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Title: Comparison of overexpansion capabilities and thrombogenicity at the side branch ostia after implantation of four different drug eluting stents
Authors: Gasior, Pawel
Lu, Shengjie
Ng, Jaryl Chen Koon
Toong, Daniel Wee Yee
Wong, Philip En Hou
Foin, Nicolas
Kedhi, Elvin
Wojakowski, Wojciech
Ang, Hui Ying
Keywords: Science::Medicine
Issue Date: 2020
Source: Gasior, P., Lu, S., Ng, J. C. K., Toong, D. W. Y., Wong, P. E. H., Foin, N., . . . Ang, H. Y. (2020). Comparison of overexpansion capabilities and thrombogenicity at the side branch ostia after implantation of four different drug eluting stents. Scientific Reports, 10(1), 20791-. doi:10.1038/s41598-020-75836-6
Journal: Scientific Reports
Abstract: Interventions in bifurcation lesions often requires aggressive overexpansion of stent diameter in the setting of long tapering vessel segment. Overhanging struts in front of the side branch (SB) ostium are thought to act as a focal point for thrombi formation and consequently possible stent thrombosis. This study aimed to evaluate the overexpansion capabilities and thrombogenicity at the SB ostia after implantation of four latest generation drug-eluting stents (DES) in an in-vitro bifurcation model. Four clinically available modern DES were utilized: one bifurcation dedicated DES (Bioss LIM C) and three conventional DES (Ultimaster, Xience Sierra, Biomime). All devices were implanted in bifurcation models with proximal optimization ensuring expansion before perfusing with porcine blood. Optical coherence tomography (OCT), immunofluorescence (IF) and scanning electron microscope analysis were done to determine thrombogenicity and polymer coating integrity at the over-expanded part of the stents. Computational fluid dynamics (CFD) was performed to study the flow disruption. OCT (p = 0.113) and IF analysis (p = 0.007) demonstrated lowest thrombus area at SB ostia in bifurcation dedicated DES with favorable biomechanical properties compared to conventional DES. The bifurcated DES also resulted in reduced area of high shear rate and maximum shear rate in the CFD analysis. This study demonstrated numerical differences in terms of mechanical properties and acute thrombogenicity at SB ostia between tested devices.
ISSN: 2045-2322
DOI: 10.1038/s41598-020-75836-6
Rights: © 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Fulltext Permission: open
Fulltext Availability: With Fulltext
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