Study of the evolution of the shear stress on the restenosis after coronary angioplasty.
In this article, we analyze the influence of fluid dynamics variables on the development of obstructive coronary artery disease in the medium term after percutaneous coronary intervention with stent implantation. We have analyzed a group of seven patients and the study is focused on the mid-right coronary artery. In these patients we have studied the relationship between wall shear stress and arterial wall thickness both immediately after stent implantation and six months later. The realistic three-dimensional (3D) reconstruction of the arteries is performed with the data obtained with intravascular ultrasound (IVUS) and angiography. The commercial code Fluent is used to solve the Navier-Stokes equations. Special attention is paid to the shear stress on the wall arteries and the corresponding thickness. The results show that there is a negative correlation for most of the cases between the wall shear stress and increase in wall thickness. A model is proposed to study the instability at the wall, and qualitative agreement is found.
Dpto. Ingeniería Energética y Fluidomecánica, Universidad Politécnica de Madrid, C/José Gutiérrez Abascal, 2. 28006 Madrid, Spain. garcia@etsii.upm.es
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J
García
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A
Crespo
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J
Goicolea
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M
Sanmartín
C
C
García
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001794:Blood Pressure; D003198:Computer Simulation; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D023903:Coronary Restenosis / Q000209:etiology* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology* / Q000601:surgery*; D018450:Disease Progression; D006083:Graft Occlusion, Vascular; D006801:Humans; D008955:Models, Cardiovascular; D033081:Shear Strength; D013314:Stress, Mechanical; D016896:Treatment Outcome