Evaluation of coronary stents and atherosclerosis employing optical coherence tomography and computational fluid modelling

Abstract

Atherosclerotic coronary artery disease (CAD) is a major health burden worldwide and percutaneous coronary intervention (PCI) is an established treatment for this condition. Both PCI and invasive imaging techniques have evolved tremendously over the past few decades. Limitations of angiography were largely overcome, first by intra-vascular ultrasound, and then, optical coherence tomography (OCT), which is now recognized as the most sensitive and validated tool to examine the vessel lumen, plaque composition and stent-vessel wall interface. This thesis centers on randomized, OCT trials of coronary atherosclerosis and stents. In-vivo, comparative studies of drug eluting stents were conducted to directly observe their mechanical and healing characteristics. Results of these trials subsequently laid foundation for computational fluid dynamics (CFD) experiments and some illuminating observations were made around the effects of stent malapposition on intra coronary flow dynamics. It is the information of this kind that guides scientists to refine stent designs and clinicians, to improve procedural outcomes.