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On Studying the Interaction Between Different Stent Models and Rabbit Tracheal Tissue: Numerical, Endoscopic and Histological Comparison

  • Medical Stents: State of the Art and Future Directions
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Abstract

Stenting technique is employed worldwide for treating atherosclerotic vessel and tracheal stenosis. Both diseases can be treated by means of metallic stents which present advantages but are affected by the main problem of restenosis of the stented area. In this study we have built a rabbit trachea numerical model and we have analyzed it before and after insertion and opening of two types of commercial stent: a Zilver® FlexTM Stent and a WallStentTM. In experimental parallel work, two types of stent were implanted in 30 New Zealand rabbits divided in two groups of 10 animals corresponding to each stent type and a third group made up of 10 animals without stent. The tracheal wall response was assessed by means of computerized tomography by endoscopy, macroscopic findings and histopathological study 90 days after stent deployment. Three idealized trachea models, one model for each group, were created in order to perform the computational study. The animal model was used to validate the numerical findings and to attempt to find qualitative correlations between numerical and experimental results. Experimental findings such as inflammation, granuloma and abnormal tissue growth, assessed from histomorphometric analyses were compared with derived numerical parameters such as wall shear stress (WSS) and maximum principal stress. The direct comparison of these parameters and the biological response supports the hypothesis that WSS and tensile stresses may lead to a greater tracheal epithelium response within the stented region, with the latter seeming to have the dominant role. This study may be helpful for improving stent design and demonstrates the feasibility offered by in-silico investigated tracheal structural and fluid dynamics.

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Acknowledgments

This study was supported by the CIBER-BBN financed by the Instituto de Salud Carlos III with assistance from the European Regional Development Fund and by the Spanish Ministry of Science and Technology through Research Project DPI2013-44391-P; the Department of Industry and Innovation (Government of Aragon) through the research group Grant T88 (Fondo Social Europeo). The experimental study was supported by the Instituto de Salud Carlos III, through research project PI08/1424 and was performed by the Minimally Invasive Techniques Research Group (GITMI) of Aragón Government. The experimental tests have been performed by the ICTS “NANBIOSIS”, more specifically by the Tissue & Scaffold Characterization Unit (U13) of the CIBER in Bioengineering, Biomaterials & Nanomedicne (CIBER-BBN at the University of Zaragoza.

Conflict of interest

None of the authors of this work has conflict of interest with other people and organizations.

Ethical Standards

All institutional and national guidelines for the care and use of laboratory animals were followed and approved by the appropriate institutional committees. The work reported in this manuscript does not involve human subjects.

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Authors and Affiliations

  1. Aragón Institute of Engineering Research, University of Zaragoza, C/María de Luna s/n, 50018, Zaragoza, Spain

    J. Chaure, E. Peña, M. A. Martínez & M. Malvè

  2. Centro de Investigación en Red en Bioingeniería, CIBER-BBN, Biomateriales y Nanomedicina, C/Poeta Mariano Esquillor s/n, 50018, Zaragoza, Spain

    E. Peña, M. A. De Gregorio, M. A. Martínez & M. Malvè

  3. Grupo de Investigación Técnicas de Mínima Invasión (GITMI), Faculty of Veterinary, Universidad de Zaragoza, C/Miguel Servet 177, 50013, Zaragoza, Spain

    C. Serrano, R. Fernández-Parra, F. Lostalé & M. A. De Gregorio

  4. Departamento de Ingeniería Mecánica, Energética y de Materiales, Universidad Pública de Navarra, Campus Arrosadía, 31006, Pamplona, Spain

    M. Malvè

  5. École Nationale Vétérinaire d’Alfort, 7 Avenue du Général de Gaulle, 94704, Maisons-Alfort, France

    R. Fernández-Parra

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  1. J. Chaure
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  2. C. Serrano
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  3. R. Fernández-Parra
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  4. E. Peña
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  5. F. Lostalé
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  6. M. A. De Gregorio
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  7. M. A. Martínez
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  8. M. Malvè
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Correspondence to E. Peña.

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Associate Editor Peter McHugh oversaw the review of this article.

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Chaure, J., Serrano, C., Fernández-Parra, R. et al. On Studying the Interaction Between Different Stent Models and Rabbit Tracheal Tissue: Numerical, Endoscopic and Histological Comparison. Ann Biomed Eng 44, 368–381 (2016). https://doi.org/10.1007/s10439-015-1504-3

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  • DOI: https://doi.org/10.1007/s10439-015-1504-3

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