Flow disturbances in stent-related coronary evaginations: a computational fluid-dynamic simulation study

Radu, Maria D.; Pfenniger, Aloïs; Räber, Lorenz; de Marchi, Stefano F.; Obrist, Dominik; Kelbæk, Henning; Windecker, Stephan; Serruys, Patrick W.; Vogel, Rolf (2014). Flow disturbances in stent-related coronary evaginations: a computational fluid-dynamic simulation study. EuroIntervention, 10(1), pp. 113-123. Europa Digital & Publishing 10.4244/EIJV10I1A18

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Aims: Angiographic ectasias and aneurysms in stented segments have been associated with late stent thrombosis. Using optical coherence tomography (OCT), some stented segments show coronary evaginations reminiscent of ectasias. The purpose of this study was to explore, using computational fluid-dynamic (CFD) simulations, whether OCT-detected coronary evaginations can induce local changes in blood flow. Methods and results: OCT-detected evaginations are defined as outward bulges in the luminal vessel contour between struts, with the depth of the bulge exceeding the actual strut thickness. Evaginations can be characterised cross ectionally by depth and along the stented segment by total length. Assuming an ellipsoid shape, we modelled 3-D evaginations with different sizes by varying the depth from 0.2-1.0 mm, and the length from 1-9 mm. For the flow simulation we used average flow velocity data from non-diseased coronary arteries. The change in flow with varying evagination sizes was assessed using a particle tracing test where the particle transit time within the segment with evagination was compared with that of a control vessel. The presence of the evagination caused a delayed particle transit time which increased with the evagination size. The change in flow consisted locally of recirculation within the evagination, as well as flow deceleration due to a larger lumen - seen as a deflection of flow towards the evagination. Conclusions: CFD simulation of 3-D evaginations and blood flow suggests that evaginations affect flow locally, with a flow disturbance that increases with increasing evagination size.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)
UniBE Contributor:	Pfenniger, Aloïs, Räber, Lorenz, De Marchi, Stefano, Obrist, Dominik, Windecker, Stephan, Vogel, Rolf
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1774-024X
Publisher:	Europa Digital & Publishing
Language:	English
Submitter:	Judith Liniger
Date Deposited:	24 Mar 2014 09:57
Last Modified:	02 Mar 2023 23:24
Publisher DOI:	10.4244/EIJV10I1A18
PubMed ID:	24213249
URI:	https://boris.unibe.ch/id/eprint/41647