Comparison of endothelial shear stress between ultrathin strut Bioresorbable Polymer Drug Eluting Stent vs Durable Polymer Drug Eluting Stent post-stent implantation: An optical coherence tomography substudy from BIOFLOW II.

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Citation: Cardiovascular Revascularization Medicine. 2023 Nov 25PMID: 38042738Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Recent clinical data indicate a different performance of biodegradable polymer (BP)-drug eluting stent (DES) compared to durable polymer (DP)-DES. Whether this can be explained by a beneficial impact of BP-DES stent design on the local hemodynamic forces distribution remains unclear.CONCLUSION: In this OCT sub-study of the BIOFLOW II trial, the NIT was statistically different between groups of patients treated with BP-DES and DP-DES. In addition, regions of low ESS were associated with increased NIT in all studied devices. Copyright © 2023 Elsevier Inc. All rights reserved.METHODS AND RESULTS: We retrospectively identified patients from the BIOFLOW II trial that had undergone OCT imaging. OCT data were utilized to reconstruct the surface of the stented segment at baseline and 9 months follow-up, simulate blood flow, and measure ESS and NIT in the stented segment. The patients were divided into 3 groups depending on whether DP-DES (N = 8, n = 56,160 sectors), BP-DES with a stent diameter of >3 mm (strut thickness of 80 mum, N = 6, n = 36,504 sectors), or BP-DES with a stent diameter of <=3 mm (strut thickness of 60 mum, N = 8, n = 50,040 sectors) were used for treatment. The ESS, and NIT distribution and the association of these two variables were estimated and compared among the 3 groups.OBJECTIVES: To compare endothelial shear stress (ESS) distribution after implantation of ultrathin (us) BP-DES and DP-DES and examine the association between ESS and neointimal thickness (NIT) distribution in the two devices at 9 months follow up.RESULTS: In the DP-DES group mean NIT was 0.18 +/- 0.17 mm and ESS 1.68 +/- 1.66 Pa; for the BP-DES <=3 mm group the NIT was 0.17 +/- 0.11 mm and ESS 1.49 +/- 1.24 Pa and for the BP-DES >3 mm group 0.20 +/- 0.23 mm and 1.42 +/- 1.24 Pa respectively (p < 0.001 for both NIT and ESS comparisons across groups). A negative correlation between NIT and baseline ESS was found, the correlation coefficient for all the stented segments was -0.33, p < 0.001.All authors: Beyene S, Tufaro V, Garg M, Gkargkoulas F, Calderon AT, Safi H, Waksman R, Windecker S, Torii R, Melaku GD, Bulant CA, Bourantas CV, Blanco PJ, Garcia-Garcia HMFiscal year: FY2024Digital Object Identifier: Date added to catalog: 2024-01-22
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Journal Article MedStar Authors Catalog Article 38042738 Available 38042738

Available in print through MWHC library: 2002 - present

BACKGROUND: Recent clinical data indicate a different performance of biodegradable polymer (BP)-drug eluting stent (DES) compared to durable polymer (DP)-DES. Whether this can be explained by a beneficial impact of BP-DES stent design on the local hemodynamic forces distribution remains unclear.

CONCLUSION: In this OCT sub-study of the BIOFLOW II trial, the NIT was statistically different between groups of patients treated with BP-DES and DP-DES. In addition, regions of low ESS were associated with increased NIT in all studied devices. Copyright © 2023 Elsevier Inc. All rights reserved.

METHODS AND RESULTS: We retrospectively identified patients from the BIOFLOW II trial that had undergone OCT imaging. OCT data were utilized to reconstruct the surface of the stented segment at baseline and 9 months follow-up, simulate blood flow, and measure ESS and NIT in the stented segment. The patients were divided into 3 groups depending on whether DP-DES (N = 8, n = 56,160 sectors), BP-DES with a stent diameter of >3 mm (strut thickness of 80 mum, N = 6, n = 36,504 sectors), or BP-DES with a stent diameter of <=3 mm (strut thickness of 60 mum, N = 8, n = 50,040 sectors) were used for treatment. The ESS, and NIT distribution and the association of these two variables were estimated and compared among the 3 groups.

OBJECTIVES: To compare endothelial shear stress (ESS) distribution after implantation of ultrathin (us) BP-DES and DP-DES and examine the association between ESS and neointimal thickness (NIT) distribution in the two devices at 9 months follow up.

RESULTS: In the DP-DES group mean NIT was 0.18 +/- 0.17 mm and ESS 1.68 +/- 1.66 Pa; for the BP-DES <=3 mm group the NIT was 0.17 +/- 0.11 mm and ESS 1.49 +/- 1.24 Pa and for the BP-DES >3 mm group 0.20 +/- 0.23 mm and 1.42 +/- 1.24 Pa respectively (p < 0.001 for both NIT and ESS comparisons across groups). A negative correlation between NIT and baseline ESS was found, the correlation coefficient for all the stented segments was -0.33, p < 0.001.

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