Abstract 17675: The Relationship of Endothelial Shear Stress after Stent Implantation with In-Stent Neointimal Hyperplasia and Clinical Outcomes in Humans

Background: Neointimal in-stent hyperplasia (ISH) is a frequent complication of percutaneous coronary interventions (PCI), and ultimately may lead to in-stent restenosis (ISR). ISH may develop in regions of low endothelial shear stress (ESS) within the stent, but the relationship between ESS magnitude, the extent of ISH and subsequent clinical events has not been investigated. In patients with an acute coronary syndrome treated with PCI, we assessed the impact of post-PCI ESS on the ISH and ISR requiring repeat PCI. Methods: We investigated the PREDICTION Study database with focus on stents. 3D coronary reconstruction by angiography & intravascular ultrasound was performed in 374 patients after stent implantation (baseline, BL) and at 6-10 month follow-up (FU). Each stent was divided into 1.5mm-long segments, within which we calculated ESS at BL with computational fluid dynamics. At FU, we assessed percent ISH (ISH area/stent area) and the occurrence of a clinically indicated PCI in the same locations. Re...