Biomedical subjects

Michael R Moreno

Publications and source records attributed to Michael R Moreno.

3 recordsLinked to original sources

PubMed2006

Effects of stent design parameters on normal artery wall mechanics.

A stent is a device designed to restore flow through constricted arteries. These tubular scaffold devices are delivered to the afflicted region and deployed using minimally invasive techniques. Stents must have sufficient radial strength to prop the diseased artery open. The presence of a stent can subject the artery to abnormally high stresses that can trigger adverse biologic responses culminating in restenosis. The primary aim of this investigation was to investigate the effects of varying stent "design parameters" on the stress field induced in the normal artery wall and the radial displacement achieved by the stent. The generic stent models were designed to represent a sample of the attributes incorporated in present commercially available stents. Each stent was deployed in a homogeneous, nonlinear hyperelastic artery model and evaluated using commercially available finite element analysis software. Of the designs investigated herein, those employing large axial strut spacing, blunted corners, and higher amplitudes in the ring segments induced high circumferential stresses over smaller areas of the artery's inner surface than all other configurations. Axial strut spacing was the dominant parameter in this study, i.e., all designs employing a small stent strut spacing induced higher stresses over larger areas than designs employing the large strut spacing. Increasing either radius of curvature or strut amplitude generally resulted in smaller areas exposed to high stresses. At larger strut spacing, sensitivity to radius of curvature was increased in comparison to the small strut spacing. With the larger strut spacing designs, the effects of varying amplitude could be offset by varying the radius of curvature and vice versa. The range of minimum radial displacements from the unstented diastolic radius observed among all designs was less than 90 microm. Evidence presented herein suggests that stent designs incorporating large axial strut spacing, blunted corners at bends, and higher amplitudes exposed smaller regions of the artery to high stresses, while maintaining a radial displacement that should be sufficient to restore adequate flow.

Animals↗

PubMed2003

Effects of periodic body acceleration on the in vivo vasoactive response to N-omega-nitro-L-arginine and the in vitro nitric oxide production.

Periodic acceleration (pGz), a novel method of ventilatory support, is achieved using a platform that moves cyclically in the headward-footward direction. PGz has been shown to increase vascular shear stress and regional blood flows, as well as decrease pulmonary and systemic vascular resistances. PGz also increases nitric oxide (NO) production. This study was undertaken to determine the effects of pGz on the NO inhibiting effects of N-w-nitro-L-arginine (L-NAME) in vivo, and to determine if increased NO production due to pGz could be reproduced in vitro with isolated arteries. Pigs were assigned to conventional ventilation (CV), or pGz, with no additional breathing assistance. L-NAME was infused in cumulative doses of 1, 3, 10, 30, and 100 mg/kg. Cardiac output decreased in both groups by 50%. There was also a dose-dependent increase in blood pressure, pulmonary artery pressure, and vascular resistances. However, pGz attenuated the vascular response of L-NAME. Isolated porcine aortas exposed to nonpulsatile, pulsatile, and pulsatile flow plus pGz exhibited an increase in nitrites with the addition of pulsatile flow (300%, relative to steady flow), and a further increase with pGz (1000%, relative to steady flow). It has been determined that pGz, a novel method of increasing shear stress on the vascular endothelium. attenuates the vasoactive response to L-NAME. The in vitro experiments demonstrated that increases in NO production in vivo could be reproduced in vitro, which provides the opportunity to investigate the mechanisms of cardiovascular pGz effects.

Acceleration↗

PubMed2003

Platelet adhesion to simulated stented surfaces.

PURPOSE: To determine if the protrusion of stent struts into the flow stream, which creates stagnation along the wall dependent on the strut spacing, has an effect on platelet adhesion. METHODS: Three 2-dimensional stents with different strut spacings were placed in a flat-plate flow chamber. Human blood was collected and platelets were labeled with indium 111. The blood with radioactive platelets was pumped through the flow chamber for 30 minutes to produce a pulsatile wall shear stress of 10+/-5 dynes/cm2 (mean +/- amplitude at 1 Hz). A gamma counter measured radioactivity along the surface and on the stents. Computational flow simulations provided specific data on flow separation and wall shear stress for each stent strut spacing tested (2.5, 4.0, and 7.0 times the strut height). RESULTS: The presence of any stent provoked an elevation in platelet adhesion within the stented region (p<0.05). The stents with larger strut spacing had higher platelet adhesion on the substrate in the stented region (1.71+/-0.63 normalized platelet deposition for the 7.0 model and 2.11+/-1.02 for the 4.0 model) than stents with smaller strut spacing (1.37+/-0.68 for the 2.5 model, p<0.05). The stents themselves showed platelet adhesion levels that were 3 to 7 times higher than the substrates, with a similar dependence on stent strut spacing. CONCLUSIONS: Additional knowledge of the role of mechanical factors in stent restenosis will aid in designing stents that minimize intimal hyperplasia and restenosis. The results of this study demonstrate the importance of stent design-mediated blood flow patterns, with smaller strut spacings minimizing platelet adhesion per unit strut area.

Blood Platelets↗