Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment
The BioMimics 3D self-expanding nitinol stent represents a strategy for femoropopliteal intervention that is alternative or complementary to deployment of drug-coated stents or balloons. Whereas conventional straight stents reduce arterial curvature and disturb blood flow, creating areas of low wall...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | International Journal of Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/9795174 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560724443922432 |
|---|---|
| author | Timothy M. Sullivan Thomas Zeller Masato Nakamura Colin G. Caro Michael Lichtenberg |
| author_facet | Timothy M. Sullivan Thomas Zeller Masato Nakamura Colin G. Caro Michael Lichtenberg |
| author_sort | Timothy M. Sullivan |
| collection | DOAJ |
| description | The BioMimics 3D self-expanding nitinol stent represents a strategy for femoropopliteal intervention that is alternative or complementary to deployment of drug-coated stents or balloons. Whereas conventional straight stents reduce arterial curvature and disturb blood flow, creating areas of low wall shear, where neointimal hyperplasia predominantly develops, the helical centerline geometry of the BioMimics 3D maintains or imparts arterial curvature, promotes laminar swirling blood flow, and elevates wall shear to protect against atherosclerosis and restenosis. In the multicenter randomized MIMICS trial, treatment of femoropopliteal disease with the BioMimics 3D (n=50) significantly improved 2-year primary patency (log-rank test p=0.05) versus a control straight stent (n=26), with no cases of clinically driven target lesion revascularization between 12 and 24 months (log-rank test p=0.03 versus controls). In geometric X-ray analysis, the BioMimics stent was significantly more effective in imparting a helical shape even when the arterial segment was moderately to severely calcified. Computational fluid dynamics analysis showed that average wall shear was significantly higher with the helical centerline stent (1.13±0.13 Pa versus 1.06±0.12 Pa, p=0.05). A 271-patient multicenter international MIMICS-2 trial and a 500-patient real-world MIMICS-3D registry are underway. |
| format | Article |
| id | doaj-art-34b4679299384fd0900ac896912c02cb |
| institution | Kabale University |
| issn | 2090-2824 2090-2832 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Vascular Medicine |
| spelling | doaj-art-34b4679299384fd0900ac896912c02cb2025-02-03T01:26:52ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322018-01-01201810.1155/2018/97951749795174Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal SegmentTimothy M. Sullivan0Thomas Zeller1Masato Nakamura2Colin G. Caro3Michael Lichtenberg4Vascular/Endovascular Surgery, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USADepartment of Angiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Bad Krozingen, GermanyDivision of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, JapanDepartment of Bioengineering, Imperial College, London, UKVascular Center Klinikum Arnsberg, Arnsberg, GermanyThe BioMimics 3D self-expanding nitinol stent represents a strategy for femoropopliteal intervention that is alternative or complementary to deployment of drug-coated stents or balloons. Whereas conventional straight stents reduce arterial curvature and disturb blood flow, creating areas of low wall shear, where neointimal hyperplasia predominantly develops, the helical centerline geometry of the BioMimics 3D maintains or imparts arterial curvature, promotes laminar swirling blood flow, and elevates wall shear to protect against atherosclerosis and restenosis. In the multicenter randomized MIMICS trial, treatment of femoropopliteal disease with the BioMimics 3D (n=50) significantly improved 2-year primary patency (log-rank test p=0.05) versus a control straight stent (n=26), with no cases of clinically driven target lesion revascularization between 12 and 24 months (log-rank test p=0.03 versus controls). In geometric X-ray analysis, the BioMimics stent was significantly more effective in imparting a helical shape even when the arterial segment was moderately to severely calcified. Computational fluid dynamics analysis showed that average wall shear was significantly higher with the helical centerline stent (1.13±0.13 Pa versus 1.06±0.12 Pa, p=0.05). A 271-patient multicenter international MIMICS-2 trial and a 500-patient real-world MIMICS-3D registry are underway.http://dx.doi.org/10.1155/2018/9795174 |
| spellingShingle | Timothy M. Sullivan Thomas Zeller Masato Nakamura Colin G. Caro Michael Lichtenberg Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment International Journal of Vascular Medicine |
| title | Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment |
| title_full | Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment |
| title_fullStr | Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment |
| title_full_unstemmed | Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment |
| title_short | Swirling Flow and Wall Shear: Evaluating the BioMimics 3D Helical Centerline Stent for the Femoropopliteal Segment |
| title_sort | swirling flow and wall shear evaluating the biomimics 3d helical centerline stent for the femoropopliteal segment |
| url | http://dx.doi.org/10.1155/2018/9795174 |
| work_keys_str_mv | AT timothymsullivan swirlingflowandwallshearevaluatingthebiomimics3dhelicalcenterlinestentforthefemoropoplitealsegment AT thomaszeller swirlingflowandwallshearevaluatingthebiomimics3dhelicalcenterlinestentforthefemoropoplitealsegment AT masatonakamura swirlingflowandwallshearevaluatingthebiomimics3dhelicalcenterlinestentforthefemoropoplitealsegment AT colingcaro swirlingflowandwallshearevaluatingthebiomimics3dhelicalcenterlinestentforthefemoropoplitealsegment AT michaellichtenberg swirlingflowandwallshearevaluatingthebiomimics3dhelicalcenterlinestentforthefemoropoplitealsegment |