of restenosis when vessel expansion is done by balloon only. Indeed, the post-procedural lumen diameter is the most telling predictor of the expected long-term lumen diameter [28]. The deployment of a vascular stent greatly reduces the incidence of elastic recoil by serving to mechanically hold the vessel open. However, in the treatment of calcified and highly fibrous lesions, acute stent recoil of up to 15%–30% is commonly observed [28]. Stent deployment also further complicates the immunological response by triggering a foreign body response from the implantation of a biomaterial into the body. When performing an angioplasty procedure, particularly in conjunction with stent deployment, a certain degree of vascular injury is inevitable. However, the initial injury can be further complicated by the inflammatory response, the severity of which can ultimately dictate the degree of restenosis and subsequently affect procedural success.
A review on femoropopliteal arterial deformation during daily lives and nickel-titanium stent properties
Published in Journal of Medical Engineering & Technology, 2022
Ali K. Kareem, Mustafa M. Gabir, Inas R. Ali, Al E. Ismail, Ishkrizat Taib, Nofrizalidris Darlis, Omar M. Almoayed
PAD lesions gradually grow without any clinical signs in patients (similar to coronary artery lesions), and that growth leads to deforming artery by increasing diameter [25], and the artery-wall thickness to make balancing with internal stress as well as haemodynamics-shear stress [9,26,27]. When the diameter of the artery reaches its maximum widening, and the diameter of the artery can no longer increase, the blood flow is altered since the progressive calcification causes the lumen of the FPA to narrow. The cardiovascular lesion may be treated and improved in some cases through the use of medical therapy and a physical exercise programme. Still, some other cases worsen depending on the severity of the lesion [10]. During the development of signs of the cardiovascular lesion, about 7% of patients received cardiovascular therapy or used the re-cardiovascular (called bypass) [10,28], as illustrated in Figure 6. Intravascular therapy is generally more favoured than bypass surgery due to its shorter recovery time, as well as its natural invasion [29]. Intravascular intervention occurs by inserting a balloon angioplasty into the common femoral artery (or the pedal or brachial arteries in less common cases) to reopen the blocked artery. In cases of complex injuries, the small permanent medical mesh (called a stent) is inserted into the blocked artery to restore blood flow. Yet, the choice of the appropriate decision to be made depends on several criteria to be taken into accounts, such as the durability wall of the anatomy of the diseased artery, the patient’s preference, and the patient’s risk factors.
A damaged Ogden material tube under pressure: stability and bifurcation analysis
Published in Soft Materials, 2020
Kriti Arya, Somnath Sarangi, Ranjan Bhattacharyya
Inflammatory diseases like atherosclerosis should be treated effectively and efficiently. A very common technique nowadays is of angioplasty, wherein blocked arterial tissue is mechanically widened. The material damage incurred to the arterial wall during angioplasty is the reason for a successful surgery.[1] Moreover, sometimes due to the application of high pressure during angioplasty there is a chance of bulging of the arterial wall and is also a common feature exhibited by rubber balloons. The incompressible damaged Ogden material tube is mimicked to an arterial tissue, and the associated stability and bifurcation analysis of the small amplitude oscillations are investigated. We use dissipation inequality[2] to formulate the damage in arterial tissue due to angioplasty. The considered damage model is a function of the first invariant of the left Cauchy-Green deformation tensor and follows next in Section 2. Similar invariant-based damage approaches are used by[3] and.[4] In,[5] an efficient numerical technique is used for evaluating material parameters, and it is shown that the damage model in [3] retains its numerical stability whereas the one in[6] loses the same.