Annals of Biomedical Engineering

, Volume 37, Issue 7, pp 1310–1321 | Cite as

In Vitro, Time-Resolved PIV Comparison of the Effect of Stent Design on Wall Shear Stress

  • John Charonko
  • Satyaprakash Karri
  • Jaime Schmieg
  • Santosh Prabhu
  • Pavlos VlachosEmail author


The effect of stent design on wall shear stress (WSS) and oscillatory shear index (OSI) was studied in vitro using time-resolved digital particle image velocimetry (DPIV). Four drug-eluting stents [XIENCE V® (Abbott Vascular), TAXUS® Liberté® (Boston Scientific), Endeavor® (Medtronic), and Cypher® (J&J Cordis)] and a bare-metal stent [VISION® (Abbott Vascular)] were implanted into compliant vessel models, and the flow was measured in physiologically accurate coronary conditions featuring reversal and realistic offsets between pressure and flowrate. DPIV measurements were made at three locations under two different flow rates (resting: Re = 160, f = 70 bpm and exercise: Re = 300, f = 120 bpm). It was observed that design substantially affected the WSS experienced at the vessel walls. Averaged values between struts ranged from 2.05 dynes/cm2 (Cypher®) to 8.52 dynes/cm2 (XIENCE V®) in resting conditions, and from 3.72 dynes/cm2 (Cypher®) to 14.66 dynes/cm2 (VISION®) for the exercise state. Within the stent, the WSS dropped and the OSI increased immediately distal to each strut. In addition, an inverse correlation between average WSS and OSI existed. Comparisons with recently published results from animal studies show strong correlation between the measured WSS and observed endothelial cell coverage. These results suggest the importance of stent design on the WSS experienced by endothelial cells in coronary arteries.


Coronary arteries Blood flow Phase offset Oscillatory shear index Drug-eluting stent Bare metal stent Endothelial cells 



Abbott Vascular provided partial support for this research. This material is also based upon work supported by the National Science Foundation under CAREER award #0547434.


  1. 1.
    Abiven, C., and P. P. Vlachos. Super spatio-temporal resolution, digital PIV system for multi-phase flows with phase differentiation and simultaneous shape and size quantification. In: 2002 Proceedings of the ASME IMECE. New Orleans, LA: ASME, 2002.Google Scholar
  2. 2.
    Adrian, R.J. Twenty years of particle image velocimetry. Experiments in Fluids. 39:159-169, 2005.CrossRefGoogle Scholar
  3. 3.
    Al Suwaidi, J., P.B. Berger, C.S. Rihal, K.N. Garratt, M.R. Bell, H.H. Ting, J.F. Bresnahan, D.E. Grill, and D.R. Holmes. Immediate and long-term outcome of intracoronary stent implantation for true bifurcation lesions. Journal of the American College of Cardiology. 35:929-936, 2000.PubMedCrossRefGoogle Scholar
  4. 4.
    Balossino, R., F. Gervaso, F. Migliavacca, and G. Dubini. Effects of different stent designs on local hemodynamics in stented arteries. Journal of Biomechanics. 41:1053-1061, 2008.PubMedCrossRefGoogle Scholar
  5. 5.
    Benard, N., D. Coisne, E. Donal, and R. Perrault. Experimental study of laminar blood flow through an artery treated by a stent implantation: characterisation of intra-stent wall shear stress. Journal of Biomechanics. 36:991-998, 2003.PubMedCrossRefGoogle Scholar
  6. 6.
    Berry, J.L., J.E. Moore, V.S. Newman, and W.D. Routh. In vitro flow visualization in stented arterial segments. Journal of Vascular Investigation. 3:63-68, 1997.Google Scholar
  7. 7.
    Berry, J., A. Santamarina, J. Moore, S. Roychowdhury, and W. Routh. Experimental and Computational Flow Evaluation of Coronary Stents. Annals of Biomedical Engineering. 28:386-398, 2000.PubMedCrossRefGoogle Scholar
  8. 8.
    Charonko, J.J., S.A. Ragab, and P.P. Vlachos. A scaling parameter for predicting pressure wave reflection in stented arteries. Journal of Medical Devices. 3:11006-011006-10, 2009.Google Scholar
  9. 9.
    Chiu, J., L. Chen, C. Chen, P. Lee, and C. Lee. A model for studying the effect of shear stress on interactions between vascular endothelial cells and smooth muscle cells. Journal of Biomechanics. 37:531-539, 2004.PubMedCrossRefGoogle Scholar
  10. 10.
    Duraiswamy, N., R.T. Schoephoerster, M.R. Moreno, and James E. Moore Jr. Stented Artery Flow Patterns and Their Effects on the Artery Wall. Annual Review of Fluid Mechanics. 39:357-382, 2006.CrossRefGoogle Scholar
  11. 11.
    Edelman, E.R., and C. Rogers. Pathobiologic Responses to Stenting. The American Journal of Cardiology. 81:4E-6E, 1998.PubMedCrossRefGoogle Scholar
  12. 12.
    Edelman, E.R., and C. Rogers. Stent-Versus-Stent Equivalency Trials : Are Some Stents More Equal Than Others? Circulation. 100:896-898, 1999.PubMedGoogle Scholar
  13. 13.
    El-Omar, M., G. Dangas, I. Iakovou, and R. Mehran. Update on In-stent Restenosis. Current Interventional Cardiology Reports. 3:296-305, 2001.PubMedGoogle Scholar
  14. 14.
    Finn, A.V., M. Joner, G. Nakazawa, F. Kolodgie, J. Newell, M.C. John, H.K. Gold, and R. Virmani. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation. 115:2435-2441, 2007.PubMedCrossRefGoogle Scholar
  15. 15.
    Fischman, D.L., M.B. Leon, D.S. Baim, R.A. Schatz, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent Restenosis Study Investigators. The New England Journal of Medicine. 331:496-501, 1994.PubMedCrossRefGoogle Scholar
  16. 16.
    Hopkins, R. Lehman drug-eluting stent survey results. Medical Supplies and Devices Industry Update. Lehman Brothers Equity Research, 2003.Google Scholar
  17. 17.
    Johnston, B.M., P.R. Johnston, S. Corney, and D. Kilpatrick. Non-Newtonian blood flow in human right coronary arteries: steady state simulations. Journal of Biomechanics. 37:709-720, 2004.PubMedCrossRefGoogle Scholar
  18. 18.
    Johnston, B.M., P.R. Johnston, S. Corney, and D. Kilpatrick. Non-Newtonian blood flow in human right coronary arteries: Transient simulations. Journal of Biomechanics. 39:1116-1128, 2006.PubMedCrossRefGoogle Scholar
  19. 19.
    Joner, M., G. Nakazawa, A.V. Finn, S.C. Quee, et al. Endothelial Cell Recovery Between Comparator Polymer-Based Drug-Eluting Stents. Journal of the American College of Cardiology. 52:333-342, 2008.PubMedCrossRefGoogle Scholar
  20. 20.
    Karri, S., J. Charonko, and P. P. Vlachos. Robust wall gradient estimation using radial basis functions and proper orthogonal decomposition (POD) for particle image velocimetry (PIV) measured fields. Meas. Sci. Technol. 20:045401, 2009.Google Scholar
  21. 21.
    Kastrati, A., J. Mehilli, J. Dirschinger, F. Dotzer, et al. Intracoronary Stenting and Angiographic Results : Strut Thickness Effect on Restenosis Outcome (ISAR-STEREO) Trial. Circulation. 103:2816-2821, 2001.PubMedGoogle Scholar
  22. 22.
    Kastrati, A., J. Mehilli, J. Dirschinger, J. Pache, et al. Restenosis after coronary placement of various stent types. The American Journal of Cardiology. 87:34-39, 2001.PubMedCrossRefGoogle Scholar
  23. 23.
    Kleinstreuer, C., S. Hyun, J.R. Buchanan, P.W. Longest, J.P. Archie, and G.A. Truskey. Hemodynamic parameters and early intimal thickening in branching blood vessels. Critical Reviews in Biomedical Engineering. 29:1-64, 2001.PubMedGoogle Scholar
  24. 24.
    LaDisa, J.F., I. Guler, L.E. Olson, D.A. Hettrick, J.R. Kersten, D.C. Warltier, and P.S. Pagel. Three-dimensional computational fluid dynamics modeling of alterations in coronary wall shear stress produced by stent implantation. Annals of Biomedical Engineering. 31:972-980, 2003.PubMedCrossRefGoogle Scholar
  25. 25.
    LaDisa, J.F., L.E. Olson, I. Guler, D.A. Hettrick, S.H. Audi, J.R. Kersten, D.C. Warltier, and P.S. Pagel. Stent design properties and deployment ratio influence indexes of wall shear stress: a three-dimensional computational fluid dynamics investigation within a normal artery. Journal of Applied Physiology. 97:424-430, 2004.PubMedCrossRefGoogle Scholar
  26. 26.
    LaDisa, J.F., L.E. Olson, I. Guler, D.A. Hettrick, J.R. Kersten, D.C. Warltier, and P.S. Pagel. Circumferential vascular deformation after stent implantation alters wall shear stress evaluated with time-dependent 3D computational fluid dynamics models. Journal of Applied Physiology. 98:947-957, 2005.Google Scholar
  27. 27.
    Lee, S. W., L. Antiga, and D. A. Steinman. Correlation among hemodynamic parameters at the carotid bifurcation. In: Proceedings of the 2008 Summer Bioengineering Conference. Marco Island, FL: ASME, 2008.Google Scholar
  28. 28.
    Lewis, G. Materials, fluid dynamics, and solid mechanics aspects of coronary artery stents: a state-of-the-art review. Journal of Biomedical Materials Research. Part B, Applied Biomaterials. 86B:569-590, 2008.PubMedCrossRefGoogle Scholar
  29. 29.
    Malek, A.M., S.L. Alper, and S. Izumo. Hemodynamic Shear Stress and Its Role in Atherosclerosis. JAMA. 282:2035-2042, 1999.PubMedCrossRefGoogle Scholar
  30. 30.
    Nakazawa, G., A.V. Finn, M.C. John, F.D. Kolodgie, and R. Virmani. The Significance of Preclinical Evaluation of Sirolimus-, Paclitaxel-, and Zotarolimus-Eluting Stents. The American Journal of Cardiology. 100:S36-S44, 2007.CrossRefGoogle Scholar
  31. 31.
    Nakazawa, G., A.V. Finn, and R. Virmani. Drug-eluting stent pathology–should we still be cautious? Nature Clinical Practice. Cardiovascular Medicine. 5:1, 2008.PubMedCrossRefGoogle Scholar
  32. 32.
    Natarajan, S., and M.R. Mokhtarzadeh-Dehghan. A numerical and experimental study of periodic flow in a model of a corrugated vessel with application to stented arteries. Medical Engineering & Physics. 22:555-566, 2000.PubMedCrossRefGoogle Scholar
  33. 33.
    Orlic, D., E. Bonizzoni, G. Stankovic, F. Airoldi, et al. Treatment of multivessel coronary artery disease with sirolimus-eluting stent implantation: immediate and mid-term results. Journal of the American College of Cardiology. 43:1154-1160, 2004.PubMedCrossRefGoogle Scholar
  34. 34.
    Ozolanta, I., G. Tetere, B. Purinya, and V. Kasyanov. Changes in the mechanical properties, biochemical contents and wall structure of the human coronary arteries with age and sex. Medical Engineering & Physics. 20:523-533, 1998.PubMedCrossRefGoogle Scholar
  35. 35.
    Pahakis, M.Y., J.R. Kosky, R.O. Dull, and J.M. Tarbell. The role of endothelial glycocalyx components in mechanotransduction of fluid shear stress. Biochemical and Biophysical Research Communications. 355:228-233, 2007.PubMedCrossRefGoogle Scholar
  36. 36.
    Pfisterer, M., H.P. Brunner-La Rocca, P.T. Buser, P. Rickenbacher, et al. Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents. Journal of the American College of Cardiology. 48:2584-2591, 2006.PubMedCrossRefGoogle Scholar
  37. 37.
    Qiu, Y., and J.M. Tarbell. Numerical Simulation of Pulsatile Flow in a Compliant Curved Tube Model of a Coronary Artery. Journal of Biomechanical Engineering. 122:77-85, 2000.PubMedCrossRefGoogle Scholar
  38. 38.
    Rosamond, W., K. Flegal, G. Friday, K. Furie, et al. Heart Disease and Stroke Statistics–2007 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 115:e69-171, 2007.PubMedCrossRefGoogle Scholar
  39. 39.
    Simon, C., J.C. Palmaz, and E.A. Sprague. Influence of topography on endothelialization of stents: clues for new designs. Journal of Long-Term Effects of Medical Implants. 10:143-151, 2000.PubMedGoogle Scholar
  40. 40.
    Stone, P.H., A.U. Coskun, S. Kinlay, M.E. Clark, et al. Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study. Circulation. 108:438-444, 2003.PubMedCrossRefGoogle Scholar
  41. 41.
    Stone, P.H., A.U. Coskun, S. Kinlay, J.J. Popma, et al. Regions of low endothelial shear stress are the sites where coronary plaque progresses and vascular remodelling occurs in humans: an in vivo serial study. Eur Heart J. 28:705-710, 2007.PubMedCrossRefGoogle Scholar
  42. 42.
    Topol, E.J. Coronary-artery stents–gauging, gorging, and gouging. The New England Journal of Medicine. 339:1702-1704, 1998.PubMedCrossRefGoogle Scholar
  43. 43.
    Topol, E.J., and P.W. Serruys. Frontiers in Interventional Cardiology. Circulation. 98:1802-1820, 1998.PubMedGoogle Scholar
  44. 44.
    Tortoriello, A., and G. Pedrizzetti. Flow-tissue interaction with compliance mismatch in a model stented artery. Journal of Biomechanics. 37:1-11, 2004.PubMedCrossRefGoogle Scholar
  45. 45.
    Wentzel, J.J., F.J.H. Gijsen, N. Stergiopulos, P.W. Serruys, C.J. Slager, and R. Krams. Shear stress, vascular remodeling and neointimal formation. Journal of Biomechanics. 36:681-688, 2003.PubMedCrossRefGoogle Scholar
  46. 46.
    Wereley, S.T., and C.D. Meinhart. Second-order accurate particle image velocimetry. Experiments in Fluids. 31:258-268, 2001.CrossRefGoogle Scholar
  47. 47.
    Yao, Y., A. Rabodzey, and C.F. Dewey. Glycocalyx modulates the motility and proliferative response of vascular endothelium to fluid shear stress. Am J Physiol Heart Circ Physiol. 293:H1023-1030, 2007.PubMedCrossRefGoogle Scholar
  48. 48.
    Yazdani, S.K., J. Moore, J.L. Berry, and P.P. Vlachos. DPIV Measurements of Flow Disturbances in Stented Artery Models: Adverse affects of Compliance Mismatch. Journal of Biomechanical Engineering. 126:559-566, 2004.PubMedCrossRefGoogle Scholar
  49. 49.
    Zhou, J., R.J. Adrian, S. Balachandar, and T.M. Kendall. Mechanisms for Generating Coherent Packets of Hairpin Vortices in Channel Flow. Journal of Fluid Mechanics. 387:353-396, 1999.CrossRefGoogle Scholar

Copyright information

© Biomedical Engineering Society 2009

Authors and Affiliations

  • John Charonko
    • 1
  • Satyaprakash Karri
    • 1
  • Jaime Schmieg
    • 1
  • Santosh Prabhu
    • 2
  • Pavlos Vlachos
    • 1
    Email author
  1. 1.Virginia TechBlacksburgUSA
  2. 2.Abbott VascularSanta ClaraUSA

Personalised recommendations