Related Experiment Video
Updated: May 6, 2026
Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research
Published on: October 20, 2023
Temporal correlation between wall shear stress and in-stent stenosis after Wingspan stent in swine model
M Fujimoto1, H Takao2, T Suzuki3
1From the Division of Interventional Neuroradiology (M.F., H.T., Y.S., F.M., S.T., Y.M., F.V.), Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California moto.fujimo@gmail.com.
Insights
Physiologic wall shear stress influences in-stent stenosis after intracranial stent placement. Low shear stress correlates with stenosis growth, while high shear stress is linked to stenosis regression.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Medical Device Technology
Background:
- Intracranial atherosclerosis treatment trials have faced challenges, necessitating a deeper understanding of stent-related complications.
- The relationship between blood flow dynamics and biological responses after intracranial stent placement requires further investigation.
Purpose of the Study:
- To investigate the role of wall shear stress in the development and regression of in-stent stenosis.
- To analyze the correlation between temporal changes in wall shear stress and in-stent stenosis in a preclinical model.
Main Methods:
- Deployment of five Wingspan stents in swine ascending pharyngeal arteries.
- Evaluation of temporal wall shear stress and in-stent stenosis at multiple time points post-stenting.
- Correlation analysis between wall shear stress patterns and in-stent stenosis progression/regression.
Main Results:
- In-stent stenosis peaked at nearly 40% by day 14, with subsequent decrease by day 28.
- Wall shear stress patterns exhibited a time-dependent characteristic correlating with stenosis changes.
- Significant correlation found between early low wall shear stress and stenosis growth, and between later high wall shear stress and stenosis regression.
Conclusions:
- Physiologic wall shear stress plays a critical role in controlling the biphasic changes of in-stent stenosis.
- Findings suggest wall shear stress as a potential factor influencing outcomes in intracranial stenting.
Background And Purpose:
A recent randomized clinical trial on intracranial atherosclerosis was discontinued because of the higher frequency of stroke and death in the angioplasty and stent placement group than in the medical treatment group. An in-depth understanding of the relationship between biologic responses and flow dynamics is still required to identify the current limitations of intracranial stent placement.
Materials And Methods:
Five Wingspan stents were deployed in tapered swine ascending pharyngeal arteries. Temporal wall shear stress distributions and in-stent stenosis were evaluated at days 0, 7, 14, and 28 after stent placement. The physiologic role of wall shear stress was analyzed regarding its correlation with in-stent stenosis.
Results:
In-stent stenosis reached a peak of nearly 40% at day 14 and decreased mainly at the distal stent segment until day 28. The wall shear stress demonstrated a characteristic pattern with time on the basis of the in-stent stenosis change. The wall shear stress gradient increased from the proximal to distal segment until day 14. At day 28, the trend was reversed dramatically, decreasing from the proximal to the distal segment. A significant correlation between the in-stent stenosis growth until day 14 and low wall shear stress values just after stent placement was detected. In-stent stenosis regression between days 14 and 28 was also associated with the high wall shear stress values at day 14.
Conclusions:
These data suggest that the physiologic wall shear stress can control the biphasic in-stent stenosis change in tapered arteries.
