Multiscale agent-based modeling of restenosis after percutaneous transluminal angioplasty: Effects of tissue damage and hemodynamics on cellular activity

Restenosis following percutaneous transluminal angioplasty (PTA) in femoral arteries is a major cause of failure of the revascularization procedure. The arterial wall response to PTA is driven by multifactorial, multiscale processes, whose complete understanding is lacking. Multiscale agent-based modeling frameworks, simulating the network of mechanobiological events at cell-tissue scale, can contribute to decipher the pathological pathways of restenosis. In this context, the present study proposes a fully-automated multiscale agent-based modeling framework simulating the arterial wall remodeling due to the wall damage provoked by PTA and to the altered hemodynamics in the post-operative months.