In-stent Flow Hemodynamics and the Risk of STent Failure Following Bioresorbable Vascular ScAFFolds Implantation – the STAFF Study

Abstract

Background: Myocardial revascularization procedures have undergone important developments over the last decades, which led to a major shift in current clinical practice and therapeutic guidelines across the world. Bare metal and drug-eluting stents present several limitations, all centered on the concept of disturbed coronary hemodynamics after implantation, which can be surpassed by bioresorbable vascular scaffolds (BVS). BVSs are fourth-generation stents used in coronary revascularization procedures, but despite all the promising initial results published on their efficiency, several clinical trials have reported unsatisfactory results, and the main explanation was accredited to improper implantation method. Shear stress is a central element of intravascular homeostasis; it controls vascular remodeling, as well as the development, progression, and destabilization of atheromatous plaques. This study aims to assess the role of in-stent flow hemodynamics (evaluated by computational determination of shear stress via coronary CT imaging) in predicting the clinical evolution following BVS implantation.

Keywords

• bioresorbable scaffolds
• in-stent hemodynamics
• shear stress
• predilatation time
• inflation pressures