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Assessment of the hemodynamic characteristics of Absorb BVS in a porcine coronary artery model

Tenekecioglu, E; Torii, R; Bourantas, C; Abdelghani, M; Cavalcante, R; Sotomi, Y; Crake, T; ... Serruys, PW; + view all (2017) Assessment of the hemodynamic characteristics of Absorb BVS in a porcine coronary artery model. International Journal of Cardiology , 227 pp. 467-473. 10.1016/j.ijcard.2016.11.005. Green open access

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Abstract

BACKGROUND AND AIM: Local hemodynamic changes are one of the main factors that determine the vessel wall biological response after stent/scaffold implantation. Computational fluid dynamic studies provide an opportunity to investigate the rheological effects of implanted stent/scaffold. The aim of this study was to assess the local hemodynamic microenvironment in scaffolded segments in porcine coronary models. METHODS: In six epicardial coronary arteries of healthy mini-pigs, six Absorb bioresorbable vascular scaffolds (Absorb BVS) were implanted. Optical coherence tomography(OCT) was performed after scaffold implantation and the images were fused with the angiographic data to reconstruct the three-dimensional coronary artery anatomy. Blood flow simulations were performed, and endothelial shear stress(ESS) distribution was estimated for each scaffolded segment. In a linear mixed-effect model, the contributing factors for low (< 1.0 Pa) ESS levels were assessed. At 30-day post-implantation, histopathological assessment was performed at 2 scaffolds. RESULTS: In scaffolded segments, the median ESS was 0.57 (IQR: 0.29–0.99) Pa. In linear mixed-effect analysis, cross-section area was associated with low shear stress levels. In scaffolded segments, the percentage of the recirculation zone per scaffolded luminal surface was 3.26 ± 2.07%. At 30-day histopathological assessment of implanted vessel segments revealed minimal injury score, minimal neointimal inflammation and minimal adventitial inflammation scores with moderate endothelial coverage. Fibrin accumulation was seen at 95.69 ± 2.47% of the struts. CONCLUSION: The thick rectangular strut design of the Absorb BVS incited flow disruptions with low shear stress inducing fibrin accumulation. CFD assessment can be used to guide improvements in the scaffold design for a more “hemo-compatible” geometry.

Type: Article
Title: Assessment of the hemodynamic characteristics of Absorb BVS in a porcine coronary artery model
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ijcard.2016.11.005
Publisher version: http://doi.org/10.1016/j.ijcard.2016.11.005
Language: English
Additional information: © 2016 Elsevier Ireland Ltd. All rights reserved. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Endothelial shear stress, Bioresorbable scaffold, Computational fluid dynamic, ENDOTHELIAL SHEAR-STRESS, BIORESORBABLE VASCULAR SCAFFOLD, STENT RESTENOSIS, IMPLANTATION, THROMBOSIS, PATTERNS, FLOW, DIFFERENTIATION, DYNAMICS, DESIGN
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/1529032
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