The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Impact of Bioresorbable Scaffold Design Characteristics on Local Hemodynamic Forces - an ex vivo Assessment with Computational Fluid Dynamics Simulations

DOI: 10.4244/EIJ-D-19-00657

1. Department of Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands, Netherlands
2. LaBS, Dept. of Chemistry, Materials and Chemical Engineering “Giulio Natta”, Politecnico di Milano, Milan, Italy
3. Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
4. Department of Mechanical Engineering, University College London, London, United Kingdom
5. PoliToBIOMed Lab, Dept. of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy

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Aims: Bioresorbable scaffold (BRS) regions exposed to flow-recirculation, low time-averaged wall shear stress (TAWSS) and high oscillatory shear index (OSI), develop increased neo-intima tissue. We investigated hemodynamic features in 4 different BRSs. 

Methods and results:  Fantom (strut height (SH) = 125µm), Fantom Encore (SH = 98µm), Absorb (SH = 157µm) and Magmaris (SH = 150µm) BRSs were deployed in phantom tubes and imaged with microCT. Both 2D and 3D geometrical scaffold models were reconstructed. Computational fluid dynamics (CFD) was performed to compute TAWSS and OSI.Thicker struts had larger recirculation zones and lower TAWSS in 2D. Absorb had the largest recirculation zone and lowest TAWSS (240µm and -0.18 Pa), followed by Magmaris (170µm and -0.15 Pa), Fantom (140µm and -0.14 Pa) and Fantom Encore (100µm and -0.13 Pa). Besides strut size, stent design played a dominant role in 3D. The highest percentage area adverse TAWSS (<0.5 Pa) and OSI (>0.2) were found for Fantom (56% and 30%) and Absorb (53% and 33%), followed by Fantom Encore (30% and 25%) and Magmaris (25% and 20%). Magmaris had the smallest areas due to a small footprint and rounded struts. 

Conclusions: Due to stent design both Fantom Encore and Magmaris showed smaller TAWSS and OSI than Fantom and Absorb. This study quantifies which scaffold features are most important to reduce long-term restenosis.

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