Influence of catheter insertion on the hemodynamic environment in coronary arteries
Xiaopeng Tian1, Anqiang Sun1, Xiao Liu1
1Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, International Joint Research Center of Aerospace Biotechnology & Medical Engineering, Ministry of Science and Technology, School of Biological Science and Medical Engineering, Beihang University, 100191 Beijing, China.
Insights
Catheter insertion during intravascular stenting significantly alters coronary artery blood flow, increasing wall shear stress (WSS) and potentially raising risks for thrombosis and restenosis. These hemodynamic changes may increase vulnerability to perioperative complications.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Hemodynamics
Background:
- Intravascular stenting is a common procedure to restore blood flow, but perioperative complications like thrombosis and restenosis persist.
- Catheter insertion during stenting disrupts normal blood flow dynamics within coronary arteries.
Purpose of the Study:
- To investigate the hemodynamic disturbances caused by catheter insertion during intravascular stenting.
- To determine if these disturbances contribute to perioperative complications.
Main Methods:
- A realistic 3D model of the left coronary artery was created.
- Blood flow patterns were simulated numerically at seven stages of catheter insertion.
Main Results:
- Catheter insertion significantly increased wall shear stress (WSS) and velocity in the left anterior descending (LAD) artery.
- High WSS was observed on the catheter itself, particularly at its tip.
- Endothelial cells in the LAD were exposed to elevated WSS, increasing the risk of platelet aggregation.
Conclusions:
- Catheter-induced hemodynamic changes, including elevated WSS, may increase the vulnerability of coronary arteries to perioperative complications.
- Understanding these hemodynamic effects is crucial for mitigating risks associated with intravascular stenting.
Abstract:
Intravascular stenting is one of the most commonly used treatments to restore the vascular lumen and flow conditions, while perioperative complications such as thrombosis and restenosis are still nagging for patients. As the catheter with crimped stent and folded balloon is directly advanced through coronary artery during surgery, it is destined to cause interference as well as obstructive effect on blood flow. We wonder how the hemodynamic environment would be disturbed and weather these disturbances cause susceptible factors for those complications. Therefore, a realistic three-dimensional model of left coronary artery was reconstructed and blood flow patterns were numerically simulated at seven different stages in the catheter insertion process. The results revealed that the wall shear stress (WSS) and velocity in left anterior descending (LAD) were both significantly increased after catheter inserted into LAD. Besides, the WSS on the catheter, especially at the ending of the catheter, was also at high level. Compared with the condition before catheter inserted, the endothelial cells of LAD was exposed to high-WSS condition and the risk of platelet aggregation in blood flow was increased. These influences may make coronary arteries more vulnerable for perioperative complications.
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