Effects of different positions of intravascular stent implantation in stenosed vessels on in-stent restenosis: An experimental and numerical simulation study

JOURNAL OF BIOMECHANICS

卷:113

Article

He, Shicheng^1,2  Liu, Wanling¹  Qu, Kai¹  Yin, Tieying¹  Qiu, Juhui¹  Li, Yan¹  Yuan, Kunshan³  Zhang, Haijun³  Wang, Guixue¹ 

[1] Chongqing Univ, State & Local Joint Engn Lab Vasc Implants, Minist Educ, Key Lab Biorheol Sci & Technol,Bioengn Coll, Chongqing 400030, Peoples R China

[2] Southeast Univ, Sch Biol Sci & Med Engn, State Key Lab Bioelect, Nanjing 210096, Peoples R China

[3] Natl United Engn Lab Biomed Mat Modificat, Dezhou 251100, Shandong, Peoples R China

关键词: Intravascular stents;    Atherosclerosis;    Restenosis;    Hemodynamics;   

DOI  :  10.1016/j.jbiomech.2020.110089

来源: Elsevier

【 摘 要 】

Percutaneous coronary intervention (PCI) has been widely used in the treatment of atherosclerosis, while in-stent restenosis (ISR) has not been completely resolved. Studies have shown that changes in intravascular mechanical environment are related to ISR. Hence, an in-depth understanding of the effects of stent intervention on vascular mechanics is important for clinically optimizing stent implantation and relieving ISR. Nine rabbits with stenotic carotid artery were collected by balloon injury. Intravascular stents were implanted into different longitudinal positions (proximal, middle and distal relative to the stenotic area) of the stenotic vessels for numerical simulations. Optical coherence tomography (OCT) scanning was performed to reconstruct the three-dimensional configuration of the stented carotid artery and blood flow velocity waveforms were collected by Doppler ultrasound. The numerical simulations were performed through direct solution of Naiver-Stokes equation in ANSYS. Results showed that the distributions of time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) and relative residual time (RRT) in near-end segment were distinctively different from other regions of the stent which considered to promote restenosis for all three models. Spearman rank correlation analysis showed a significant correlation between hemodynamic descriptors and the stent longitudinal positions (r(TAWSS) =-0.718, r(OSI) = 0.898, r(RRT) = 0.818, p < 0.01). Histology results of the near-end segment showed neointima thickening deepened with the longitudinal positions of stent which was consistent with the numerical simulations. The results suggest that stent implantation can promote restenosis at the near-end segment. As the stenting position moves to distal end, the impact on ISR is more significant. (C) 2020 Elsevier Ltd. All rights reserved.

【 授权许可】

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