Effects of local hemodynamics and plaque characteristics on neointimal response following bioresorbable scaffolds implantation in coronary bifurcations

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  • Miao Chu, Department of Cardiology, Campo de Gibraltar Health Trust, Algeciras (Cádiz), Spain.
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  • Juan Luis Gutiérrez-Chico, Department of Cardiology, Campo de Gibraltar Health Trust, Algeciras (Cádiz), Spain.
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  • Yingguang Li, Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
  • ,
  • Emil N Holck
  • Su Zhang, School of Biomedical Engineering, Shanghai Jiao Tong University, Room 123, No. 1954, Huashan Road, Shanghai, 200030, People's Republic of China.
  • ,
  • Jiayue Huang, School of Biomedical Engineering, Shanghai Jiao Tong University, Room 123, No. 1954, Huashan Road, Shanghai, 200030, People's Republic of China.
  • ,
  • Zehang Li, School of Biomedical Engineering, Shanghai Jiao Tong University, Room 123, No. 1954, Huashan Road, Shanghai, 200030, People's Republic of China.
  • ,
  • Lianglong Chen, Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
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  • Evald H Christiansen
  • Jouke Dijkstra, Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
  • ,
  • Niels R Holm
  • Shengxian Tu, School of Biomedical Engineering, Shanghai Jiao Tong University, Room 123, No. 1954, Huashan Road, Shanghai, 200030, People's Republic of China. sxtu@sjtu.edu.cn.

Heterogeneous neointimal response has been observed after implantation of all generations of coronary stents. Our aim was assessing local factors of shear stress (SS) and plaque characteristics in neointimal response after implantation of bioresorbable scaffolds (BRS) in bifurcations. Ten patients from the BIFSORB pilot study were analysed. Follow-up optical frequency domain imaging (OFDI) was performed at 1 month and 2 years. Coronary lumen and BRS structure were reconstructed by fusion of OFDI and angiography and were used for subsequent flow simulation. Plaque arc degree and SS were quantified using post-procedural OFDI data and were matched with follow-up OFDI using anatomical landmarks. Strut-level and segment-level analysis were performed for 1-month and 2-year follow-up respectively. A total of 444 struts (54 jailing struts) were included at 1-month follow-up. Time-average SS (TASS) was significantly lower for covered struts than for uncovered struts in non-bifurcation segments (TASS: 1.81 ± 1.87 vs. 3.88 ± 3.72 Pa, p < 0.001). The trend remained the same for jailing struts, although statistically insignificant (TASS: 10.85 ± 13.12 vs. 13.64 ± 14.48 Pa, p = 0.328). For 2-year follow-up, a total of 66 sub-regions were analysed. Neointimal hyperplasia area (NTA) was negatively correlated with TASS in core-segments (ρ = - 0.389, p = 0.037) and positively correlated with plaque arc degree in non-core segments (ρ = 0.387, p = 0.018). Slightly stronger correlations with NTA were observed when combining TASS and plaque arc degree in both core segments (ρ = - 0.412, p = 0.026) and non-core segments (ρ = - 0.395, p = 0.015). Hemodynamic microenvironment and baseline plaque characteristics may regulate neointimal response after BRS implantation in bifurcation. These findings underline the combined role of plaque characteristics and local hemodynamics in vessel healing after stent implantation.

Original languageEnglish
JournalThe international journal of cardiovascular imaging
Volume36
Issue2
Pages (from-to)241-249
Number of pages9
ISSN1569-5794
DOIs
Publication statusPublished - 2020

    Research areas

  • Optical coherence tomography, Plaque arc degree, Shear stress, Stent healing

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