You are currently viewing Impact of bifurcation stenting on Endothelial Shear Stress

Impact of bifurcation stenting on Endothelial Shear Stress

Impact of bifurcation stenting on Endothelial Shear Stress

European Bifurcation Club 2014 – EBC 2014 – Bordeaux, France

Bifurcation stenting: learning from bench and simulation

Impact of bifurcation stenting on Endothelial Shear Stress

Author: Ghassan Kassab, MD, California Medical Innovations Ins1tute, San Diego, CA, USA

 

INTRODUCTION

  • Despite advances in percutaneus coronary interventions and the introduction of drug eluding stents (DES), in-stent restenosis and stent thrombosis remain a clinically significant problem for bifurcations.
  • The purpose of this study is to determine the effect of dual bifurcation stenting on hemodynamic parameters known to influence restenosis and thrombosis.
  • We hypothesized that double sten<ng, especially with a longer (e.g., 30% longer than lesion) SB stent has a negative effect on wall shear stress (WSS), wall shear stress gradient (WSSG), and oscillatory shear index (OSI).

METHODS

  • To test this hypothesis, we developed computational models of dual stents at bifurcations and non- Newtonian blood simulations.
  • The models were then interfaced, meshed and solved in a validated finite element package.
  • The blood was modeled with flow waveform based on human leT coronary artery pulsatile velocity measurements applied at the inlet of vessel.

CONCLUSION

  • Stenting of SB can produce comparable endothelialmhemodynamic parameters as provisional stenting for the shorter SB stent.
  • A longer SB stent induces worst endothelial hemodynamic parameters than a shorter stent.
  • Undersized stents exaggerate the negative endothelial hemodynamic effects of SB stenting.

 

Download here

Leave a Reply