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，支架用于治疗心绞痛或心脏病发作患者的心脏血管阻塞。在大多数这些患者中，支架治疗是有效的，可以改善症状和预期寿命。然而，也有一小部分患者的支架失败和阻塞，导致死亡或严重的心脏病发作。动物研究表明，支架植入后的血流模式可以预测支架是否有堵塞的风险。然而，缺乏关于血流对人体支架阻塞的作用的数据。这是因为很难创建已经用支架治疗的心脏血管的模型。本研究旨在解决这一问题。我们将分析心脏血管的图像，这些图像是由在这些血管中推进的导丝拍摄的。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使用我们开发的新方法进行支架治疗的血管模型，然后我们将在这些模型中模拟血流以评估流动模式。我们将在120名患者中进行大规模研究，其中40名患者因支架堵塞而心脏病发作。然后，我们将比较阻塞并导致心脏病发作的支架和未导致心脏病发作的支架治疗血管中的血流模式。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流动模式。这些信息很重要，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.