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Related Experiment Videos

Developing pulsatile flow in a deployed coronary stent.

Divakar Rajamohan1, Rupak K Banerjee, Lloyd H Back

  • 1Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH 45221, USA.

Journal of Biomechanical Engineering
|May 19, 2006
PubMed
Summary
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Restenosis after stent implantation is linked to neointimal formation. This study reveals that specific stent designs and flow dynamics, particularly low or negative wall shear stress downstream of struts, significantly increase restenosis risk.

Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Fluid Dynamics

Background:

  • Stent implantation can lead to restenosis, a pathological tissue growth.
  • Vessel geometry, size, and stent design influence hemodynamics, impacting restenosis.
  • Local wall shear stress (WSS) distribution is a key factor in the restenosis process.

Purpose of the Study:

  • To quantify hemodynamic parameters and WSS distributions in a deployed coronary stent.
  • To analyze the impact of these hemodynamic changes on restenosis.
  • To evaluate the effect of entrance flow in a branched coronary artery model.

Main Methods:

  • Three-dimensional computational fluid dynamics (CFD) analysis of pulsatile flow.
  • Quantification of hemodynamic parameters, including WSS distributions.

Related Experiment Videos

  • Calculation of modified oscillatory shear index (mOSI) to assess flow patterns.

    • Main Results:

    • Complex 3D WSS variations observed within the stented region.
    • High WSS (530 dyn/cm2) at cross-link intersections; low/negative WSS (-10 to 10 dyn/cm2) downstream of struts.
    • Persistent flow recirculation identified downstream of strut intersections.
    • Areas with low/negative WSS correlate with potential thrombus and platelet accumulation.

    Conclusions:

    • The immediate downstream regions of stent strut intersections are highly susceptible to restenosis.
    • High shear stress at strut intersections may promote platelet activation and emboli formation.
    • Understanding hemodynamic alterations is crucial for mitigating stent-related restenosis.