Comparison of endothelial shear stress between ultrathin strut bioresorbable polymer drug-eluting stent vs durable-polymer drug-eluting stent post-stent implantation: An optical coherence tomography substudy from BIOFLOW II.

Autor: Beyene S; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Tufaro V; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Garg M; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Gkargkoulas F; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Calderon AT; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Safi H; Department of Mechanical Engineering, University College London, London, UK., Waksman R; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Windecker S; Cardiology Department, Inselspital, Bern University, Bern, CH, Switzerland., Torii R; Department of Mechanical Engineering, University College London, London, UK., Melaku GD; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA., Bulant CA; National Scientific and Technical Research Council (CONICET) and Pladema Institute, National University of the Center, Tandil, Bs. As., Argentina., Bourantas CV; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK; Institute of Cardiovascular Sciences, University College London, London, UK., Blanco PJ; National Laboratory for Scientific Computing and National Institute of Science and Technology in Medicine Assisted by Scientific Computing, Petrópolis, Brazil., Garcia-Garcia HM; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: hector.m.garciagarcia@medstar.net.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2024 Apr; Vol. 61, pp. 26-34. Date of Electronic Publication: 2023 Nov 25.
DOI: 10.1016/j.carrev.2023.11.014
Abstrakt: Background: Recent clinical data indicate a different performance of biodegradable polymer (BP)-drug eluting stent (DES) compared to durable polymer (DP)-DES. Whether this can be explained by a beneficial impact of BP-DES stent design on the local hemodynamic forces distribution remains unclear.
Objectives: To compare endothelial shear stress (ESS) distribution after implantation of ultrathin (us) BP-DES and DP-DES and examine the association between ESS and neointimal thickness (NIT) distribution in the two devices at 9 months follow up.
Methods and Results: We retrospectively identified patients from the BIOFLOW II trial that had undergone OCT imaging. OCT data were utilized to reconstruct the surface of the stented segment at baseline and 9 months follow-up, simulate blood flow, and measure ESS and NIT in the stented segment. The patients were divided into 3 groups depending on whether DP-DES (N = 8, n = 56,160 sectors), BP-DES with a stent diameter of >3 mm (strut thickness of 80 μm, N = 6, n = 36,504 sectors), or BP-DES with a stent diameter of ≤3 mm (strut thickness of 60 μm, N = 8, n = 50,040 sectors) were used for treatment. The ESS, and NIT distribution and the association of these two variables were estimated and compared among the 3 groups.
Results: In the DP-DES group mean NIT was 0.18 ± 0.17 mm and ESS 1.68 ± 1.66 Pa; for the BP-DES ≤3 mm group the NIT was 0.17 ± 0.11 mm and ESS 1.49 ± 1.24 Pa and for the BP-DES >3 mm group 0.20 ± 0.23 mm and 1.42 ± 1.24 Pa respectively (p < 0.001 for both NIT and ESS comparisons across groups). A negative correlation between NIT and baseline ESS was found, the correlation coefficient for all the stented segments was -0.33, p < 0.001.
Conclusion: In this OCT sub-study of the BIOFLOW II trial, the NIT was statistically different between groups of patients treated with BP-DES and DP-DES. In addition, regions of low ESS were associated with increased NIT in all studied devices.
Competing Interests: Declaration of competing interest Ron Waksman: Advisory Board: Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Consultant: Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Grant Support: AstraZeneca, Biotronik, Boston Scientific, Chiesi; Speakers Bureau: AstraZeneca, Chiesi; Investor: MedAlliance. All other authors have no conflicts of interest to disclose.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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