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Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Amann-Vesti B. R. 1, Kozerke S. 2, Krieger E. 1, Boesiger P. 2, Koppensteiner R. 1
1 Division of Angiology, University Hospital, Zurich. Switzerland
2 Institute for Biomedical Engineering, University and ETH, Zurich, Switzerland
Aim. Wall shear stress (WSS) has been implied in the pathogenesis of restenosis after percutaneous transluminal angioplasty (PTA). Aims of the present study were to calculate WSS in the superficial femoral artery (SFA) from magnetic resonance imaging (MRI) and from duplex sonography in healthy controls and in patients after PTA of the SFA to evaluate the predictive value of WSS for restenosis.
Methods. WSS was assessed by calculating the slope of velocity profiles at the vessel wall from data obtained with velocity encoded cine MR and with duplex using the formula: Shear stress=4×blood viscosity×peak blood velocity/internal diameter. Seventeen patients were studied 1 day after successful PTA of the SFA. Restenosis was determined by duplex ultrasound at the 6-months follow-up visit.
Results. In healthy controls WSS values calculated from MRI and from duplex were similar (1.86±0.35 N/m2 vs 1.88±0.34 N/m2, n.s.). In patients the values obtained with duplex were higher than those obtained with MRI (4.1±2.3 N/m2 vs 2.4±1.2 N/m2, p=0.002). With both methods postinterventional WSS was higher in patients developing restenosis (duplex 5.4±2.2 N/m2, MRI 3.1±0.9 N/m2) than in those without restenosis (duplex 2.7±1.4 N/m2, MRI 1.5±0.7 N/m2) and was revealed to be an independent predictor of restenosis (p=0.03).
Conclusion. This is the first study demonstrating that increased postinterventional WSS in the SFA is predictive for restenosis. WSS values obtained with MRI and duplex were different in patients, however with both methods higher WSS was associated with restenosis.