Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model’s clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.

再狭窄是通过球囊血管成形术或支架置入治疗动脉粥样硬化的主要不良反应之一。在干预期间，动脉壁过度拉伸，导致一系列细胞事件和随后的新内膜形成。这种机械刺激及其机械生物学效应可以在生物力学模拟中重现。这些模型的目的是预测这些程序的长期结果，以帮助增加对再狭窄形成的理解并允许在计算机治疗的优化。我们提出了再狭窄的预测有限元模型，使用旨在模拟软组织生长和重塑的均质约束混合建模框架。我们将结果与人类冠状动脉的临床观察结果和非人类灵长类动物模型的实验结果进行比较。我们还通过测试其对不同球囊载荷和药物洗脱球囊使用的反应来探索该模型的临床相关性。结果与实验数据的比较显示了模型的相关性。我们展示了它预测体内观察到的向内和向外重塑的能力，并且我们展示了从生物力学的角度更好地理解再狭窄形成的重要性。