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Role of biomechanical stresses (fluid and solid) in bifurcation stent restenosis

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Role of biomechanical stresses (fluid and solid) in bifurcation stent restenosis

European Bifurcation Club 2018 – EBC 2018 – Brussels, Belgium

COMPUTATIONAL STENTING SIMULATIONS: FROM COMPUTERS TO REAL-TIME DECISION MAKING

Role of biomechanical stresses (fluid and solid) in bifurcation stent restenosis

Author: John F. LaDisa, Jr. PhD, Marquette University and the Medical, Medical College of Wisconsin

 

CONCLUSION

  • Restenosis rates can still be suboptimal after DES implantation for certain lesions
  • Image-based computational fluid dynamics (CFD) studies show an inverse correlation between wall shear stress (WSS) and neointimal hyperplasia (NH) for BMS.
  • Prior studies have optimized stent geometry to improve WSS patterns from BMS, but for DES it is debatable as to whether optimizing WSS alone, in concert with other mechanical stimuli, translates into clinical benefits
  • Drugs on DES should mitigate WSS-based NH seen with BMS, but the effectiveness of such drugs depends on mechanical stimuli during deployment.
  • Despite substantial image-based computational modeling work in branched coronary arteries, a lack of material property and biological reaction data from coronary plaques limits the application of such models.

 

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