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An in-silico study on the role of smooth muscle cells migration in neointimal formation after coronary stenting

Hannan Tahir, Ioana Niculescu, Carles Bona-Casas, Roeland M.H. Merks, Alfons G. Hoekstra (2015) An in-silico study on the role of smooth muscle cells migration in neointimal formation after coronary stenting. Journal of the Royal Society Interface 12: 20150358. doi:10.1098/rsif.2015.0358

Excessive migration and proliferation of smooth muscle cells has been observed as a major factor contributing to the development of in-stent restenosis after coronary stenting. Building upon the results from in-vivo experiments, we formulated a hypothesis that the speed of the initial tissue re-growth response is determined by the early migration of smooth muscle cells from the injured intima. To test this hypothesis, a Cellular Potts model of the stented artery is developed where stent struts were deployed at different depths into the tissue. An extreme scenario with a ruptured internal elastic lamina was also considered to study the role of severe injury on the tissue re-growth. Based on the outcomes, we hypothesize that a deeper stent deployment results in on average larger fenestrae in the elastic lamina, allowing easier migration of smooth muscle cells into the lumen. The data also suggest that growth of the neointimal lesions due to smooth muscle cells proliferation is strongly dependent on the initial number of migrated cells, which form an initial condition for the later phase of the vascular repair. This mechanism could explain the in-vivo observation that the initial rate of neointima formation and injury score are strongly correlated. [ http://rsif.royalsocietypublish ing.org/content/12/108/20150358 ]