Author + information
- Bill Gogas1,
- Elizabeth Thompson2,
- David Molony2,
- Nikolaos Spilias1,
- Kozo Okada3,
- Yasuhiro Honda3,
- Alessandro Veneziani4,
- Don P. Giddens5,
- Richard Rapoza6,
- Jeffrey J. Popma7 and
- Gregg Stone8
- 1Emory University School of Medicine, Atlanta, Georgia, United States
- 2Emory University, Atlanta, Georgia, United States
- 3Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, United States
- 4Emory University Department of of Mathematics and Computer Science
- 5Emory University Department of Biomedical Engineering, Atlanta, Georgia, United States
- 6Abbott Vascular, Santa Clara, California, United States
- 7Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- 8Cardiovascular Research Foundation, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, New York, United States
Wall shear stress (WSS) following stent deployment may affect strut healing patterns through established mechanobiologic pathways.
Fused angiographic and IVUS-derived WSS were calculated in coronary arteries from patients enrolled in the ABSORB III Imaging study (n=92), randomized 2:1 to Absorb bioresorbable scaffold (BVS) or the Xience V (XV) stent. Underexpansion was defined as stent area <90% of distal and proximal reference area. WSS was compared between underexpanded and downstream segments (immediately distal to underexpanded segments).
Absorb BVS-treated arteries showed significantly greater plaque burden in the 5-mm proximal edges compared to XV-stented arteries: 51.0%±10.0% vs. 44.0%±12.0% (p<0.007). Underexpanded segments were observed both in Absorb BVS and XV treated arteries 43.4%±24.0% vs. 37.4%±24.9% (p=0.58). WSS in Absorb BVS-treated vessels was not significantly different than in XV-treated vessels: 1.90±1.01 Pa vs. 2.24±0.97 Pa (p=0.13). Regions immediately downstream from underexpanded Absorb BVS segments had lower WSS than underexpanded segments: 1.50± 0.86 Pa vs. 2.27± 1.09 Pa (p<0.03). A similar trend was observed with XV-treated vessels (Figure).
In the ABSORB III imaging substudy, Absorb BVS-treated arteries had greater proximal plaque burden compared to XV treated arteries. Regions immediately downstream from underexpanded Absorb segments demonstrated lower WSS. 3-year follow-up imaging data will be presented and will demonstrate whether these observed hemodynamic disturbances drive adverse device healing and potentially outcomes.
CORONARY: Bioresorbable Vascular Scaffolds