Angiography-Based Superficial Wall Strain of De Novo Stenotic Coronary Arteries: Serial Assessment of Vessels Treated with Bioresorbable Scaffold or Drug-Eluting Stent

Objectives: This study sought to present an angiography-based computational model for serial assessment of superficial wall strain (SWS, dimensionless) of de-novo coronary stenoses treated with either bioresorbable scaffold (BRS) or drug-eluting stent (DES). Background: A novel method for SWS allows the assessment of the mechanical status of arteries in-vivo, which may help for predicting cardiovascular outcomes. Methods: Patients with arterial stenosis treated with BRS (n= 21) or DES (n= 21) were included fromABSORB Cohort B1 and AIDA trials. The SWS analyses were performed along with quantitative coronary angiography (QCA) at pre-PCI, post-PCI, and 5-year follow-up. Measurements of QCA and SWS parameters were quantified at the treated segment and adjacent 5-mm proximal and distal edges. Results: Before PCI, the peak SWS on the 'to be treated' segment (0.79 +/- 0.36) was significantly higher than at both virtual edges (0.44 +/- 0.14 and 0.45 +/- 0.21; both p < 0.001). The peak SWS in the treated segment significantly decreased by 0.44 +/- 0.13 (p < 0.001). The surface area of high SWS decreased from 69.97mm(2) to 40.08mm(2) (p = 0.002). The peak SWS in BRS group decreased to a similar extent ( p = 0.775) from 0.81 +/- 0.36 to 0.41 +/- 0.14 (p < 0.001), compared with DES group from 0.77 +/- 0.39 to 0.47 +/- 0.13 (p= 0.001). Relocation of highSWS to device edgeswas often observed in both groups after PCI (35 of 82 cases, 41.7 %). At follow-up of BRS, the peak SWS remained unchanged compared to post-PCI (0.40 +/- 0.12 versus 0.36 +/- 0.09, p= 0.319). Conclusion: Angiography-based SWS provided valuable information about the mechanical status of coronary arteries. Device implantation led to a significant decrease of SWS to a similar extent with either polymer-based scaffolds or permanent metallic stents. (c) 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study presents a computational model for assessing superficial wall strain (SWS) of de-novo coronary stenoses treated with bioresorbable scaffold (BRS) or drug-eluting stent (DES). The model utilizes angiography data to evaluate the mechanical status of arteries in-vivo, providing valuable information for predicting cardiovascular outcomes.