Computational fluid dynamics applied to virtually deployed drug-eluting coronary bioresorbable scaffolds: Clinical translations derived from a proof-of-concept

Authors

  • Bill D Gogas 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Boyi Yang 2. Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Tiziano Passerini 2.Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia
  • Alessandro Veneziani 2. Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Marina Piccinelli 3. Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Gaetano Esposito 2. Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Emad Rasoul-Arzrumly 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Mosaab Awad 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
  • Girum Mekonnen 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Olivia Y Hung 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Beth Holloway 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Michael McDaniel 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Don Giddens 4. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Spencer B King III 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 5. Saint Joseph's Heart and Vascular Institute, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia
  • Habib Samady 1. Andreas Gruentzig Cardiovascular Center, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia 6. Emory GT Imaging Biomechanical Core Laboratory, Emory University School of Medicine, Atlanta, Georgia

Abstract

Background: Three-dimensional design simulations of coronary metallic stents utilizing mathematical and computational algorithms have emerged as important tools for understanding biomechanical stent properties, predicting the interaction of the implanted platform with the adjacent tissue, and informing stent design enhancements. Herein, we demonstrate the hemodynamic implications following virtual implantation of bioresorbable scaffolds using finite element methods and advanced computational fluid dynamics (CFD) simulations to visualize the device-flow interaction immediately after implantation and following scaffold resorption over time. 

Methods and Results: CFD simulations with time averaged wall shear stress (WSS) quantification following virtual bioresorbable scaffold deployment in idealized straight and curved geometries were performed. WSS was calculated at the inflow, endoluminal surface (top surface of the strut), and outflow of each strut surface post-procedure (stage I) and at a time point when 33% of scaffold resorption has occurred (stage II). The average WSS at stage I over the inflow and outflow surfaces was 3.2 and 3.1 dynes/cm2respectively and 87.5 dynes/cm2over endoluminal strut surface in the straight vessel. From stage I to stage II, WSS increased by 100% and 142% over the inflow and outflow surfaces, respectively, and decreased by 27% over the endoluminal strut surface. In a curved vessel, WSS change became more evident in the inner curvature with an increase of 63% over the inflow and 66% over the outflow strut surfaces. Similar analysis at the proximal and distal edges demonstrated a large increase of 486% at the lateral outflow surface of the proximal scaffold edge. 

Conclusions: The implementation of CFD simulations over virtually deployed bioresorbable scaffolds demonstrates the transient nature of device/flow interactions as the bioresorption process progresses over time. Such hemodynamic device modeling is expected to guide future bioresorbable scaffold design.

Downloads

Published

2017-06-30

Issue

Vol. 2014 No. 4 (2014)

Section

Research articles

License

This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.