Relationship between neointimal thickness and shear stress after Wallstent implantation in human coronary arteries.
Circulation
; 103(13): 1740-5, 2001 Apr 03.
Article
in En
| MEDLINE
| ID: mdl-11282904
ABSTRACT
BACKGROUND:
In-stent restenosis by excessive intimal hyperplasia reduces the long-term clinical efficacy of coronary stents. Because shear stress (SS) is related to plaque growth in atherosclerosis, we investigated whether variations in SS distribution are related to variations in neointima formation. METHODS ANDRESULTS:
In 14 patients, at 6-month follow-up after coronary Wallstent implantation, 3D stent and vessel reconstruction was performed with a combined angiographic and intravascular ultrasound technique (ANGUS). The bare stent reconstruction was used to calculate in-stent SS at implantation, applying computational fluid dynamics. The flow was selected to deliver an average SS of 1.5 N/m(2). SS and neointimal thickness (Th) values were obtained with a resolution of 90 degrees in the circumferential and 2.5 mm in the longitudinal direction. For each vessel, the relationship between Th and SS was obtained by linear regression analysis. Averaging the individual slopes and intercepts of the regression lines summarized the overall relationship. Average Th was 0.44+/-0.20 mm. Th was inversely related to SS Th=(0.59+/-0.24)-(0.08+/-0.10)xSS (mm) (P<0.05).CONCLUSIONS:
These data show for the first time in vivo that the Th variations in Wallstents at 6-month follow-up are inversely related to the relative SS distribution. These findings support a hemodynamic mechanism underlying in-stent neointimal hyperplasia formation.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Stents
/
Tunica Intima
/
Coronary Vessels
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Circulation
Year:
2001
Document type:
Article
Affiliation country:
Netherlands