1. Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
- Author
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Scott A. Berceli, Jared M. Rozowsky, Diego Gallo, Monika Colombo, Anna Corti, Stefano Casarin, Francesco Migliavacca, Claudio Chiastra, and Yong He
- Subjects
medicine.medical_specialty ,Time Factors ,Science ,Area change ,medicine.medical_treatment ,0206 medical engineering ,Lumen (anatomy) ,Hemodynamics ,1 year follow up ,02 engineering and technology ,Constriction, Pathologic ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,Peripheral Arterial Disease ,0302 clinical medicine ,Restenosis ,Negatively associated ,Internal medicine ,medicine ,Humans ,Computer Simulation ,Aged ,Spatial Analysis ,Multidisciplinary ,Superficial femoral artery ,business.industry ,Stent ,Atrial Remodeling ,Middle Aged ,medicine.disease ,020601 biomedical engineering ,Femoral Artery ,Logistic Models ,Risk factors ,Peripheral vascular disease ,Cardiology ,Medicine ,Stents ,business ,Shear Strength ,Tomography, X-Ray Computed ,Biomedical engineering ,Follow-Up Studies - Abstract
In-stent restenosis (ISR) is the major drawback of superficial femoral artery (SFA) stenting. Abnormal hemodynamics after stent implantation seems to promote the development of ISR. Accordingly, this study aims to investigate the impact of local hemodynamics on lumen remodeling in human stented SFA lesions. Ten SFA models were reconstructed at 1-week and 1-year follow-up from computed tomography images. Patient-specific computational fluid dynamics simulations were performed to relate the local hemodynamics at 1-week, expressed in terms of time-averaged wall shear stress (TAWSS), oscillatory shear index and relative residence time, with the lumen remodeling at 1-year, quantified as the change of lumen area between 1-week and 1-year. The TAWSS was negatively associated with the lumen area change (ρ = − 0.75, p = 0.013). The surface area exposed to low TAWSS was positively correlated with the lumen area change (ρ = 0.69, p = 0.026). No significant correlations were present between the other hemodynamic descriptors and lumen area change. The low TAWSS was the best predictive marker of lumen remodeling (positive predictive value of 44.8%). Moreover, stent length and overlapping were predictor of ISR at follow-up. Despite the limited number of analyzed lesions, the overall findings suggest an association between abnormal patterns of WSS after stenting and lumen remodeling.
- Published
- 2021