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Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries

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...

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Autores principales: Colombo, Monika, He, Yong, Corti, Anna, Gallo, Diego, Casarin, Stefano, Rozowsky, Jared M., Migliavacca, Francesco, Berceli, Scott, Chiastra, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810829/
https://www.ncbi.nlm.nih.gov/pubmed/33452294
http://dx.doi.org/10.1038/s41598-020-80681-8
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author Colombo, Monika
He, Yong
Corti, Anna
Gallo, Diego
Casarin, Stefano
Rozowsky, Jared M.
Migliavacca, Francesco
Berceli, Scott
Chiastra, Claudio
author_facet Colombo, Monika
He, Yong
Corti, Anna
Gallo, Diego
Casarin, Stefano
Rozowsky, Jared M.
Migliavacca, Francesco
Berceli, Scott
Chiastra, Claudio
author_sort Colombo, Monika
collection PubMed
description 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.
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spelling pubmed-78108292021-01-21 Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries Colombo, Monika He, Yong Corti, Anna Gallo, Diego Casarin, Stefano Rozowsky, Jared M. Migliavacca, Francesco Berceli, Scott Chiastra, Claudio Sci Rep Article 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. Nature Publishing Group UK 2021-01-15 /pmc/articles/PMC7810829/ /pubmed/33452294 http://dx.doi.org/10.1038/s41598-020-80681-8 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Colombo, Monika
He, Yong
Corti, Anna
Gallo, Diego
Casarin, Stefano
Rozowsky, Jared M.
Migliavacca, Francesco
Berceli, Scott
Chiastra, Claudio
Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title_full Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title_fullStr Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title_full_unstemmed Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title_short Baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
title_sort baseline local hemodynamics as predictor of lumen remodeling at 1-year follow-up in stented superficial femoral arteries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810829/
https://www.ncbi.nlm.nih.gov/pubmed/33452294
http://dx.doi.org/10.1038/s41598-020-80681-8
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