Abstract
Hemodynamic factors such as low wall shear stress have been shown to influence endothelial healing and atherogenesis in stent-free vessels. However, in stented vessels, a reliable quantitative analysis of such relations has not been possible due to the lack of a suitable method for the accurate acquisition of blood flow. The objective of this work was to develop a method for the precise reconstruction of hemodynamics and quantification of wall shear stress in stented vessels. We have developed such a method that can be applied to vessels stented in or ex vivo and processed ex vivo. Here we stented the coronary arteries of ex vivo porcine hearts, performed vascular corrosion casting, acquired the vessel geometry using micro-computed tomography and reconstructed blood flow and shear stress using computational fluid dynamics. The method yields accurate local flow information through anatomic fidelity, capturing in detail the stent geometry, arterial tissue prolapse, radial and axial arterial deformation as well as strut malapposition. This novel compound method may serve as a unique tool for spatially resolved analysis of the relationship between hemodynamic factors and vascular biology. It can further be employed to optimize stent design and stenting strategies.
Highlights
Atherosclerosis is the leading cause of death in most developed countries, predominantly as a result of myocardial infarction due to coronary heart disease (CHD)
We will further show how this method yields detailed blood flow fields and wall shear stress maps in stented coronary arteries, noting that it can be used in ex vivo human arteries with minimal change to the protocol
[48] in coronary arteries can lead in conjunction with the elasticity of the vessel wall to tissue prolapse [49,50]
Summary
Atherosclerosis is the leading cause of death in most developed countries, predominantly as a result of myocardial infarction due to coronary heart disease (CHD). CHD is characterized by progressive atherosclerotic plaques that narrow (stenose) the coronary artery lumen, thereby reducing blood flow to the myocardium. Expedient endothelial regeneration reduces NIH [8,9], and endothelial regeneration itself is influenced by blood flow. The required level of precision can currently not be achieved clinically using phase-contrast magnetic resonance imaging (PC-MRI) [12], Doppler ultrasound, or other flow measurement techniques [13215. For this reason, flow field reconstruction using computational fluid dynamics (CFD) based on medical image data has become the state-of-the-art for determining WSS in stent-free vessels [11,16,17,18,19]
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