冠脉支架内再狭窄的血流动力学研究进展

doi:10.3969/j.issn.0258-8021. 2015. 03.013

摘要
图/表
参考文献
相关文章 (1)

全文: PDF (1362 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要冠脉支架术后再狭窄是严重且高发的医学事件。局部血流动力学因素，特别是壁面剪切应力(WSS)，对冠脉粥样硬化斑块的形成、发展和不均匀性有着重要的影响。最近的基础和临床在体研究表明，WSS也可能与支架内再狭窄的发生有关。从支架内再狭窄的形成机制出发，分析冠脉支架后的力学环境对再狭窄的作用机制，详细阐述近年基于计算流体力学（CFD）方法的冠脉支架内再狭窄的血流动力学研究进展。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	何玉娜蔺嫦燕^#*

关键词 ：冠状动脉, 壁面剪切力, 支架内再狭窄, 计算流体力学

Abstract：Coronary stent restenosis is a high incidence and severe medical event. Local hemodynamic factors, wall shear stress (WSS) in particular, critically affect the formation, progression and heterogeneity of atherosclerotic plaque. Emerging preclinical and clinical in vivo evidences now suggest that WSS may also contribute to the occurrence of stent restenosis. This review starts from the formation mechanism of instent restenosis, analyzes the mechanism of mechanical environment in coronary stent restenosis and elaborates the computational fluid dynamics (CFD) research progress in haemodynamics associated with instent restenosis in detail.

Key words： coronary wall shear stress stent restenosis computational fluid dynamics

基金资助:北京市自然科学基金(3112011)

引用本文:

何玉娜蔺嫦燕^#*. 冠脉支架内再狭窄的血流动力学研究进展[J]. 中国生物医学工程学报, 2015, 34(3): 354-359.

链接本文:

http://cjbme.csbme.org/CN/10.3969/j.issn.0258-8021. 2015. 03.013 或 http://cjbme.csbme.org/CN/Y2015/V34/I3/354

［1］Yang SS, Tang L, Ge GH, et al. Metaanalysis of the long term effects of different interventions on chronic total coronary occlusions ［J］. Eur Rev Med Pharmacol Sci, 2013, 17(12): 1583-1589. 
［2］Alcalai R, Viola N, Mosseri M, et al. The value of percutaneous coronary intervention in aortic valve stenosis with coronary artery disease ［J］. Am J Med, 2007, 120(2): 185.e7-185.e13. 
［3］Chatzizisis YS, Coskun AU, Jonas M, et al. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior ［J］. J Am Coll Cardiol, 2007, 49(25): 2379-2393.
［4］Papafaklis MI, Koskinas KC, Chatzizisis YS, et al. Invivo assessment of the natural history of coronary atherosclerosis: vascular remodeling and endothelial shear stress determine the complexity of atherosclerotic disease progression ［J］. Curr Opin Cardiol, 2010, 25(6): 627-638. 
［5］Koskinas KC, Chatzizisis YS, Antoniadis AP, et al. Role of Endothelial Shear Stress in Stent Restenosis and Thrombosis, Pathophysiologic Mechanisms and Implications for Clinical Translation ［J］. J Am Coll Cardiol, 2012, 59(15): 1337-1349.
［6］Barakat AI. Blood flow and arterial endothelial dysfunction: Mechanisms and implications ［J］. Cr Phys, 2013, 14(6): 479-496.
［7］Murphy J, Boyle F. Predicting neointimal hyperplasia in stented arteries using timedependant computational fluid dynamics: a review ［J］. Comput Biol Med, 2010, 40(4): 408-418.
［8］LaDisa JF Jr, Guler I, Olson LE, et al. Threedimensional computtional fluid dynamic modeling of alterations in coronary wall shear stress produced by stent implantation ［J］. Ann Biomed Eng, 2003, 31(8): 972-980.
［9］LaDisa JF Jr, Olson LE, Douglas HA, et al. Alterations in regional vascular geometry produced by theoretical stent implantation influence distributions of wall shear stress: analysis of a curved coronary artery using 3D computational fluid dynamics modeling ［J］. Biomed Eng Online, 2006, 5:40.
［10］孙安强, 邓小燕. 冠状动脉支架血流动力学中的几个问题［J］. 生物物理学报, 2011, 27(8): 669-675．
［11］Chen HY, Hermiller J, Sinha AK, et al. Effects of stent sizing on endothelial and vessel wall stress: Potential mechanisms for instent restenosis ［J］. J Appl Physiol, 2009, 106(5): 1686-1691.
［12］Jimenez JM, Davies PF. Hemodynamically driven stent strut design ［J］. Ann Biomed Eng, 2009, 37(8): 1483-1494. 
［13］Mejia J, Ruzzeh B, Mongrain R, et al. Evaluation of the effect of stent strut profile on shear stress distribution using statistical moments ［J］. Biomed Eng Online, 2009, 8:8.［14］LaDisa JF Jr, Olson LE, Guler I, et al. Stent design properties and deployment ratio influence indexes of wall shear stress: a threedimensional computational fluid dynamics investigation within a normal artery ［J］. J Appl Physiol, 2004, 97(1): 424-430.
［15］Murasato Y, Hikichi Y, Horiuchi M. Examination of stent deformation and gap formation after complex stenting of left main coronary artery bifurcations using microfocus computed tomography ［J］. J Interv Cardiol, 2009, 22(2):135-144.
［16］Katritsis DG, Theodorakakos A, Pantos I, et al. Flow patterns at stented coronary bifurcations computational fluid dynamics analysis ［J］. Circ Cardiovasc Interv, 2012, 5(4): 530-539.
［17］Carlier SG, van Damme LC, Blommerde CP, et al. Augmentation of wall shear stress inhibits neointimal hyperplasia after stent implantation: inhibition through reduction of inflammation? ［J］. Circulation, 2003, 107(21): 2741-2746.
［18］LaDisa JF Jr, Olson LE, Molthen RC, et al. Alterations in wall shear stress predict sites of neointimal hyperplasia after stent implantation in rabbit iliac arteries ［J］. Am J Physiol Heart Circ Physiol, 2005, 288(5): H2465-H2475.
［19］Fujimoto M, Takao H, Suzuki T, et al. Temporal correlation between wall shear stress and instent stenosis after wingspan stent in swine model ［J］. AJNR Am J Neuroradiol, 2014, 35(5): 994-998.
［20］Morlacchi S, Keller B, Arcangeli P, et al. Hemodynamics and instent restenosis: microCT images, histology, and computer simulations ［J］. Ann Biomed Eng, 2011, 3910): 2615-2626.
［21］Virmani R, Kolodgie FD, Farb A, et al. Drug eluting stents: are human and animal studies comparable? Heart, 2003, 89:133-138.
［22］Wentzel JJ, Krams R, Schuurbiers JC, et al. Relationship between neointimal thickness and shear stress after Wallstent implantation in human coronary arteries ［J］. Circulation, 2001, 103(13): 1740 -1745.
［23］Stone PH, Coskun AU, Kinlay S, et al. Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and instent restenosis in humans: in vivo 6-month followup study ［J］. Circulation, 2003,
108(4): 438-444.
［24］Sanmartin M, Goicolea J, Garcia C, et al. Influence of shear stress on instent restenosis: in vivo study using 3D reconstruction and computational fluid dynamics ［J］. Rev Esp Cardiol, 2006, 59(1): 20-27.
［25］Gijsen FJ, Oortman RM, Wentzel JJ, et al. Usefulness of shear stress pattern in predicting neointima distribution in sirolimuseluting stents in coronary arteries ［J］. Am J Cardiol, 2003, 92(11): 1325-1328.
［26］Papafaklis MI, Katsouras CS, Theodorakis PE, et al. Coronary dilatation 10 weeks after paclitaxeleluting stent implantation. No role of shear stress in lumen enlargement? ［J］. Heart Vessels, 2007, 22(4): 268-273.
［27］Suzuki N, Nanda H, Angiolillo D J, et al. Assessment of potential relationship between wall shear stress and arterial wall response after bare metal stent and sirolimuseluting stent implantation in patients with diabetes mellitus［J］. Int J Cardiovasc Imag, 2008, 24(4): 357-364.
［28］Gundert TJ, Shadden SC, Williams AR, et al. A rapid and computationally inexpensive method to virtually implant current and nextgeneration stents into subjectspecific computational fluid dynamics models ［J］. Ann Biomed Eng, 2011, 39(5):1423-1437.
［29］Morlacchi S, Migliavacca F. Modeling stented coronary arteries: where we are, where to go ［J］. Ann Biomed Eng, 2013, 41(7): 1428-1444.
［30］Zhang Junmei, Zhong Liang, Su Boyang, et al. Perspective on CFD studies of coronary artery disease lesions and hemodynamics: A review ［J］. Int J Numer Method Biomed Eng, 2014, 30(6): 659-680.
［31］Chiastra C, Migliavacca F, Martinez MA, et al. On the necessity of modelling fluidstructure interaction for stented coronary arteries ［J］. J Mech Behav Biomed Mater, 2014, 34: 217-230.