Effects of residual stenosis on carotid artery after stent implantation: a numerical study
Effects of residual stenosis on carotid artery after stent implantation: a numerical study
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DOI：
10.1016/j.medntd.2021.100105
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发表时间：
2021-12
影响因子：
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通讯作者：
Zhenmin Fan;Lijun Dong;Xiao Liu;Yingying Zhang;Nannan Zhang;Xia Ye;Xiaoyan Deng
中科院分区：
文献类型：
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作者：
Zhenmin Fan;Lijun Dong;Xiao Liu;Yingying Zhang;Nannan Zhang;Xia Ye;Xiaoyan Deng
具有残余狭窄（RS）的支架部署与支架内再狭窄和血栓形成的风险增加有关。目前工作的目的是探索 RS 不良事件的潜在生物力学机制。构建具有 RS 的患者特异性颈动脉模型，以研究宿主动脉支架植入后的壁剪切应力 (WSS)、速度、相对停留时间 (RRT) 和振荡剪切指数 (OSI)。结果显示，支架动脉伴RS会导致狭窄喉部出现明显的涡流、停滞和再循环区，其中较多区域TAWSS异常低、RRT和OSI异常高。此外，重度RS、长支架和颈总动脉(CCA)支架置入术会显着增强RS支架置入术对宿主动脉速度、WSS、RRT和OSI的影响。这些结果表明，RS支架置入可能会加剧支架周围和未置入支架的其他区域的不良血流，导致临床不良事件增加。因此，为了获得更好的支架术后效果，RS支架植入需要谨慎和仔细考虑，特别是对于RS严重、支架较长和某些部位支架的宿主动脉。
Stent deployments with residual stenosis (RS) were linked to increased risk of in-stent restenosis and thrombosis. The objective of the present work was to explore the underlying biomechanical mechanism(s) for adverse events with RS. The patient-specific carotid models with RS were constructed to investigate wall shear stress (WSS), velocity, relative residence time (RRT), and oscillating shear index (OSI) after stenting in the host artery. The results showed that stented artery accompanied by RS would result in evident vortex, stagnation and recirculation zone at the stenosis throat, where relatively more areas were at abnormal low level of TAWSS, high level of RRT and OSI. Moreover, effects of stenting with RS on velocity, WSS, RRT and OSI in host artery would be significantly enhanced by severe RS, long stent and common carotid artery (CCA) stenting. These results indicated that stenting with RS might aggravate adverse flow around the stent and the other region without stent, leading to increased adverse events in clinic. Therefore, to obtain better poststenting outcomes, stenting with RS requires caution and careful consideration, especially for the host artery with a severe RS, long stent and some locations of stenting.