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Persistence of the pathology of in-stent restenosis even with the advent ofdrug-eluting stents warrants the development of highly resolved in silicomodels. These computational models assist in gaining insights into thetransient biochemical and cellular mechanisms involved and thereby optimize thestent implantation parameters. Within this work, an already establishedfully-coupled Lagrangian finite element framework for modeling the restenoticgrowth is enhanced with the incorporation of endothelium-mediated effects andpharmacological influences of rapamycin-based drugs embedded in the polymericlayers of the current generation drug-eluting stents. The continuum mechanicaldescription of growth is further justified in the context of thermodynamicconsistency. Qualitative inferences are drawn from the model developed hereinregarding the efficacy of the level of drug embedment within the struts as wellas the release profiles adopted. The framework is then intended to serve as atool for clinicians to tune the interventional procedures patient-specifically.

Computational modeling of in-stent restenosis: Pharmacokinetic and pharmacodynamic evaluation