A process based model for investigating the re-endothelialization of stented vessels

Understanding the consequences and complications that arise after the implantation of a stent in a blood vessel is a complex and multidisciplinary topic. The objective of this thesis is to simulate processes such as re-endothelialization and in-stent restenosis using models based on fluid dynamics parameters. In the first chapter we introduce the fundamental clinical and medical aspects regarding stent implantation and its consequences. Numerous studies have explored these phenomena through in-vivo simulations or clinical results to grasp the primary causes, while only a few have proposed virtual simulations to reproduce the occlusion process. In the second chapter, we discuss the results of these various approaches, along with their respective advantages, drawbacks, and limitations. In the third chapter we focus on the methods used and the modeling choices taken during the simulations. Our study focuses on singular stent type, under ideal flow conditions. The basic idea is to simulate endothelial growth varying locally the dynamical viscosity profile. Firstly, we assess the progression in steady-state flow for a single stented artery. Then we proceed with unsteady flows, considering two different vessel geometries and rheological models. In the fourth and fifth chapter we will present the results of the stationary and time dependent simulations, respectively. We focus on the changes of the main blood flow parameters and the corresponding computed neointimal growth. At last, we will compare the results of our different simulations, considering the various regimes and geometries, and assess them with both in-vivo data and multiscale numerical simulations results found in the literature.