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Dynamic Changes of 3D Bending Angle Through the Cardiac Cycle: Implications With Bioresorbable Scaffold Performance
Simone Fezzi1, Jiayue Huang2, Paolo Alberto Del Sole3
1Division of Cardiology, Department of Medicine, Verona University Hospital, Verona, Italy; The Lambe Institute for Translational Medicine, Smart Sensors Laboratory and Curam, National University of Ireland, Galway, Ireland.
Greater changes in coronary artery bending after bioresorbable scaffold implantation predict higher long-term risk of target-vessel failure. Restoring baseline biomechanics after scaffold resorption is key for patient outcomes.
Area of Science:
- Cardiovascular research
- Medical device technology
- Biomedical engineering
Background:
- Predictors of adverse events after bioresorbable scaffold (BRS) percutaneous coronary intervention (PCI) are known.
- The impact of vessel biomechanical properties on BRS outcomes requires further investigation.
Purpose of the Study:
- To evaluate changes in coronary artery biomechanics, specifically maximum bending angle (BAmax), after BRS implantation.
- To determine the relationship between these biomechanical changes and the long-term incidence of target-vessel failure (TVF).
Main Methods:
- Three-dimensional BAmax was calculated at end-diastole and end-systole, pre- and post-BRS implantation.
- Cardiac motion-induced angulation change (ΔcBAmax) and scaffold-induced angulation changes were computed.
- Long-term TVF incidence was assessed in relation to pre- and post-implantation biomechanics.
Main Results:
- BRS implantation reduced BAmax in both diastole and systole.
- Vessels with higher baseline BAmax and ΔcBAmax were associated with increased TVF risk.
- Greater scaffold-induced changes in ΔcBAmax independently predicted TVF (aHR 1.65 per 10° increase).
Conclusions:
- PCI with BRS alters coronary artery biomechanics, decreasing BAmax changes during the cardiac cycle.
- The magnitude of scaffold-induced biomechanical change is a significant predictor of long-term TVF.
- Coronary artery biomechanics largely restored after BRS resorption.
