Why the study?
The study was conducted to identify and compare areas of disturbed flow and potential hemodynamic risk sites between bioresorbable vascular scaffolds and drug-eluting stents.
Does the Absorb BVS compared to Xience DES increase areas of disturbed flow and potential risk sites in an idealized coronary artery model?
Does the Absorb BVS compared to Xience DES increase areas of disturbed flow and potential risk sites in an idealized coronary artery model?
Computational fluid dynamics analysis demonstrates that bioresorbable vascular scaffolds create more disturbed flow and higher particle residence times than drug-eluting stents, correlating with increased clinical risks of thrombosis and restenosis.
Answers are grounded in this paper and cite their sources.
Does not support changing stent selection; leaves open whether flow disturbances drive BVS thrombosis risks.
A three-dimensional, transient computational fluid dynamics analysis was conducted on an idealised geometry of a coronary artery fitted with representative geometries of an Absorb bioresorbable vascular scaffold (BVS) or a Xience drug-eluting stent (DES) in order to identify and compare areas of disturbed flow and potential risk sites. A non-Newtonian viscosity model was used with a transient velocity boundary condition programmed with user-defined functions. At-risk areas were quantified in terms of several parameters linked to restenosis: wall shear stress, time-averaged wall shear stress, oscillatory shear index, particle residence time, and shear rate. Results indicated that 71% of the BVS stented surface area had time-averaged wall shear stress values under 0.4 Pa compared to 45% of the DES area. Additionally, high particle residence times were present in 23% and 8% of the BVS and DES areas, respectively, with risk areas identified as being more prominent in close proximity to crowns and link struts. These results suggest an increased risk for thrombosis and neointimal hyperplasia for the BVS compared to the DES, which is in agreement with the outcomes of clinical trials. It is intended that the results of this study may be used as a pre-clinical tool to aid in the design of bioresorbable coronary stents.
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Elliott et al. (2023) studied Coronary artery disease. Absorb bioresorbable vascular scaffold (BVS) vs. Xience drug-eluting stent (DES) was evaluated on Proportion of stented surface area with time-averaged wall shear stress under 0.4 Pa.
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