Low coronary flow velocity and shear stress predict restenosis after sirolimus-eluting stent implantation

Scand Cardiovasc J. 2009;43(5):298-303. doi: 10.1080/14017430902785493.

Abstract

Objectives: This study sought to assess predictive values of coronary flow velocity and an index of shear stress throughout the vessel for angiographic restenosis after sirolimus-eluting stent implantation.

Design: The study patients underwent successful implantation of a sirolimus-eluting stent for de novo lesions located in native coronary vessels and underwent follow-up angiography 6-9 months later. The TIMI frame count method and quantitative digital angiographic analysis were performed based on the post-stenting angiogram. Coronary flow velocity and Reynolds number, an index of shear stress, were measured.

Results: Post-stenting digital angiograms from 267 patients were analyzed. We divided the study patients into two groups: a Restenosis group with 21 patients and a Non-Restenosis group with 246 patients. The Restenosis group indicated significantly lower coronary flow velocity (137.7+/-35.6 mm/sec versus 241.1+/-72.9 mm/sec, p = 0.0001) and lower Reynolds number (107.0+/-35.8 versus 199.2+/-67.1, p = 0.0001) than did the Non-Restenosis group.

Conclusions: Lowered coronary flow velocity and shear stress after sirolimus-eluting stenting may predict the risk of restenosis.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Blood Flow Velocity
  • Cardiovascular Agents / administration & dosage*
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Coronary Circulation*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / etiology*
  • Coronary Restenosis / physiopathology
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Prosthesis Design
  • Regression Analysis
  • Risk Assessment
  • Risk Factors
  • Sirolimus / administration & dosage*
  • Stress, Mechanical
  • Time Factors
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Sirolimus