Division of Cardiology, University of Illinois at Chicago, Chicago, IL, USA.
J Interv Cardiol. 2022 Mar 26;2022:5981027. doi: 10.1155/2022/5981027. eCollection 2022.
Coronary arteries are exposed to a variety of complex biomechanical forces during a normal cardiac cycle. These forces have the potential to contribute to coronary stent failure. Recent advances in stent design allow for the transmission of native pulsatile biomechanical forces in the stented vessel. However, there is a significant lack of evidence in a human model to measure vessel motion in native coronary arteries and stent conformability. Thus, we aimed to characterize and define coronary artery radial deformation and the effect of stent implantation on arterial deformation.
Intravascular ultrasound (IVUS) pullback DICOM images were obtained from human coronary arteries using a coronary ultrasound catheter. Using two-dimensional speckle tracking, coronary artery radial deformation was defined as the inward and outward displacement (mm) and velocity (cm/s) of the arterial wall during the cardiac cycle. These deformation values were obtained in native and third-generation drug-eluting stented artery segments.
A total of 20 coronary artery segments were independently analyzed pre and poststent implantation for a total of 40 IVUS runs. Stent implantation impacted the degree of radial deformation and velocity. Mean radial deformation in native coronary arteries was 0.1230 mm ± 0.0522 mm compared to 0.0775 mm ± 0.0376 mm in stented vessels (=0.0031). Mean radial velocity in native coronary arteries was 0.1194 cm/ ± 0.0535 cm/s compared to 0.0840 cm/ ± 0.0399 cm/s in stented vessels (=0.0228).
In this in vivo analysis of third-generation stents, stent implantation attenuates normal human coronary deformation during the cardiac cycle. The implications of these findings on stent failure and improved clinical outcomes require further investigation.
在正常的心脏周期中，冠状动脉会受到多种复杂的生物力学力的作用。这些力有可能导致冠状动脉支架失效。最近支架设计的进步允许在支架血管中传递天然搏动的生物力学力。然而，在人体模型中，缺乏测量天然冠状动脉和支架顺应性的血管运动的证据。因此，我们旨在描述和定义冠状动脉的径向变形以及支架植入对动脉变形的影响。
使用冠状动脉超声导管从人体冠状动脉中获得血管内超声（IVUS）回拉 DICOM 图像。使用二维斑点追踪，冠状动脉的径向变形定义为动脉壁在心脏周期中的向内和向外位移（mm）和速度（cm/s）。这些变形值是在天然和第三代药物洗脱支架动脉段中获得的。
总共 20 个冠状动脉段在支架植入前后分别进行了独立分析，总共进行了 40 次 IVUS 运行。支架植入影响了径向变形和速度的程度。天然冠状动脉的平均径向变形为 0.1230±0.0522mm，而支架血管为 0.0775±0.0376mm（=0.0031）。天然冠状动脉的平均径向速度为 0.1194±0.0535cm/s，而支架血管为 0.0840±0.0399cm/s（=0.0228）。
在对第三代支架的这项体内分析中，支架植入会减弱正常人心血管在心脏周期中的变形。这些发现对支架失效和改善临床结果的影响需要进一步研究。
