Key result
Thin-strut ArterioSorb yields ~108% higher in-scaffold endothelial shear stress than the thicker Absorb scaffold.
Why the study?
Does ArterioSorb Absorbable Drug-Eluting Scaffold improve endothelial wall shear stress distribution compared to Absorb everolimus-eluting Bioresorbable Vascular Scaffold in animal coronary arteries?
Does ArterioSorb Absorbable Drug-Eluting Scaffold improve endothelial wall shear stress distribution compared to Absorb everolimus-eluting Bioresorbable Vascular Scaffold in animal coronary arteries?
ArterioSorb, with thinner struts, is associated with a more favorable endothelial wall shear stress distribution compared to the thicker-strut Absorb scaffold in an animal model.
Thinner-strut scaffolds may favorably alter shear stress; leaves open clinical translation from this animal model.
Optical coherence tomography based computational flow dynamic (CFD) modeling provides detailed information about the local flow behavior in stented/scaffolded vessel segments. Our aim is to investigate the in-vivo effect of strut thickness and strut protrusion on endothelial wall shear stress (ESS) distribution in ArterioSorb Absorbable Drug-Eluting Scaffold (ArterioSorb) and Absorb everolimus-eluting Bioresorbable Vascular Scaffold (Absorb) devices that struts with similar morphology (quadratic structure) but different thickness. In three animals, six coronary arteries were treated with ArterioSorb. At different six animals, six coronary arteries were treated with Absorb. Following three-dimensional(3D) reconstruction of the coronary arteries, Newtonian steady flow simulation was performed and the ESS were estimated. Mixed effects models were used to compare ESS distribution in the two devices. There were 4591 struts in the analyzed 477 cross-sections in Absorb (strut thickness = 157 µm) and 3105 struts in 429 cross-sections in ArterioSorb (strut thickness = 95 µm) for the protrusion analysis. In cross-section level analysis, there was significant difference between the scaffolds in the protrusion distances. The protrusion was higher in Absorb (97% of the strut thickness) than in ArterioSorb (88% of the strut thickness). ESS was significantly higher in ArterioSorb (1.52 ± 0.34 Pa) than in Absorb (0.73 ± 2.19 Pa) (p = 0.001). Low- and very-low ESS data were seen more often in Absorb than in ArterioSorb. ArterioSorb is associated with a more favorable ESS distribution compared to the Absorb. These differences should be attributed to different strut thickness/strut protrusion that has significant effect on shear stress distribution.
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Tenekecioğlu et al. (2018) studied Healthy coronary arteries (animal model) (n=9). ArterioSorb Absorbable Drug-Eluting Scaffold vs. Absorb Bioresorbable Vascular Scaffold (157 µm strut thickness) was evaluated on In-scaffold mean endothelial shear stress (ESS) at cross-section level (Pa) (p=0.001). ArterioSorb, featuring thinner struts, resulted in significantly higher in-scaffold mean endothelial shear stress (1.52 ± 0.34 Pa) compared to the thicker-strut Absorb scaffold (0.73 ± 2.19 Pa).
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