Development of a novel method for detailed evaluation of blood flow patterns in stented segments and assessment of their role in stent thrombosis

今天，支架被用来治疗心绞痛或心脏病发作患者的心脏血管阻塞。在大多数患者中，支架治疗是有效的，并改善了症状和预期寿命。然而，有一小部分患者支架失败并堵塞，导致死亡或严重心脏病发作。在动物身上的研究表明，支架植入后的血流模式可以预测支架有堵塞的风险。然而，关于血流在人类支架阻塞中的作用的数据缺乏。这是因为很难建立已经用支架治疗过的心脏血管的模型。本研究旨在解决这一问题。我们将分析心脏血管的图像，这些图像是通过在这些血管中推进的电线拍摄的。在这些图像中，我们可以看到血管壁和支架的细节。我们将使用这些图像来创建支架治疗的血管模型，使用我们开发的一种新方法，然后我们将模拟这些模型中的血液流动，以评估血流模式。我们将在120名患者中进行大规模的研究，其中40名患者因支架堵塞而心脏病发作。然后，我们将比较堵塞并导致心脏病发作的支架中的血流模式，以及接受支架治疗但未导致事件的血管中的血流模式。我们相信，这项研究将使我们能够确定可能导致支架堵塞的血流模式。这一信息很重要，因为它将帮助我们改进未来支架的设计，以及我们放置支架的方式，以降低支架堵塞和未来心脏病发作的风险。

Stents are used today to treat the blockages of the vessels of the heart in patients who have angina or suffered a heart attack. In most of these patients, stent treatment is effective and improves symptoms and life expectancy. However, there is a small proportion of patients where the stents fail and block, causing either death or a major heart attack. Studies in animals have shown that the blood flow patterns following stent implantation can predict stents that are at risk to block. However, there is lack of data about the role of blood flow on stent blockage in humans. This is because it is very difficult to create models of the vessels of the heart that have been treated with stents. This study aims to address this problem. We will analyse images of the vessels of the heart taken by a wire that is advanced in these vessels. In these images we can see details of the vessel wall and of the stent. We will use these images to create models of the vessels treated with stents using a new method that we have developed and then we will simulate blood flow in these models to assess the flow patterns. We will do that at scale in 120 patients of whom 40 had a heart attack because of a blocked stent. We will then compare the flow patterns in stents that blocked and caused a heart attack and in vessels treated with stents that did not cause an event. We believe that this research will allow us to identify the flow patterns that can cause stent blockage. This information is important as it will help us to improve the design of future stents and also the way that we put stents so as to reduce the risk of stent blockage and future heart attacks.