Coronary Shear Stress after Implantation of Bioresorbable Scaffolds – a Modern Interdisciplinary Concept at the Border between Interventional Cardiology and Cardiac Imaging

Abstract

Bioresorbable scaffolds/stents offer new and exciting perspectives in the treatment of patients with acute coronary syndromes, especially after the recent development of invasive imaging techniques, such as optical coherence tomography, which allow complete assessment of vascu-lar segments. A particular advantage of bioresorbable scaffolds is that once the biosorption of the scaffold is complete, the vascular segment regains its normal physiological functions, thus eliminating the risk of late complications. New studies show the importance of shear stress in the progression of vascular atherosclerosis or in accelerating endothelial turnover. Based on the current knowledge in this field, a future standardized determination of shear stress may help in the long-term follow-up of patients that have suffered or are at risk of developing an acute coronary syndrome.

Assessment of lesion-associated myocardial ischemia based on fusion coronary CT imaging – the FUSE-HEART study

“…Location of coronary lesions may also play a significant role on the clinical outcomes, since it has been demonstrated that an increased shear stress at the level of coronary bifurcations may accelerate the plaque vulnerabilisation process, [ 25 ] while location in the proximal left anterior descendant artery is association with an increased risk of cardiac arrest. [ 26 ]…”