Key result
Simulated partial bioresorbable scaffold resorption increases wall shear stress by up to ~142%.
Why the study?
Three-dimensional design simulations of coronary metallic stents have become important for understanding biomechanical properties and device-tissue interactions, but similar hemodynamic analyses for bioresorbable scaffolds during resorption are lacking.
Computational fluid dynamics simulations reveal that wall shear stress dynamics change significantly as bioresorbable scaffolds undergo resorption, providing insights for future device design.
Answers are grounded in this paper and cite their sources.
WSS changes during BRS resorption merit preclinical validation; leaves open optimal design parameters for clinical translation.
BACKGROUND: Three-dimensional design simulations of coronary metallic stents utilizing mathematical and computational algorithms have emerged as important tools for understanding biomechanical stent properties, predicting the interaction of the implanted platform with the adjacent tissue, and informing stent design enhancements. Herein, we demonstrate the hemodynamic implications following virtual implantation of bioresorbable scaffolds using finite element methods and advanced computational fluid dynamics (CFD) simulations to visualize the device-flow interaction immediately after implantation and following scaffold resorption over time. METHODS AND RESULTS: CFD simulations with time averaged wall shear stress (WSS) quantification following virtual bioresorbable scaffold deployment in idealized straight and curved geometries were performed. WSS was calculated at the inflow, endoluminal surface (top surface of the strut), and outflow of each strut surface post-procedure (stage I) and at a time point when 33% of scaffold resorption has occurred (stage II). The average WSS at stage I over the inflow and outflow surfaces was 3.2 and 3.1 dynes/cm(2) respectively and 87.5 dynes/cm(2) over endoluminal strut surface in the straight vessel. From stage I to stage II, WSS increased by 100% and 142% over the inflow and outflow surfaces, respectively, and decreased by 27% over the endoluminal strut surface. In a curved vessel, WSS change became more evident in the inner curvature with an increase of 63% over the inflow and 66% over the outflow strut surfaces. Similar analysis at the proximal and distal edges demonstrated a large increase of 486% at the lateral outflow surface of the proximal scaffold edge. CONCLUSIONS: The implementation of CFD simulations over virtually deployed bioresorbable scaffolds demonstrates the transient nature of device/flow interactions as the bioresorption process progresses over time. Such hemodynamic device modeling is expected to guide future bioresorbable scaffold design.
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Gogas et al. (2014) studied Coronary artery disease. Virtual implantation of bioresorbable scaffolds was evaluated on Time averaged wall shear stress (WSS). CFD simulations of virtually deployed bioresorbable scaffolds demonstrated that wall shear stress increased by 100% and 142% over inflow and outflow surfaces as scaffold resorption progressed to 33%.
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