Cor Vasa 2016, 58(5):e518-e521 | DOI: 10.1016/j.crvasa.2015.08.005

High shear stress on the background of clinical restenosis at the site of step-down phenomenon after drug eluting stent implantation

Csaba Jenei^a, Gábor Závodszky^b, György Paál^b, Balázs Tar^c, Zsolt Kőszegi^a,c,*

^a Szabolcs - Szatmár - Bereg County Hospitals and University Teaching Hospital, Nyíregyháza, Hungary

^b Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary

^c Institute of Cardiology, University of Debrecen, Debrecen, Hungary

A retrospective modeling was performed in a case with restenosis after 6 months of a DES implantation to investigate the effect of the step-down at the distal edge of the stent on the wall shear stress (WSS) using 3D coronary angiography reconstruction and the intracoronary pressure traces during a cardiac cycle. The kinetics of the WSS was calculated through the cardiac cycle along the reconstructed vessel by fluid dynamic analysis. Contrary to the previous reports the greatest amplitude and average of the arterial WSS was detected where the restenosis developed later at the site of the step-down.

Keywords: DES; Restenosis; Shear stress

Received: August 3, 2015; Revised: August 17, 2015; Accepted: August 18, 2015; Published: October 1, 2016  Show citation