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Stent strut streamlining and thickness reduction promote endothelialization
Journal of The Royal Society Interface ( IF 3.7 ) Pub Date : 2021-08-18 , DOI: 10.1098/rsif.2021.0023
Duy T. Nguyen 1 , Alexander F. Smith 2 , Juan M. Jiménez 1, 2
Affiliation  

Stent thrombosis (ST) carries a high risk of myocardial infarction and death. Lack of endothelial coverage is an important prognostic indicator of ST after stenting. While stent strut thickness is a critical factor in ST, a mechanistic understanding of its effect is limited and the role of haemodynamics is unclear. Endothelialization was tested using a wound-healing assay and five different stent strut models ranging in height between 50 and 150 µm for circular arc (CA) and rectangular (RT) geometries and a control without struts. Under static conditions, all stent strut surfaces were completely endothelialized. Reversing pulsatile disturbed flow caused full endothelialization, except for the stent strut surfaces of the 100 and 150 µm RT geometries, while fully antegrade pulsatile undisturbed flow with a higher mean wall shear stress caused only the control and the 50 µm CA geometries to be fully endothelialized. Modest streamlining and decrease in height of the stent struts improved endothelial coverage of the peri-strut and stent strut surfaces in a haemodynamics dependent manner. This study highlights the impact of the stent strut height (thickness) and geometry (shape) on the local haemodynamics, modulating reendothelialization after stenting, an important factor in reducing the risk of stent thrombosis.



中文翻译:

支架支柱流线型和厚度减少促进内皮化

支架血栓形成 (ST) 具有很高的心肌梗塞和死亡风险。内皮覆盖不足是支架置入术后 ST 的重要预后指标。虽然支架支柱厚度是 ST 的关键因素,但对其影响的机制理解有限,血液动力学的作用尚不清楚。使用伤口愈合试验和五种不同的支架支柱模型对内皮化进行了测试,该模型高度在 50 到 150 µm 之间,用于圆弧 (CA) 和矩形 (RT) 几何形状以及没有支柱的对照。在静态条件下,所有支架支柱表面完全内皮化。除了 100 和 150 µm RT 几何形状的支架支柱表面外,逆转脉动扰动流导致完全内皮化,而具有更高平均壁剪切应力的完全顺行脉动不受干扰流仅导致控制和 50 µm CA 几何结构完全内皮化。支架支柱的适度流线型和高度降低以血液动力学依赖的方式改善了支柱周围和支架支柱表面的内皮覆盖。该研究强调了支架支柱高度(厚度)和几何形状(形状)对局部血流动力学的影响,调节支架置入后的再内皮化,这是降低支架血栓形成风险的重要因素。

更新日期:2021-08-19
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