Strut Position, Blood Flow, and Drug Deposition: Implications for Single and Overlapping Drug-Eluting Stents
Circulation Balakrishnan et al.
111: 2958
Data Supplement
Files in this Data Supplement:
- Figure I
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(EPS) (1.17 MB). Total arterial drug deposition depends on the degree of strut embedding. The average drug content in the wall drops as these fully coated DES struts are embedded into the arterial wall to greater extents and removed from flow. Typically a stent strut indents the elastic lamina and bows the underlying tissue but is still subject to flow and very much surrounded by areas of flow separation.
- Figure II
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(EPS) (1.22 MB). The axial concentration profile at a plane 1.5 strut heights deep into the artery is changed by DES strut embedding. As the strut is driven deeper into the wall, the local concentration rises and extent of higher concentration propelled down stream drops. Typically a stent strut indents the elastic lamina and bows the underlying tissue but is still subject to flow and very much surrounded by areas of flow separation.
- Figure III
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(EPS) (1.22 MB). The concentration profile of drug along the length of the artery at an arterial depth of 1.5 strut heights is subtly changed when the shape of the strut tops are changed. To isolate the effect of shape from dose only the base of each strut (color outline) and not the tops (black outline) were coated with drug. This effectively maintained the dose constant as each strut had an identical surface area of coating, which cannot be similarly controlled with the different shapes. Flow in the blood vessel is from left to right and the bottom left edge of the strut is aligned with the origin of the Cartesian coordinate system. Drug concentration on the ordinate within the arterial wall (colored curves that correspond to respective colored struts) is plotted against longitudinal position on the abscissa. In all cases the arterial drug concentration rises before the strut and peaks slightly beyond the strut. While the proximal concentration is unaffected by the geometry of the strut, the down stream concentration is extended, likely as a result of differential effects on flow by different shaped struts.
- Figure IV
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(EPS) (1.26 MB). The axial concentration profile at a plane 1.5 strut heights deep into the artery is only subtly changed by strut shape. In this depiction flow runs from left to right, and drug-eluting strut surfaces are depicted in color (red for triangular and green for squared strut tops). In both cases drug concentration, is lowest in the tissue at the most proximal upstream portion of the artery, and increases along the length of the stented vessel. The triangular top strut increases the distal spread of drug beyond the strut and minimal level of drug between struts but in barely discernible quantities.