Three-dimensional analysis of in vivo coronary stent--coronary artery interactions

Abstract

Stent implantation results in important three-dimensional (3D) changes in arterial geometry which may be associated with adverse events. Previous attempts to quantify these 3D changes have been limited by two-dimensional techniques. Using a 3D reconstruction technique, vessel curvatures at end-diastole (ED) and end-systole (ES) were measured before and after stent placement of 100 stents (3 stent cell designs, 6 stent types). After stenting, the mean curvature at ED and ES decreased by 22 and 21%, respectively, and represents a straightening effect on the treated vessel. This effect was proportional to the amount of baseline curvature as high vessel curvature predicted more profound vessel straightening. When analyzed by stent cell design, closed-cell stents resulted in more vessel straightening than other designs (open cell or modified slotted tubes). Stent implantation resulted in the transmission of shape changes to stent ends and generated hinge points or buckling. Stent implantation creates 3D changes in arterial geometry which can be quantified using a 3D reconstruction technique.