One particular complexity of coronary artery is the natural tapering of the vessel with proximal segments having larger caliber and distal tapering as the vessel get smaller. The natural tapering of a coronary artery often leads to proximal incomplete stent apposition (ISA). ISA alters coronary hemodynamics and creates pathological path to develop complications such as in-stent restenosis, and more worryingly, stent thrombosis (ST). By employing state-of-the-art computer-aided design software, generic stent hoops were virtually deployed in an idealized tapered coronary artery with decreasing malapposition distance. Pulsatile blood flow simulations were carried out using computational fluid dynamics (CFD) on these computer-aided design models. CFD results reveal unprecedented details in both spatial and temporal development of microrecirculation environments throughout the cardiac cycle (CC). Arterial tapering also introduces secondary microrecirculation. These primary and secondary microrecirculations provoke significant fluctuations in arterial wall shear stress (WSS). There has been a direct correlation with changes in WSS and the development of atherosclerosis. Further, the presence of these microrecirculations influence strongly on the local levels of blood viscosity in the vicinity of the malapposed stent struts. The observation of secondary microrecirculations and changes in blood rheology is believed to complement the wall (-based) shear stress, perhaps providing additional physical explanations for tissue accumulation near ISA detected from high resolution optical coherence tomography (OCT).
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Research-Article
Elevated Blood Viscosity and Microrecirculation Resulting From Coronary Stent Malapposition
Eric K. W. Poon,
Eric K. W. Poon
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: epoon@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: epoon@unimelb.edu.au
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Vikas Thondapu,
Vikas Thondapu
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia;
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia;
Faculty of Medicine, Dentistry, and Health Sciences,
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: vthondapu@student.unimelb.edu
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: vthondapu@student.unimelb.edu
Search for other works by this author on:
Umair Hayat,
Umair Hayat
Faculty of Medicine, Dentistry and Health Sciences,
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: umair_hayat@hotmail.com
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: umair_hayat@hotmail.com
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Peter Barlis,
Peter Barlis
Department of Medicine,
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: pbarlis@unimelb.edu.au
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: pbarlis@unimelb.edu.au
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Chooi Yin Yap,
Chooi Yin Yap
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: c.yap3@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: c.yap3@student.unimelb.edu.au
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Po-Hung Kuo,
Po-Hung Kuo
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: phkuo@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: phkuo@student.unimelb.edu.au
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Qisen Wang,
Qisen Wang
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: qisenw@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: qisenw@student.unimelb.edu.au
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Jiawei Ma,
Jiawei Ma
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: Jiaweim@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: Jiaweim@student.unimelb.edu.au
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Shuang J. Zhu,
Shuang J. Zhu
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: sjzhu@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: sjzhu@unimelb.edu.au
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Andrew S. H. Ooi
Andrew S. H. Ooi
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: a.ooi@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: a.ooi@unimelb.edu.au
Search for other works by this author on:
Eric K. W. Poon
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: epoon@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: epoon@unimelb.edu.au
Vikas Thondapu
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia;
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia;
Faculty of Medicine, Dentistry, and Health Sciences,
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: vthondapu@student.unimelb.edu
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: vthondapu@student.unimelb.edu
Umair Hayat
Faculty of Medicine, Dentistry and Health Sciences,
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: umair_hayat@hotmail.com
Department of Medicine,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: umair_hayat@hotmail.com
Peter Barlis
Department of Medicine,
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: pbarlis@unimelb.edu.au
Faculty of Medicine, Dentistry and Health Sciences,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: pbarlis@unimelb.edu.au
Chooi Yin Yap
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: c.yap3@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: c.yap3@student.unimelb.edu.au
Po-Hung Kuo
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: phkuo@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: phkuo@student.unimelb.edu.au
Qisen Wang
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: qisenw@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: qisenw@student.unimelb.edu.au
Jiawei Ma
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: Jiaweim@student.unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: Jiaweim@student.unimelb.edu.au
Shuang J. Zhu
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: sjzhu@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: sjzhu@unimelb.edu.au
Stephen Moore
Andrew S. H. Ooi
Department of Mechanical Engineering,
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: a.ooi@unimelb.edu.au
Melbourne School of Engineering,
The University of Melbourne,
Melbourne 3010, Victoria, Australia
e-mail: a.ooi@unimelb.edu.au
1Corresponding author.
Manuscript received June 27, 2017; final manuscript received January 28, 2018; published online March 5, 2018. Assoc. Editor: Keefe B. Manning.
J Biomech Eng. May 2018, 140(5): 051006 (9 pages)
Published Online: March 5, 2018
Article history
Received:
June 27, 2017
Revised:
January 28, 2018
Citation
Poon, E. K. W., Thondapu, V., Hayat, U., Barlis, P., Yap, C. Y., Kuo, P., Wang, Q., Ma, J., Zhu, S. J., Moore, S., and Ooi, A. S. H. (March 5, 2018). "Elevated Blood Viscosity and Microrecirculation Resulting From Coronary Stent Malapposition." ASME. J Biomech Eng. May 2018; 140(5): 051006. https://doi.org/10.1115/1.4039306
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