Local Flow Patterns After Implantation of Bioresorbable Vascular Scaffold in Coronary Bifurcations　― Novel Findings by Computational Fluid Dynamics

• Published in: Circulation Journal 2018/05/25, Vol.82(6), pp.1575-1583
• Main Authors: Li, Yingguang, Li, Zehang, Holck, Emil N., Xu, Bo, Karanasos, Antonios, Fei, Zhenyu, Chang, Yunxiao, Chu, Miao, Dijkstra, Jouke, Christiansen, Evald H., Reiber, Johan H. C., Holm, Niels R., Tu, Shengxian
• Format: Article
• Language: English
• Subjects: Absorbable Implants; Aged; Bifurcation; Computational fluid dynamics; Coronary Angiography - methods; Coronary Vessels - surgery; Female; Fractional flow reserve; Fractional Flow Reserve, Myocardial; Hemodynamics; Humans; Male; Middle Aged; Models, Cardiovascular; Shear stress; Stents; Stress, Mechanical; Tissue Scaffolds; Tomography, Optical Coherence - methods; Wound Healing
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-17-1332

Background:Development of methods for accurate reconstruction of bioresorbable scaffolds (BRS) and assessing local hemodynamics is crucial for investigation of vascular healing after BRS implantation.Methods and Results:Patients with BRS that crossed over in a coronary bifurcation were included for analysis. Reconstructions of the coronary lumen and BRS were performed by fusion of optical coherence tomography and coronary angiography generating a tree model (TM) and a hybrid model with BRS (TM-BRS). A virtual BRS model with thinner struts was created and all 3 models were analyzed using computational fluid dynamics to derive: (1) time-average shear stress (TASS), (2) TASS gradient (TASSG), which represents SS heterogeneity, and (3) fractional flow reserve (FFR). Reconstruction of the BRS was successful in all 10 patients. TASS and TASSG were both higher by TM-BRS than by TM in main vessels (difference 0.27±4.30 Pa and 10.18±27.28 Pa/mm, P