Platelet Adhesion to Simulated Stented Surfaces

Robaina, Samuel; Jayachandran, Bhavani; He, Yong; Frank, Andreas; Moreno, Michael R.; Schoephoerster, Richard T.; Moore, James E.

doi:10.1177/152660280301000522

Cited by 21 publications

(14 citation statements)

References 19 publications

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“…Higher degrees of platelet aggregation have been noted in regions where instantaneous streamlines point toward the wall. One result of this behavior is that in areas where stent struts are very closely packed, and the mainstream of the flow “skims over” the top of the stagnant area in between, platelet aggregation is lowest (9). Presumably, delivery of blood-borne inflammatory cells follows similar patterns.…”

mentioning

confidence: 99%

Increased artery wall stress post-stenting leads to greater intimal thickening

Timmins

Miller

Clubb

et al. 2011

Laboratory Investigation

109

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Since the first human procedure in the late 1980s, vascular stent implantation has been accepted as a standard form of treatment of atherosclerosis. Despite their tremendous success, these medical devices are not without their problems, as excessive neointimal hyperplasia can result in the formation of a new blockage (restenosis). Clinical data suggest that stent design is a key factor in the development of restenosis. Additionally, computational studies indicate that the biomechanical environment is strongly dependent on the geometrical configuration of the stent, and therefore possibly involved in the development of restenosis. We hypothesize that stents that induce higher stresses on the artery wall lead to a more aggressive pathobiologic response, as determined by the amount of neointimal hyperplasia. The aim of this investigation was to examine the role of solid biomechanics in the development of restenosis. A combination of computational modeling techniques and in vivo analysis were employed to investigate the pathobiologic response to two stent designs that impose greater or lesser levels of stress on the artery wall. Stent designs were implanted in a porcine model (pigs) for approximately 28 days and novel integrative pathology techniques (quantitative micro-computed tomography, histomorphometry) were utilized to quantify the pathobiologic response. Concomitantly, computational methods were used to quantify the mechanical loads that the two stents place on the artery. Results reveal a strong correlation between the computed stress values induced on the artery wall and the pathobiologic response; the stent that subjected the artery to the higher stresses had significantly more neointimal thickening at stent struts (high stress stent: 0.197 ± 0.020 mm vs. low-stress stent: 0.071 ± 0.016 mm). Therefore, we conclude that the pathobiologic differences are a direct result of the solid biomechanical environment, confirming the hypothesis that stents that impose higher wall stresses will provoke a more aggressive pathobiological response.

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mentioning

confidence: 99%

Increased artery wall stress post-stenting leads to greater intimal thickening

Timmins

Miller

Clubb

et al. 2011

Laboratory Investigation

109

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“…In addition, it is not well understood how changes in local geometry affect near-wall flow. Several investigations have shown that flow in and around stent struts play a significant role in platelet binding, thrombus formation, and neointimal hyperplasia [40][41][42]. These phenomena each have an effect on remodeling behavior around the strut area and interact in a way that does not produce significant differences within these force ranges.…”

Section: Discussionmentioning

confidence: 99%

A link between stent radial forces and vascular wall remodeling: The discovery of an optimal stent radial force for minimal vessel restenosis

Freeman

Snowhill

Nosher

2010

Connective Tissue Research

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Coronary and peripheral artery disease (PAD) continue to be primary causes of morbidity and mortality in western nations; percutaneous transluminal angioplasty (PTA) with stenting has become a popular treatment. Unfortunately, restenosis is a significant problem following intravascular stent placement. This study considers the contribution of stent forces in vascular stenosis and remodeling to develop an equation for identifying the optimal stent force. z-Type stents of three radial forces [low (3.4 N), high (16.4 N), and ultrahigh (19.4 N)] were deployed into the iliac arteries of a juvenile porcine model. Vessel diameters were measured before, after deployment, and again at 30 days. At 30 days animals were killed and the vessels fixed in situ. After implantation, there was a significant increase in total thickness and neointimal hyperplasia with increasing stent force. The model for vessel radius and experimental data was in agreement. The model shows that maximum late-term radius is achieved with a stent deployment stress of 480 kPa, which occurs at the end of the stress-strain curve nonlinear domain and beginning of the high-strain collagen domain. The results and calculations suggest that an optimal stent force exists that is subject to the geometry, structure, and mechanics of the target vessel. To achieve maximum late-term dilatation, stents should not produce stress in the vessel wall greater than the end of the transitional domain of the vessel's stress-strain curve. This finding is extremely important for vascular stent development and will be expanded to preliminary vessel wall injury and atherosclerotic models.

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“…Endovasküler perspektiften bakıl-dığında akut stent trombozunda, aktive olan trombositlerin "shear stress" (kan akımı) altın-da stent metal yüzeyine adezyonu ve ardından agregesyonu gerçekleşir [13]. Yani agonistle aktive edilen trombositlerin, shear stress altın-da (manyetik karıştırıcı) metal yüzeye (gümüş kaplı bakır elektrodlar) yapışması ve sonuçta elektrodlar arası artan empedansın sayısal veriye dönüştürülmesi şeklindeki çalışma prensibi, Multiplate Analyser testini endovasküler tedaviler için teoride daha doğru test yapmaktadır.…”

Section: Endovasküler Perspektife Göre Hangi Test?unclassified

Nöroendovasküler Girişimsel Tedavilerde Anti-trombotik İlaç Kullanımı

Oran¹,

Çınar²

2018

Trd Sem

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Platelet Adhesion to Simulated Stented Surfaces

Cited by 21 publications

References 19 publications

Increased artery wall stress post-stenting leads to greater intimal thickening

Increased artery wall stress post-stenting leads to greater intimal thickening

A link between stent radial forces and vascular wall remodeling: The discovery of an optimal stent radial force for minimal vessel restenosis

Nöroendovasküler Girişimsel Tedavilerde Anti-trombotik İlaç Kullanımı

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