| Project/Area Number |
17K09504
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Yamaguchi University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
南 和幸 山口大学, 大学院創成科学研究科, 教授 (00229759)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2019: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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| Keywords | 虚血性心疾患 / 冠血流予備量比 / 数値流体力学 / 分岐部病変 / 薬剤溶出ステント / 光干渉断層法 / 数位流体力学 |
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| Outline of Final Research Achievements |
When a drug-eluting stent is implanted in a coronary bifurcation lesion, stent thrombosis and remote restenosis can be occurred. The side branch orifice area decreased due to the floating stent struts covering the side branch orifice in the remote phase. Complex pattern of the jailing struts associated with the stenosis at the side branch orifice. We investigated the effect of floating struts at side branch orifice on blood flow using computational fluid dynamics. Contributor to the pressure loss immediately after stent placement was not the floating struts but side branch area stenosis. However, the floating struts affected blood flow and change the flow velocity distribution. Changes of blood flow and decreasing lumen area due to lesions and stents could be a cause of stent thrombosis and restenosis. Based on these findings, we investigated the stent design and treatment strategy suitable for bifurcation lesions.
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| Academic Significance and Societal Importance of the Research Achievements |
虚血性心疾患の治療として薬剤溶出ステントを用いた冠動脈ステント留置術が重要な役割を果たしているが、分岐部病変、特に左冠動脈主幹部の分岐部病変の治療成績は未だ十分とは言えない。ステント血栓症は致死的となり、再狭窄に難渋することもある。冠動脈ステントは筒状の医療機器であるが、分岐部病変の多様性に対応できていないと考えられる。本研究で血栓症や再狭窄の因子を解明し、分岐部に適したステントデザインを探求した。今後、この知見をもとにステントを開発することにより、より安全な分岐部病変の治療を行い、遠隔期の治療成績向上が期待できる。
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