标题： 冠状动脉斑块形态对局部机械状态及支架内再狭窄的影响 显示英文标题

标题： Influence of coronary plaque morphology on local mechanical states and associated in-stent restenosis

摘要： 支架内再狭窄是经皮冠状动脉介入治疗后的一个多因素过程。 特定的形态学病变特征被观察到会促进支架内再狭窄的发生。 局部机械因素，如应力和应变，已知会影响支架植入后的组织适应。 然而，形态学特征对这些局部机械状态的影响，从而对支架内再狭窄的发生影响，仍研究不足。 本研究通过评估在支架植入过程中和植入后，对于有信息的病变形态的动脉壁中的应力分布，来研究局部机械量与支架内再狭窄之间的相关性。 我们使用基于物理的患者特异性冠状动脉模型进行支架植入过程的计算模拟。 不同的形态学特征通过高分辨率冠状动脉计算机断层扫描血管造影数据中的空间斑块组成信息进行评估。 我们量化支架内再狭窄与局部张力应力之间的相关性。 我们发现，特定的形态学特征，如周向或不对称的钙化块会导致周围组织中的应力增加。 本研究得出结论，局部应力对于评估个体支架内再狭窄风险至关重要。 显示英文摘要

摘要： In-stent restenosis after percutaneous coronary intervention is a multifactorial process. Specific morphological lesion characteristics were observed to contribute to the occurrence of in-stent restenosis. Local mechanical factors, such as stresses and strains, are known to influence tissue adaptation after stent implantation. However, the influence of morphological features on those local mechanical states and, hence, on the occurrence of in-stent restenosis remains understudied. This work investigates the correlation between local mechanical quantities and in-stent restenosis by evaluating the stress distributions in the artery wall during and after stent implantation for informative lesion morphologies. We perform computational simulations of the stenting procedure with physics-based patient-specific coronary artery models. Different morphologies are assessed using the spatial plaque composition information from high-resolution coronary computed tomography angiography data. We quantify the correlation between in-stent restenosis and local tensional stresses. We found that specific morphological characteristics like circumferential or asymmetric block calcifications result in higher stresses in the surrounding tissue. This study concludes that local stresses are critical for assessing the individual in-stent restenosis risk.