Deciphering thrombosis mechanisms: how stent implantation strategies shape outcomes through particle dynamics and experiments

Thrombosis formation after stent implantation is a significant complication of stent placement procedures. Different stent deployment strategies have varying effects on thrombosis formation. In this study, we developed dissipative particle dynamics (DPD) and in vitro experimental models to investigate the movement, adhesion, activation, and aggregation of platelets following different stent implantations, and analysed their impact on thrombosis formation. The results show that smaller stent space promote thrombosis formation, when the unique environment created by the upstream and downstream stent struts favours thrombosis formation. However, when the stent space is excessively large, this effect becomes less pronounced. Additionally, stent strut overlapping and misalignment exacerbate thrombosis after stent placement. Overlapping and misaligned stent struts create third stagnation zones that facilitate thrombosis formation, while the gap between stent struts increases the recirculation areas, further promoting thrombosis development. In conclusion, improper stent deployment, including stent space, strut interlacing, and overlapping, can enhance platelet aggregation and activation, leading to the formation of stable thrombi near the struts. This study explores the effects of post-stenting complications on thrombosis formation within the stent and provides new theoretical insights for optimising stent implantation strategies and structural design.