title: Wall shear stress in the development of in-stent restenosis revisited. A critical review of clinical data on shear stress after intracoronary stent implantation.
abstract: The average wall shear stress (WSS) is in 1 Pa range in coronary arteries, while the stretching effect of an implanted coronary stent can generate up to 3 × 105 times higher circumferential stress in the vessel wall. It is widely accepted that WSS plays a critical role in the development of restenosis after coronary stent implantation, but relevant clinical endpoint studies are lack-ing. Fluid dynamics modeling suggests an association between WSS and intimal hyperplasia, however, such an association is not established when the compensating healing process becomes an overshoot phenomenon. This review summarizes available clinical results and concepts of potential clinical importance.
authors.forename: Csaba
authors.initials: C
authors.lastname: Jenei
authors.forename: Emília
authors.initials: E
authors.lastname: Balogh
authors.forename: Gábor Tamás
authors.initials: GT
authors.lastname: Szabó
authors.affiliation: Petz Aladár County Teaching Hospital. dcsa62@gmail.com.
authors.forename: Csaba András
authors.initials: CA
authors.lastname: Dézsi
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kőszegi
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008955:Models, Cardiovascular; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011475:Prosthesis Failure; D015607:Stents / Q000009:adverse effects*; D013314:Stress, Mechanical
keywords: in-stent restenosis; percutaneous coronary intervention; stent implantation; wall shear stress