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Strut protrusion and shape impact on endothelial shear stress: insights from pre-clinical study comparing Mirage and Absorb bioresorbable scaffolds

Tenekecioglu, E; Sotomi, Y; Torii, R; Bourantas, C; Miyazaki, Y; Collet, C; Crake, T; ... Serruys, PW; + view all (2017) Strut protrusion and shape impact on endothelial shear stress: insights from pre-clinical study comparing Mirage and Absorb bioresorbable scaffolds. The International Journal of Cardiovascular Imaging 10.1007/s10554-017-1124-0. (In press). Green open access

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Abstract

Protrusion of scaffold struts is related with local coronary flow dynamics that can promote scaffold restenosis and thrombosis. That fact has prompted us to investigate in vivo the protrusion status of different types of scaffolds and their relationship with endothelial shear stress (ESS) distributions. Six Absorb everolimus-eluting Bioresorbable Vascular Scaffolds (Absorb, Abbott Vascular) and 11 Mirage sirolimus-eluting Bioresorbable Microfiber Scaffolds (Mirage, Manli Cardiology) were implanted in coronaries of eight mini pigs. Optical coherence tomography (OCT) was performed post-scaffold implantation and obtained images were fused with angiographic data to reconstruct the three dimensional coronary anatomy. Blood flow simulation was performed and ESS distribution was estimated for each scaffold. Protrusion distance was estimated using a dedicated software. Correlation between OCT-derived protrusion and ESS distribution was assessed for both scaffold groups. A significant difference was observed in the protrusion distances (156 ± 137 µm for Absorb, 139 ± 153 µm for Mirage; p = 0.035), whereas difference remained after adjusting the protrusion distances according to the luminal areas. Strut protrusion of Absorb is inversely correlated with ESS (r = -0.369, p < 0.0001), whereas in Mirage protrusion was positively correlated with EES (r = 0.192, p < 0.0001). Protrusion distance was higher in Absorb than in Mirage. The protrusion of the thick quadratic struts of Absorb has a tendency to lower shear stress in the close vicinity of struts. However, circular shape of the less thick struts of Mirage didn't show this trend in creating zone of recirculation around the struts. Strut geometry has different effect on the relationship between protrusion and shear stress in Absorb and Mirage scaffolds.

Type: Article
Title: Strut protrusion and shape impact on endothelial shear stress: insights from pre-clinical study comparing Mirage and Absorb bioresorbable scaffolds
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10554-017-1124-0
Publisher version: http://doi.org/10.1007/s10554-017-1124-0
Language: English
Additional information: Copyright © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Bioresorbable scaffold, Protrusion, Shear stress, Strut geometry
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/1549985
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