title: The effects of stenting on shear stress: relevance to endothelial injury and repair.
abstract: Stent deployment following balloon angioplasty is used routinely to treat coronary artery disease. These interventions cause damage and loss of endothelial cells (EC), and thus promote in-stent thrombosis and restenosis. Injured arteries are repaired (intrinsically) by locally derived EC and by circulating endothelial progenitor cells which migrate and proliferate to re-populate denuded regions. However, re-endothelialization is not always complete and often dysfunctional. Moreover, the molecular and biomechanical mechanisms that control EC repair and function in stented segments are poorly understood. Here, we propose that stents modify endothelial repair processes, in part, by altering fluid shear stress, a mechanical force that influences EC migration and proliferation. A more detailed understanding of the biomechanical processes that control endothelial healing would provide a platform for the development of novel therapeutic approaches to minimize damage and promote vascular repair in stented arteries.
authors.affiliation: Biomedical Engineering, Department Cardiology, ErasmusMC, Rotterdam, The Netherlands.
authors.forename: Kim
authors.initials: K
authors.lastname: Van der Heiden
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: Gijsen
authors.forename: Andrew
authors.initials: A
authors.lastname: Narracott
authors.forename: Sarah
authors.initials: S
authors.lastname: Hsiao
authors.forename: Ian
authors.initials: I
authors.lastname: Halliday
authors.forename: Julian
authors.initials: J
authors.lastname: Gunn
authors.forename: Jolanda J
authors.initials: JJ
authors.lastname: Wentzel
authors.forename: Paul C
authors.initials: PC
authors.lastname: Evans
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D000818:Animals; D001696:Biomechanical Phenomena; D002465:Cell Movement; D049109:Cell Proliferation; D003198:Computer Simulation; D003251:Constriction, Pathologic; D004730:Endothelium, Vascular / Q000293:injuries* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D040542:Mechanotransduction, Cellular; D008955:Models, Cardiovascular; D012038:Regeneration; D012039:Regional Blood Flow; D015607:Stents; D013314:Stress, Mechanical; D013927:Thrombosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D057772:Vascular System Injuries / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology
keywords: Endothelial cell; Shear stress; Stent; Vascular repair