Related Experiment Video
Updated: Sep 21, 2026
Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section
Published on: July 19, 2016
Hemodynamic analysis of coronary circulation in angulated coronary stenosis following stenting
Byoung Kwon Lee1, Ju Yong Lee, Bum Kee Hong
1Department of Internal Medicine, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea.
Insights
Coronary stenting improves blood flow and reduces wall shear stress (WSS) in angulated stenosis. Optimizing stent placement based on angle changes may enhance vascular repair and reduce restenosis.
Area of Science:
- Cardiovascular physiology
- Biomedical engineering
- Medical imaging
Background:
- Angulated coronary stenosis poses challenges for effective stenting.
- Hemodynamic forces, including wall shear stress (WSS), are implicated in atherosclerosis progression and in-stent restenosis.
- Understanding the impact of stenting on coronary hemodynamics is crucial for optimizing patient outcomes.
Purpose of the Study:
- To evaluate the influence of flow velocity and WSS on coronary atherosclerosis in angulated stenosis.
- To assess changes in hemodynamic indices after coronary stenting.
- To investigate the effect of these hemodynamic changes on in-stent restenosis.
Main Methods:
- Utilized human in vivo hemodynamic parameters and computed simulations for qualitative and quantitative analysis.
- Performed coronary angiographies (n=60) to categorize patients into two groups based on angle change post-stenting (<50% and >50%).
- Employed intracoronary Doppler data for numerical simulations to analyze flow velocity, recirculation areas, and WSS pre- and post-stenting.
Main Results:
- Significant difference in diameter stenosis percentage between groups post-stenting (40.3% vs. 25.5%, p < 0.05).
- Negative WSS areas, associated with flow recirculation, disappeared post-stenting.
- High WSS pre-stenting normalized post-stenting, particularly in the >50% angle change group (p < 0.01).
Conclusions:
- Hemodynamic forces like WSS may influence atherosclerosis evolution in angulated coronary arteries.
- Geometric factors, specifically the angular change post-stenting, appear to define optimal rheologic conditions for vascular repair.
- Stenting effectively modifies hemodynamic forces, potentially reducing the risk of in-stent restenosis.
Abstract:
The present study in angulated coronary stenosis used human in vivo hemodynamic parameters and computed simulation, both qualitatively and qualitatively, to evaluate the influence of flow velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, and their effect on evolving in-stent restenosis. Initial and follow-up coronary angiographies in patients with angulated coronary stenosis were performed (n=60). The optimal degree of coronary stenting for angulated coronary stenosis had two models, the less than 50% angle changed group (model 1, n=33) and the more than 50% angle changed group (model 2, n=27). This angle change was based on the percentage change of vascular angle between pre- and post-intracoronary stenting. The flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of the flow-velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre- and post-intracoronary stenting was calculated from three-dimensional computer simulation. As results, follow-up coronary angiogram demonstrated significant difference in the percentage of diameter stenosis between the two groups (group 1: 40.3 +/- 30.2 vs. group 2: 25.5 +/- 22.5%, p < 0.05). Negative shear area on 3D simulation, which is consistent with the re-circulation area of flow vector, was noted on the inner wall of the post-stenotic area before stenting. The negative WSS disappeared after stenting. High spatial and temporal WSS before stenting fell within the range of physiologic WSS after stenting. This finding was more prominent in model 2 (p < 0.01). The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation, termed WSS, might affect the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric characteristics, such as the angular difference between pre- and post- intracoronary stenting might define optimal rheologic properties for vascular repair after stenting.
More Related Videos
06:39Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
13:07Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
