• 제목/요약/키워드: Angulated Coronary Stenosis

검색결과 5건 처리시간 0.022초

Hemodynamic Characteristics Affecting Restenosis after Percutaneous Transluminal Coronary Angioplasty with Stenting in the Angulated Coronary Stenosis

  • Lee, Byoung-Kwon;Kwon, Hyuck-Moon;Roh, Hyung-Woon;Cho, Min-Tae;Suh, Sang-Ho
    • International Journal of Vascular Biomedical Engineering
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    • 제1권1호
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    • pp.13-23
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    • 2003
  • Backgrounds: The present study in angulated coronary stenosis was to evaluate the influence of velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, as well as their effect of evolving in-stent restenosis using human in vivo hemodynamic parameters and computed simulation quantitatively and qualitatively. Methods: Initial and follow-up coronary angiographies in the patients with angulated coronary stenosis were performed (n=80). Optimal coronary stenting in angulated coronary stenosis had two models: < 50 % angle changed(model 1, n=43), > 50% angle changed group (model 2, n=37) according to percent change of vascular angle between pre- and post-intracoronary stenting. Flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre/post-intracoronary stenting were calculated from three-dimensional computer simulation. Results: Follow-up coronary angiogram demonstrated significant difference in the percent of diameter stenosis between two groups (group 1: $40.3{\pm}30.2$ vs. group 2: $25.5{\pm}22.5%$, p<0.05). Negative WSS area on 3D simulation, which is consistent with re-circulation area of velocity vector, was noted on the inner wall of post-stenotic area before stenting. The negative WSS was disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2 (p<0.01) Conclusions: The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation termed as WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric change, such as angular difference between pre / post-intracoronary stenting might give proper information of optimal hemodynamic charateristics for vascular repair after stenting.

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협착된 관상동맥에 시술된 스텐트형상이 벽면 전단응력에 미치는 영향 (Effects of Stenting Shapes on the Wall Shear Stress in the Angulated Coronary Stenosis)

  • 조민태;서상호;유상신;권혁문
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 춘계학술대회논문집E
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    • pp.219-222
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    • 2001
  • The objective of the present study is to evaluate the effects of the stenting shapes on flow velocity and wall shear stress in angulated coronary stenosis by computer simulation. Coronary angiogram and Doppler ultrasound measurement in the patients with angulated coronary stenosis were obtained. Inlet wave velocity distribution obtained from in vivo intracoronary Doppler data was used for the numerical simulation. Spatial pattern of blood flow velocity and recirculation area were drawn through out the selected segment of coronary models. Wall shear stresses in the intracoronary stent models were calculated from three-dimensional computer simulation. A negative shear stress region, which is consistent with re-circulation area on flow pattern, was noted on the inner wall of post-stenotic area of pre-stenting model. The negative shear stress was disappeared after stenting. Shear stress in the post-stenting model was markedly reduced up to about two orders of magnitude compared to that of the pre-stenting model.

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관상동맥 협착부에 각이진 스텐트 시술시 혈류역학적 특성변화 (Changes of Hemodynamic Characteristics during Angulated Stenting in the Stenosed Coronary)

  • 서상호;조민태;권혁문;이병권
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2002년도 학술대회지
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    • pp.717-720
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    • 2002
  • The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

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