Influence of Strut Cross-section on Haemodynamics and Drug Transport in Stent-based Therapy

Articles in Press

Document Type : Research Paper

Authors
Kimiya Kasaeinia 1
Rafat Mohammadi 1
Ali Seyedhosseini 1
Pujith R.S. Vijayaratnam 2
Tracie J. Barber 2
1 Department of Mechanical Engineering, Arak University, Arak, Iran
2 School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
10.22055/jacm.2026.48692.5432
Abstract
Drug-eluting stents effectively treat stenotic vascular diseases, yet their struts can disturb blood flow and promote restenosis. Stent geometry, therefore, plays a crucial role in balancing haemodynamics with drug delivery. This study compared streamlined and non-streamlined strut cross-sections within an ideal coronary artery model using computational fluid dynamics. Strut height, width, and aspect ratio were analyzed for their effects on flow and drug transport. Results showed taller struts worsened restenosis risk but increased flow-mediated drug uptake, while greater width enhanced contact-mediated uptake. Streamlined profiles improved haemodynamics but reduced flow-mediated delivery. Among designs with equal perimeter, circular arc struts with an aspect ratio of two achieved the highest overall drug uptake; however, this configuration also increased regions of low wall shear stress, highlighting the clinical trade-off between maximising drug delivery and maintaining favourable haemodynamics.
Keywords
Drug-eluting stents
Haemodynamics
Drug delivery
Stent design
Computational fluid dynamics
Subjects

Publisher’s Note Shahid Chamran University of Ahvaz remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

[1] Mukheja, Y., Sarkar, A., Arora, R., Pal, K., Ahuja, A., Vashishth, A., Kuhad, A., Chopra,K., Jain, M., Unravelling the progress and potential of drug-eluting stents and drug-coated balloons in cardiological insurgencies, Life Sciences, 352, 2024, 122908.
[2] Song, L., Guan, C., Yu, M., Sun, Z., Fu, G., He, Y., Jia, S., Chen, J., Qi, F., Bai, J., li, W., Ge, J., Han, Y., Gao, R., Sirolimus-eluting iron bioresorbable scaffold versus cobalt-chromium everolimus-eluting stents in patients with coronary artery disease: Rationale and design of the IRONMAN-II trial, American Heart Journal, 275, 2024, 53–61.
[3] Vahedi, S.M., Azaiez, J., Optimization of polymer coating thickness and strut width in drug Eluting stents using Magnetic field, European Journal of Pharmaceutics and Biopharmaceutics, 203, 2024, 114455.
[4] Vijayaratnam, P.R.S., Reizes, J.A., Barber, T.J., The impact of strut profile geometry and malapposition on the haemodynamics and drug-transport behaviour of arteries treated with drug-eluting stents, International Journal of Numerical Methods for Heat & Fluid Flow, 32, 2022, 3881–3907.
[5] Balakrishnan, B., Tzafriri, A.R., Seifert, P., Groothuis, A., Rogers, C., Edelman, B.R., Strut position, blood flow, and drug deposition: implications for single and overlapping drug-eluting stents, Circulation, 111, 2005, 2958–2965.
[6] Ma, X., Oyamada, S., Gao, F., Wu, T., Robich, M.P., Wu, H., Wang, X., Buchholz, B., McCarthy, S., Gu, Z., Bianchi, C.F., Sellke, F.W., Laham, R., Paclitaxel/sirolimus combination coated drug-eluting stent: In vitro and in vivo drug release studies, Journal of Pharmaceutical and Biomedical Analysis, 54, 2011, 807–811.
[7] Zhang, Y., Yu, H., Deng, L., Hou, Z., Yang, J., Fang, F., Miao, M.Z., Li, W., Shen, X., Hao, D., Ma, X., Zhou, L., He, F., Liu, X., Tacrolimus combined with arsenic trioxide provides a three-in-one drug-eluting coronary stent integrating anti-restenosis, pro-endothelialization and anti-inflammation, Medicine Novel Technology Devices, 21, 2024, 100289.
[8] Kolachalama, V.B., Tzafriri, A.R., Arifin, D.Y., Edelman, E.R., Luminal flow patterns dictate arterial drug deposition in stent-based delivery, Journal of Controlled Release, 133, 2009, 24–30.
[9] Vijayaratnam, P.R.S., O’Brien, C.C., Reizes, J.A., Barber, T.J., Edelman, E.R., The impact of blood rheology on drug transport in stented arteries: Steady simulations, PLoS One, 10, 2015, e012817.
[10] Kasaeinia, K., Mohammadi, R., Seyedhosseini, A., Effect of Blood Rheology on Haemodynamics and Stent-based Drug Delivery for Coronary Arteries, European Journal of Mechanics - B/Fluids, 113, 2025, 204282.
[11] Morton, A.C., Crossman, Gunn, D.J., The influence of physical stent parameters upon restenosis, Pathologie Biologie, 52, 2004, 196–205.
[12] Jiménez, J.M., Davies, P.F., Hemodynamically driven stent strut design, Annals of Biomedical Engineering, 37, 2009, 1483–1494.
[13] Mejia, J., Ruzzeh, B., Mongrain, R., Leask, R., Bertrand, O.F., Evaluation of the effect of stent strut profile on shear stress distribution using statistical moments, Biomedical Engineering Online, 8, 2009, 1–10.
[14] Jiang, Y., Zhang, J., Zhao, W., Influence of strut cross-section of stents on local hemodynamics in stented arteries, Chinese Journal of Mechanical Engineering (English Edition), 29, 2016, 624–632.
[15] Deen, W.M., Analysis of transport phenomena, Oxford University Press, 1998.
[16] Leone, A., Simonetti, F., Avvedimento, M., Angellotti, D., Immobile Molaro, M., Franzone, A., Esposito, G., Piccolo, R., Ultrathin Struts Drug-Eluting Stents: A State-of-the-Art Review, Journal of Personalized Medicine, 12, 2022, 1378.
[17] Tada, S., Tarbell, J.M., Flow through internal elastic lamina affects shear stress on smooth muscle cells (3D simulations), American Journal of Physiology-Heart and Circulatory Physiology, 282, 2002, H576-84.
[18] O’Brien, C.C., Kolachalama, V.B., Barber, T.J., Simmons, A., Edelman, E.R., Impact of flow pulsatility on arterial drug distribution in stent-based therapy, Journal of Controlled Release, 168, 2013, 115–124.
[19] Kim, H.J., Vignon-Clementel, I.E., Coogan, J.S., Figueroa, C.A., Jansen, K.E., Taylor, C.A., Patient-specific modeling of blood flow and pressure in human coronary arteries, Annals of Biomedical Engineering, 38, 2010, 3195–3209.
[20] Van Doormaal, J.P., Raithby, G.D., Enhancements of the simple method for predicting incompressible fluid flows, Numerical Heat Transfer, 7, 1984, 147-163
[21] Kolachalama, V.B., Bressloff, N.W., Nair, P.B., Mining data from hemodynamic simulations via Bayesian emulation, Biomedical Engineering Online, 6, 2007, 47. 
[22] Orsiro Mission | Orsiro US, (n.d.). https://us.orsiro.com/orsiromission (accessed October 27, 2025).
[23] XIENCE Skypoint Ordering Information | Abbott, (n.d.). https://www.cardiovascular.abbott/us/en/hcp/products/percutaneous-coronary-intervention/xience-family/xience-skypoint/ordering-information.html (accessed October 27, 2025).
[24] Resolute Onyx TM DES, (n.d.).
Journal of Applied and Computational Mechanics

Articles in Press, Corrected Proof
Available Online from 04 January 2026