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J Appl Physiol (November 5, 2004). doi:10.1152/japplphysiol.00872.2004
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Submitted on August 12, 2004
Accepted on November 1, 2004

Circumferential vascular deformation after stent implantation alters wall shear stress evaluated using time-dependent 3D computational fluid dynamics models

John F LaDisa, Jr.1, Lars E Olson2, Ismail Guler3, Douglas A Hettrick1, Judy R Kersten4, David C Warltier5, and Paul S Pagel1*

1 Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
2 Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA
3 Boston Scientific Corporation, Maple Grove, Minnesota, USA
4 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
5 Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Medicine, Division of Cardiovascular Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

* To whom correspondence should be addressed. E-mail: pspagel{at}mcw.edu.

The success of vascular stents in the restoration of blood flow is limited by restenosis. Recent data generated from computational fluid dynamics (CFD) models suggest that stent geometry may cause local alterations in wall shear stress (WSS) that have been associated with neointimal hyperplasia (NH) and subsequent restenosis. However, previous CFD studies have ignored histological evidence of vascular straightening between circumferential stent struts. We tested the hypothesis that consideration of stent-induced vascular deformation may more accurately predict alterations in indices of WSS that may subsequently account for histological findings after stenting. We further tested the hypothesis that the severity of these alterations in WSS varies with the degree of vascular deformation after implantation. Steady-state and time-dependent simulations of 3D CFD arteries based on canine coronary artery measurements of diameter and blood flow were conducted, and WSS and WSS gradients were calculated. Circumferential straightening introduced areas of high WSS between stent struts that were absent in stented vessels of circular cross section. The area of vessel exposed to low WSS was dependent on the degree of circumferential vascular deformation and axial location within the stent. Stents with 4 versus 8 struts increased the intrastrut area of low WSS in vessels regardless of cross sectional geometry. Elevated WSS gradients were also observed between struts in vessels with polygonal cross sections. The results obtained using 3D CFD models suggest that changes in vascular geometry after stent implantation are important determinants of WSS distributions that may be associated with subsequent NH.




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Am. J. Physiol. Heart Circ. Physiol.Home page
J. F. LaDisa Jr., Lars. E. Olson, R. C. Molthen, D. A. Hettrick, P. F. Pratt, M. D. Hardel, J. R. Kersten, D. C. Warltier, and P. S. Pagel
Alterations in wall shear stress predict sites of neointimal hyperplasia after stent implantation in rabbit iliac arteries
Am J Physiol Heart Circ Physiol, May 1, 2005; 288(5): H2465 - H2475.
[Abstract] [Full Text] [PDF]




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