Key result
Closed-cell stents create slightly more low wall shear stress than open-cell stents, suggesting higher ISR risk.
Why the study?
Previous clinical studies showed restenosis after carotid and coronary stenting varies with stent design and deployment configuration, but how stent design affects in-stent hemodynamics remains unclear.
Does open-cell stent design improve local hemodynamic factors associated with in-stent restenosis compared to closed-cell stent design in a patient-specific carotid artery model?
Population
Patient-specific carotid artery reconstructed from medical images
Comparison
Two closed-cell stent designs vs one open-cell stent design
Design
Computational fluid dynamics simulation study
Authors
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Should not yet influence carotid stent selection; hypothesis-generating for cell design effects on restenosis risk.
Does open-cell stent design improve local hemodynamic factors associated with in-stent restenosis compared to closed-cell stent design in a patient-specific carotid artery model?
Absolute Event Rate: 28.29% vs 22.75%
Computational fluid dynamics suggest that closed-cell carotid stents may induce more atheroprone and procoagulant hemodynamic conditions than open-cell stents, potentially increasing the risk of in-stent restenosis.
Johari et al. (2020) studied Carotid artery stenosis (n=1). Closed-cell stents (Wallstent, XACT) vs. Open-cell stent (ACCULINK) was evaluated on Percentage area of low Time-Averaged Wall Shear Stress (TAWSS <0.4 Pa). Computational fluid dynamics simulations demonstrated that closed-cell stents created slightly larger areas of low wall shear stress compared to an open-cell stent, suggesting a potentially higher risk for in-stent restenosis.
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