title: Impact of stent implantation on endothelial shear stress.
abstract: BACKGROUND
  Endothelial shear stress (ESS) may play a key role in the pathobiology of stent restenosis (SR). Nevertheless, limited data are available about ESS and its relation to SR.
  
  
  METHODS
  We enrolled 14 patients who underwent successful percutaneous coronary intervention (PCI) in this study. Three-dimensional (3D) reconstruction of 14 coronary arteries before and after stent implantation was performed. Using computational fluid dynamics, mean ESS was calculated proximally, in tertiles within and distal to the stent, both before and after stent implantation.
  
  
  RESULTS
  Stent implantation resulted in a significant ESS decrease in the entire atherosclerotic lesion (1.83 vs. 1.26 Pa, p = 0.02). Regarding the five territories in which the entire lesion was divided, ESS decrease was marginally significant in the area of the second in-stent tertile, and in the area 5 mm distal to the stent, whereas ESS decrease was not significant in the area 5 mm proximal to the stent, and in the area of the first and third in-stent tertile. At 12 months, two patients had SR, but restenosis was not related to ESS decrease.
  
  
  CONCLUSIONS
  ESS decreases after stent implantation but not uniformly, with the major reduction being in the middle tertile of the stent, and distal to the stent. In-stent ESS decrease may create local hemodynamic conditions leading to in-stent and in-segment restenosis.
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Economou
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece. sotiriskatranas@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Katranas
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Giannoglou
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Gemitzis
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Styliadis
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Efthimiadis
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: H
authors.initials: H
authors.lastname: Karvounis
authors.affiliation: 1st Cardiology Department, AHEPA University Gerneral Hospital, Aristotle University Medical School, 1st, Kyriakidi Street, 54636, Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Ziakas
mesh_terms: D000465:Algorithms; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D004547:Elastic Tissue / Q000000981:diagnostic imaging / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D057446:Hydrodynamics; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D066230:Patient-Specific Modeling; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D033081:Shear Strength / Q000502:physiology*; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: C489443:zotarolimus; D020123:Sirolimus
keywords: Coronary artery disease; Drug-eluting stents; Endothelial shear stress; Percutaneous coronary intervention; Stent restenosis