Multi-domain modeling and simulation of blood solutes and elution in stented arteries.

The introduction of Bioresorbable Stents (BRS) in angioplasty (the clinical operation to reopen an occluded coronary with intravascular procedures), originally saluted as an important innovation, was a failure for many associated adverse events. Yet, the clinical community advocates for BRS as an unmet clinical need. The reason for the failures can be associated with the special size of the bioresorbable scaffold: the absence of a metallic core calls for an increased thickness, suspected of triggering abnormal flow patterns and biological inflammations, leading to adverse events. Accurate mathematical modeling of the fluid-wall-strut interaction and the related elution of the struts can provide a breakthrough for rigorous shape optimization. Here, we model in 3D the elution process involving all three domains (fluid, wall, and struts) coexisting together. Previous studies involved only two domains. Real cases show that the stent, the lumen, and the wall are in contact with every other subdomain. The multidomain case presents nontrivial challenges. We propose a domain decomposition approach for the numerical solution using an iterative-by-subdomain method. We prove the convergence of the iterative method. We provide preliminary results in idealized yet realistic 3D geometries. Results demonstrate that the iterative method is independent of the mesh size. [ABSTRACT FROM AUTHOR]