Progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans as a function of endothelial shear stress: An In-Vivosix-month follow-up study

Stone, Peter H.; Yeghiazarians, Yerem; Coskun, Ahmet U.; Kinlay, Scott; Clark, Maureen; Sonka, Milan; Wahle, Andreas; Ilegbusi, Olusegun J.; Popma, Jeffrey J.; Orav, John; Kuntz, Richard E.; Feldman, Charles L.

doi:10.1016/s0735-1097(03)82267-2

Cited by 95 publications

(144 citation statements)

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“…Overall, the performed IVUS image segmentation has a demonstrated reproducibility. 5,29 The inter-test correlation coefficients for 10 repeatedly imaged and independently analyzed human coronary arteries for the two measurements of lumen radius, external elastic lamina radius, plaque thickness, and endothelial shear stress were = 0.96, 0.96, 0.94, and 0.91, respectively (all p-values <0.0001). 5 Although the inclusion or exclusion of individual features is indeed affecting the WSS outcomes, the human expertise that is employed in the analyses represents the best available segmentation outcome.…”

Section: Discussionmentioning

confidence: 99%

Fluid Dynamic Analysis in a Human Left Anterior Descending Coronary Artery with Arterial Motion

et al. 2004

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A computational fluid dynamic (CFD) analysis is pre sented to describe local flow dynamics in both 3-D spatial and 4-D spatial and temporal domains from reconstructions of intravascular ultrasound (IVUS) and bi-plane angiographic fusion images. A left anterior descending (LAD) coronary artery segment geometry was accurately reconstructed and subsequently its motion was incorporated into the CFD model. The results indicate that the incorporation of motion had appreciable effects on blood flow patterns. The velocity profiles in the region of a stenosis and the circumferential distribution of the axial wall shear stress (WSS) patterns in the vessel are altered with the wall motion introduced in the simulation. The time-averaged axial WSS between simulations of steady flow and unsteady flow without arterial motion were comparable (-0.3 to 13.7 Pa in unsteady flow versus -0.2 to 10.1 Pa in steady flow) while the magnitudes decreased when motion was introduced (0.3-4.5 Pa). The arterial wall motion affects the time-mean WSS and the oscillatory shear index in the coronary vessel fluid dynamics and may provide more realistic predictions on the progression of atherosclerotic disease.

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Section: Discussionmentioning

confidence: 99%

Fluid Dynamic Analysis in a Human Left Anterior Descending Coronary Artery with Arterial Motion

et al. 2004

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“…4 Alternatively, and also as a consequence of templatebased mapping, one may consider the histogram of a particular hemodynamic quantity as a means of converting continuous spatial distributions into categorical ones. This approach was used by Stone et al 138 to demonstrate an association between regions exposed to low shear at baseline and wall remodeling at six-month follow-up, and by Friedman et al 42 to anticipate regions of porcine iliac arteries consistently exposed to low, medium or high shear. More recently, Lee et al 85 proposed the quantification of an individual vessel's ''burden'' of disturbed flow as its surface area exposed to a given hemodynamic parameter beyond a threshold value objectively defined from the statistics of the group.…”

Section: Extracting Hemodynamic Parametersmentioning

confidence: 99%

Image-Based Modeling of Blood Flow and Vessel Wall Dynamics: Applications, Methods and Future Directions

2010

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The objective of our session at the 2008 International Bio-Fluid Symposium and Workshop was to review the state-of-the-art in image-based modeling of blood flow, and identify future directions. Here we summarize progress in the field of image-based modeling of blood flow and vessel wall dynamics from mid-2005 to early 2009. We first describe the tremendous progress made in the application of image-based modeling techniques to elucidate the role of hemodynamics in vascular pathophysiology, plan treatments for congenital and acquired diseases in individual patients, and design and evaluate endovascular devices. We then review the advances that have been made in improving the methodology for modeling blood flow and vessel wall dynamics in image-based models, and consider issues related to extracting hemodynamic parameters and verification and validation. Finally, the strengths and weaknesses of current work in image-based modeling and the opportunities and threats to the field are described. We believe that with a doubling of our efforts toward the clinical application of image-based modeling tools, the next few years could surpass the tremendous gains made in the last few.

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“…14 In particular, changes in the fluid environment have been correlated with regions of neo-intimal formation, vascular remodeling, restenosis, and thrombosis. 32,51,52,56 Based on this result, it is reasonable to suspect that these clinical trends can be explained in part by alteration in wall shear stress levels as a result of differing stent design and implantation configurations, although the exact biochemical and hemodynamic pathways by which this occurs remain unclear and no one-to-one correspondence linking particular values of WSS or other hemodynamic parameters to a given patient outcome exists.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Comparison of the Effect of Stent Configuration on Wall Shear Stress Using Time-resolved Particle Image Velocimetry

et al. 2010

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Time resolved particle image velocimetry was used to measure wall shear stress (WSS) and oscillatory shear index (OSI) within a 3.0 mm diameter compliant vessel model implanted with an Abbott Vascular XIENCE V stent in five configurations: baseline, over-expanded, increased vessel diameter, two overlapped stents, and increased stent length. Flow through unstented vessels was also tested for comparison. Flow conditions featured a realistic coronary pressure-flow offset and reversal at average flow rates corresponding to resting (Re=160, f=70 bpm) and exercise conditions (Re=300, f=120 bpm). Comparisons revealed that the WSS was similar for all cases behind the first strut and downstream of the device, indicating that changes in configuration have little effect downstream. However, there were notable differences within each stent revealing reduced WSS values for all cases due to the stent-imposed expansion of the vessel wall (0.20-9.29 dynes/cm2 for Re=160 and d=3.0 mm). Over-expanding the stent with a second balloon affected the alignment of the stent geometry, and led to higher WSS at the inlet and lower values at mid-stent. The overlapped stents showed disturbed flow and a WSS deficit region downstream of the overlapped region. Analysis of the longer stent showed that the WSS within the vessel recovers with distance. An overall correlation was noted between decreased WSS values and elevated OSI. Results of this study are important because decreased WSS has been implicated in endothelial cell changes and increased restenosis, and clinical research has shown that a link exists between deployment configurations and negative patient outcomes.

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Progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans as a function of endothelial shear stress: An In-Vivosix-month follow-up study

Cited by 95 publications

References 0 publications

Fluid Dynamic Analysis in a Human Left Anterior Descending Coronary Artery with Arterial Motion

Fluid Dynamic Analysis in a Human Left Anterior Descending Coronary Artery with Arterial Motion

Image-Based Modeling of Blood Flow and Vessel Wall Dynamics: Applications, Methods and Future Directions

In Vitro Comparison of the Effect of Stent Configuration on Wall Shear Stress Using Time-resolved Particle Image Velocimetry

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