3D reconstruction of stented porcine coronaries for cfd and mass transfer analyses of in-stent restenosis

Almost 10% coronary artery stenting procedures using bare metal stents are associated with in-stent restenosis, that is, a severe hyperplastic intimal tissue response within the stented region. This results in an obstruction to flow and a return of clinical symptoms. The present study investigates the hypothesis that a greater neointimal growth response is associated with regions of the vessel wall that are subject to low (<0.5 Pa) wall shear stress (WSS) following stent deployment. Such regions may be associated with arterial wall hypoxia. The 3D geometry of a stented porcine coronary artery was used to inform a computational fluid dynamics (CFD) model of coronary flow. This type of model has the potential to predict flow patterns with greater accuracy than a model based on idealised stent geometry alone, providing predictive capabilities for clinical application. Current results support the role of low WSS in the formation of in-stent restenosis through direct comparison of case-specific CFD results with the corresponding histological sections. The methodology shows promise for the elucidation of the role of arterial wall hypoxia.