再狭窄
心脏病学
支架
血流动力学
新生内膜
医学
内科学
血栓形成
冠状动脉疾病
作者
Jaryl Ng,Christos V. Bourantas,Ryo Torii,Hui Ying Ang,Erhan Tenekecioğlu,Patrick W. Serruys,Nicolas Foin
标识
DOI:10.1161/atvbaha.117.309728
摘要
Local hemodynamic forces are well-known to modulate atherosclerotic evolution, which remains one of the largest cause of death worldwide. Percutaneous coronary interventions with stent implantation restores blood flow to the downstream myocardium and is only limited by stent failure caused by restenosis, stent thrombosis, or neoatherosclerosis. Cumulative evidence has shown that local hemodynamic forces affect restenosis and the platelet activation process, modulating the pathophysiological mechanisms that lead to stent failure. This article first covers the pathophysiological mechanisms through which wall shear stress regulates arterial disease formation/neointima proliferation and the role of shear rate on stent thrombosis. Subsequently, the article reviews the current evidence on (1) the implications of stent design on the local hemodynamic forces, and (2) how stent/scaffold expansion can influence local flow, thereby affecting the risk of adverse events.
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