Effect of the Endothelial Shear Stress Patterns on Neointimal Proliferation Following Drug-Eluting Bioresorbable Vascular Scaffold Implantation

Abstract

The hemodynamic microenvironment appears to regulate neointimal response following an Absorb BVS implantation. These findings underline the role of the ESS patterns on vessel wall healing and should be taken into consideration in the design of bioresorbable devices.

Wall shear stress in the development of in-stent restenosis revisited. A critical review of clinical data on shear stress after intracoronary stent implantation

“…In another BVS study, an inverse association between WSS and NIH was also conferred as a consequence of local hemodynamic milieu on vessel wall healing (Table 3) [30].…”

Prognostic Determinants of Coronary Atherosclerosis in Stable Ischemic Heart Disease

“…As times goes by, the struts are integrated into the vessel wall and cover by neointima (g and g′). When the shear stress at baseline is portrayed into the follow-up OCT images (g″), it became apparent that the low shear stress areas at baseline (blue) correlate with thicker neointima thickness at follow-up as compared to high shear stress areas (on top of struts in red color), which showed thinner neointima thickness (reprinted from Bourantas et al 93 with permission of the publisher. Copyright © 2014, American College of Cardiology Foundation.…”

“…A new layer of neointima and thickening of the fibrous cap overlying the necrotic core was noted (potentially turning a TCFA to thick-cap fibroatheroma; Figure 3). [92][93][94] The pilot SECRITT trial assessed the feasibility and safety of using a self-expandable bare metal stent (vShield) for focal treatment of TCFA. 95 This study showed an increase in the average fibrous cap thickness from 48±12 µm to 201±168 µm at 6-month follow-up, with no MACE associated with the device.…”

Polymers in Cardiology

“…Further examples are glycolide-containing, nanofibrous scaffolds blended with gelatin [31] or hollow fibers blended with poly(ε-caprolactone) (PCL) [32] for vascular tissue engineering, as well as glycolide-based local drug delivery systems [33][34][35]. In addition to these examples it can be pointed that PLA was intensely tested as temporary stent material in cardiology [36,37], vessel surgery [38,39] and urology [40][41][42].…”