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Haemodynamics and Flow Modification Stents for Peripheral Arterial Disease : A Review

Kokkalis, Efstratios ; Aristokleous, Nicolas LU orcid and Houston, J. Graeme (2016) In Annals of Biomedical Engineering 44(2). p.466-476
Abstract

Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its... (More)

Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its re-introduction after endovascular treatment of PAD has been suggested as a method to induce stabilised and coherent haemodynamics. Stent designs able to generate spiral flow may support endothelial function and therefore increase patency rates. This review is focused on secondary flow phenomena in arteries and the development of flow modification stent technologies for the treatment of PAD.

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author
; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endovascular, Flow modification, Flow optimisation, Helical flow, Helical stent, Peripheral arterial disease, Restenosis, Spiral flow, Spiral flow stent, Stent design, Wall shear stress
in
Annals of Biomedical Engineering
volume
44
issue
2
pages
11 pages
publisher
Springer
external identifiers
  • scopus:84959165649
  • pmid:26467554
ISSN
0090-6964
DOI
10.1007/s10439-015-1483-4
language
English
LU publication?
no
id
15ed26fe-51cc-4521-8113-3761f288e084
date added to LUP
2019-05-14 09:31:11
date last changed
2024-04-02 03:51:37
@article{15ed26fe-51cc-4521-8113-3761f288e084,
  abstract     = {{<p>Endovascular stents are widely used for the treatment of peripheral arterial disease (PAD). However, the development of in-stent restenosis and downstream PAD progression remain a challenge. Stent revascularisation of PAD causes arterial trauma and introduces abnormal haemodynamics, which initiate complicated biological processes detrimental to the arterial wall. The interaction between stent struts and arterial cells in contact, and the blood flow field created in a stented region, are highly affected by stent design. Spiral flow is known as a normal physiologic characteristic of arterial circulation and is believed to prevent the development of flow disturbances. This secondary flow motion is lost in atheromatous disease and its re-introduction after endovascular treatment of PAD has been suggested as a method to induce stabilised and coherent haemodynamics. Stent designs able to generate spiral flow may support endothelial function and therefore increase patency rates. This review is focused on secondary flow phenomena in arteries and the development of flow modification stent technologies for the treatment of PAD.</p>}},
  author       = {{Kokkalis, Efstratios and Aristokleous, Nicolas and Houston, J. Graeme}},
  issn         = {{0090-6964}},
  keywords     = {{Endovascular; Flow modification; Flow optimisation; Helical flow; Helical stent; Peripheral arterial disease; Restenosis; Spiral flow; Spiral flow stent; Stent design; Wall shear stress}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{466--476}},
  publisher    = {{Springer}},
  series       = {{Annals of Biomedical Engineering}},
  title        = {{Haemodynamics and Flow Modification Stents for Peripheral Arterial Disease : A Review}},
  url          = {{http://dx.doi.org/10.1007/s10439-015-1483-4}},
  doi          = {{10.1007/s10439-015-1483-4}},
  volume       = {{44}},
  year         = {{2016}},
}