Unloading and successful treatment with bioresorbable stents during percutaneous coronary intervention:A case report

BACKGROUND With the development of percutaneous coronary intervention(PCI),the number of interventional procedures without implantation,such as bioresorbable stents(BRS)and drug-coated balloons,has increased annually.Metal drug-eluting stent unloading is one of the most common clinical complications.Comparatively,BRS detachment is more concealed and harmful,but has yet to be reported in clinical research.In this study,we report a case of BRS unloading and successful rescue.This is a case of a 59-year-old male with the following medical history:“Type 2 diabetes mellitus”for 2 years,maintained with metformin extended-release tablets,1 g PO BID;“hypertension”for 20 years,with long-term use of metoprolol sustained-release tablets,47.5 mg PO QD;“hyperlipidemia”for 20 years,without regular medication.He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours,on February 20,2022 at 15:35.Electrocardiogram results showed sinus rhythm,ST-segment elevation in leads I and avL,and poor R-wave progression in leads V1–3.High-sensitivity troponin I level was 4.59 ng/mL,indicating an acute high lateral wall myocardial infarction.The patient’s family requested treatment with BRS,without implanta-tion.During PCI,the BRS became unloaded but was successfully rescued.The patient was followed up for 2 years;he had no episodes of angina pectoris and was in generally good condition.CONCLUSION We describe a case of a 59-year-old male experienced BRS unloading and successful rescue.By analyzing images,the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations.We discuss preventive measures for BRS unloading.

Experimental study on the effect of unloading rate on gneiss rockburst

Rockburst are often encountered in tunnel construction due to the complex geological conditions.To study the influence of unloading rate on rockburst,gneiss rockburst experiments were conducted under three groups of unloading rates.A high-speed photography system and acoustic emission(AE)system were used to monitor the entire process of rockburst process in real-time.The results show that the intensity of gneiss rockburst decreases with decrease of unloading rate,which is manifested as the reduction of AE energy and fragments ejection velocity.The mechanisms are proposed to explain this effect:(i)The reduction of unloading rate changes the crack propagation mechanism in the process of rockburst.This makes the rockbursts change from the tensile failure mechanism at high unloading rate to the tension-shear mixed failure mechanism at low unloading rate,and more energy released in the form of shear crack propagation.Then,less strain energy is converted into kinetic energy of fragments ejection.(ii)Less plate cracking degree of gneiss has taken shape due to decrease of unloading rate,resulting in the destruction of rockburst incubation process.The enlightenments of reducing the unloading rate for the project are also described quantitatively.The rockburst magnitude is reduced from the medium magnitude at the unloading rate of 0.1 MPa/s to the slight magnitude at the unloading rate of 0.025 MPa/s,which was judged by the ejection velocity.

Mechanical properties and energy evolution of Beishan shallow-layer granite under different unloading paths

Rock has mechanical characteristics and a fracture damage mechanism that are closely related to its loading history and loading path. The mechanical properties, fracture damage features, acoustic emission(AE) characteristics, and strain energy evolution of the Beishan shallow-layer granite used in triaxial unloading tests were investigated in this study. Three groups of triaxial tests, namely, conventional triaxial compression test(Group Ⅰ), maintaining deviatoric stress synchronously unloading confining pressure test(Group Ⅱ), and loading axial pressure synchronously unloading confining pressure test(Group Ⅲ), were carried out for the cylindrical granite specimens. AE monitoring device was utilized in these tests to determine the degree to which the AE waves and AE events reflected the degree of rock damage. In addition, the crack stress thresholds of the specimens were determined by volumetric strain method and AE parameter method, and strain energy evolution of the rock was explored in different damage stages. The results show that the shallow-layer granite experiences brittle failure during the triaxial loading test and unloading test, and the rock has a greater damage degree during the unloading test. The crack stress thresholds of these samples vary greatly between tests, but the threshold ratios of all samples are similar in the same crack damage stage. The Mogi-Coulomb strength criterion can better describe the unloading failure strength of the rock. The evolution of the AE parameter characteristics and strain energy differs between the specimens used in different stress path tests. The dissipative strain energy is the largest in Group Ⅱ and the smallest in Group Ⅰ.

Effects of dry-wet cycles on the mechanical properties of sandstone with unloading-induced damage

Sandstone is the fundamental material in various engineering and construction projects.However,the mechanical integrity of sandstone can be compromised by initial unloading damage resulting from activities such as engineering excavations.Furthermore,this degradation is further exacerbated under periodic dry-wet environmental conditions.This study investigated the effects of dry-wet cycles and unloading on the mechanical properties of jointed fine sandstone using uniaxial and triaxial compression tests.These tests were performed on rock samples subjected to varying unloading degrees and different numbers of dry-wet cycles.The results demonstrate that with an increase in the unloading degree from 0%to 70%,there is a corresponding decrease in peak stress ranging from 10%to 33%.Additionally,the cohesion exhibits a reduction of approximately 20%to 25%,while the internal friction angle experiences a decline of about 3.5%to 6%.These findings emphasize a significant unloading effect.Moreover,the degree of peak stress degradation in unloading jointed fine sandstone diminishes with an increase in confining pressure,suggesting that confining pressure mitigates the deterioration caused by dry-wet cycles.Additionally,as the number of dry-wet cycles increases,there is a notable decline in the mechanical properties of the sandstone,evidencing significant dry-wet degradation.Utilizing the Drucker Prager criterion,this study establishes a strength criterion and fracture criterion,denoted as σ_(1)(m,n) and K_(T)^(Ⅱ)(m, n), to quantify the combined impacts of dry-wet cycles and unloading on jointed fine sandstone,which provides a comprehensive understanding of its mechanical behavior under such conditions.

Effects of pressure relief holes on coal burst:Insights from true-triaxial unloading tests

Drilling pressure relief is one of the methods to reduce the risk of coal bursts in deep mines.However,the effect of the drill hole orientations has not been studied well enough to understand their impact on the burst failure mechanism.In this study,we investigated two designs of drill hole orientations.The first design includes drill holes located on the upper free face of the rectangular samples and labelled as upper hole(UH)and centre hole(CH)e the long axes of the drill holes are aligned with minor principal stress,s3,direction.The second design includes drill holes at the top(TH)and the side(SH)of the rectangular samples in which the long axes of the drill holes are aligned with the maximum,s1,and intermediate principal stress,s2,directions,respectively.The coal samples with the proposed drill hole orientations were subjected to the true-triaxial unloading coal burst tests.The results show that the drill holes reduce the risk of coal bursts.However,we found that the intensity of coal burst was significantly reduced with the SH-type,followed by the CH-types.We also observed that the coal burst intensity is reduced better for the CH,UH,TH,and SH-type drilling patterns.However,it was found that the orientations of drill holes have little influence on the failure mode(splitting).The acoustic emission(AE)activities for coal with drill holes noticeably decreased,especially for the UH and CH layouts.The drill holes reduced the upper limit of the AE entropy(chaos of microcracks generation).However,regarding reducing the coal burst risk,the TH and SH are less effective than UH and CH.

Forming and Springback Prediction of Strips Under Multi-square Punch Concave Forming Process Considering Partial-unloading Effects

To further investigate the forming mechanism and springback characteristics of strips under multi-square punch forming (MSPF) considering partial-unloading effects, a series of concave form ing tests of strips are conducted on the MSPF machine. This paper aims to reveal the physical mecha nism of the elastic-plastic deformation in the MSPF process considering the effect of the forming ap proaches, and derive appropriate mathematical interpretations. The theoretical model is firstly estab lished to analyse the concave forming mechanism and springback characteristics of the strip, and its accuracy is then validated by experimental data. The forming history and load evolutions are depicted to explore the required forming capacity through the proposed analytical method. Besides, the paramet ric studies are carried out to discuss their effects on the springback of the strip. The results suggest that the deformation paths of the strip are influenced by the forming approach, and the springback of the strip in convex forming is larger than that in concave forming.

Bioresorbable stent unloading during percutaneous coronary intervention:Early detection and management

In this letter,we comment on a recent case report by Sun et al in the World Journal of Cardiology.The report describes the successful management of a rare complication:The unloading or detachment of a bioresorbable stent(BRS)during percutaneous coronary intervention(PCI)in a male patient.The unloading of BRS was detected via angiography and intravascular ultrasound(IVUS)imaging of the left coronary artery and left anterior descending artery.Although this case is interesting,the authors’report lacked crucial details.Specifically,insufficient information about the type of BRS used,potential causes of BRS unloading,or whether optical coherence tomography(OCT)imaging for coronary arteries was performed before,during,or after PCI.The OCT imaging of coronary arteries before PCI can potentially prevent BRS unloading due to its higher resolution compared to IVUS.In addition,despite detecting myocardial bridging during the PCI,the authors did not provide any details regarding this variation.Here we discuss the various types of BRS,the importance of OCT in PCI,and the clinical relevance of myocardial bridging.

Study on the time delay failure characteristics of sandstone unloading under dynamic disturbance

The rockburst caused by underground engineering excavation exhibits a significant lag effect.Studies have shown that the occurrence of lag-type rockburst is closely related to the delayed failure of rocks.This paper focuses on the delayed failure characteristics of unloading-damaged sandstone under the combined action of static load and dynamic disturbance.Numerical simulations are utilized to analyze the delayed failure evolution characteristics and failure mechanisms of sandstone.The results indicate that in triaxial unloading delay failure tests,the duration of loading decreases exponentially with the increase of initial unloading damage.Compared to static load conditions,the duration of loading under dynamic disturbance decreases by more than 43%,and the average strain rate significantly increases.The number of cracks at the endpoint of triaxial unloading delay failure increases as initial unloading damage decreases,with a substantial increase in the number of cracks under dynamic disturbance.These findings provide a valuable reference for the timeliness and delayed rockburst analysis and interpretation of rock damage and failure under high-stress levels.

Failure properties of rocks in true triaxial unloading compressive test

Slabbing failure often occurs in the surround rock near a deep underground excavation. The mechanism of slabbing failure is still unclear. In order to reveal the influence of the intermediate principal stress （σ2） on slabbing failure, true triaxial unloading compressive test was carried out based on the stress path of the underground engineering excavation, i.e., unloading the minimum principal stress （σ3）, keeping σ2, increasing the maximum principal stress （σ1）. The initiation and the propagation of slabbing fracture in rock specimens were identified by examining the acoustic emission （AE） and the infrared radiation characterization. The test results show that the failure modes of the granite and red sandstone specimens are changed from shear to slabbing with the increase of σ2. The AE characteristic of rock specimen under low σ2 is swarm type which is the main shock type under high σ2. The infrared radiation properties of rock specimen under different σ2 are also different. The temperature change area is just along the shear fracture such as the uniaxial compression. With the increase of σ2, the temperature change area is planar of rock specimen which proofs that the failure mode of rock specimen turns into slabbing.

Energy conversion of rocks in process of unloading confining pressure under different unloading paths

Based on energy theory and tests of rocks with initial confining pressures of 10, 20 and 30 MPa under different unloading paths, the processes of strain energy conversion were investigated. The absorbing strain energy for axial compression, the dissipating strain energy for plastic deformation and cracks propagation, the expending strain energy for circumferential deformation, and the storing and releasing elastic strain energy were considered. Unloading paths included the condition of fixing axial pressure and unloading axial pressure, increasing axial pressure and unloading confining pressure, as well as unloading axial pressure and confining pressure simultaneously. Results show that expending strain energy for circumferential deformation has mainly evolved from absorbing strain energy for axial compression in three unloading paths during unloading processes. Dissipating strain energy is significantly increased only near the peak point. The effect of initial confining pressure on strain energy is significantly higher than that of unloading path. The strain energy is linearly increased with increasing initial confining pressure. The unloading path and initial confining pressure also have great influence on the energy dissipation. The conversion rate of strain energy in three paths is increased with increasing initial confining pressure, and the effect of initial confining pressure on conversion rate of strain energy is related with the unloading paths.

Effect of induction unloading on weakening of rock mechanics properties

The effects of induction unloading such as drilling, blasting, lancing and water-infusion softening on weakening of rock mechanics properties were investigated. Three stress paths were chosen as test schemes corresponding to the triaxial compressive test, pre-peak and post-peak unloading the confining pressure tests. The results show that compression deformation is the main cause of rock failure under loading condition. However, the strong dilatation leads to the rock failure along unloading direction. Rock failure happens even under little axial stress with confining pressure unloading. Poisson ratio increases with the decrease of confining pressure during the process of unloading. Elastic modulus increases slowly along with the decline of confining pressure, but decreases rapidly when unloaded to yielding strength. It shows that the weakening rate of rock intensity tends to be faster with easily failure under the unloading condition.

Intercellular Symplastic Connection and Isolation of the Unloading Zone in Flesh of the Developing Grape Berry

The ultrastructure and intercellular connection of the sugar unloading zone (i.e. the phloem in the dorsal vascular bundle and the phloem_surrounding the assimilate sink_cells) of grape ( Vitis vinifera× V. labrusca cv. Jingchao) berry was observed via transmission electron microscopy. The results showed that during the early developmental stages of grape berry, numerous plasmodesmata were found in the phloem between sieve element (SE) and companion cell (CC), between SE/CC complexes, between SE/CC complex and phloem parenchyma cell and in between phloem parenchyma cells, which made the phloem a symplastic integration, facilitating sugar unloading from sieve elements into both companion cells and phloem parenchyma cells via a symplastic pathway. On the contrary, there was almost no plasmodesma between phloem and its surrounding flesh photoassimilate sink_cells, neither in between the flesh photoassimilate sink_cells giving rise to a symplastic isolation both between phloem and its surrounding flesh photoassimilate sink_cells, as well as among the flesh photoassimilate sink_cells. This indicated that both the sugar unloading from phloem and postphloem transport of sugars should be mainly via an apoplastic pathway. During the ripening stage, most of the plasmodesmata between SE/CC complex and the surrounding phloem parenchyma cells were shown to be blocked by the electron_opaque globules, and a phenomenon of plasmolysis was found in a number of companion cells, indicating a symplastic isolation between SE/CC complex and its surrounding parenchyma cells during this phase. The symplastic isolation between the whole phloem and its surrounding photoassimilate sink_cells during the early developmental stages shifted to a symplastic isolation within the phloem during the ripening phase, and thus the symplastic pathway of sugar unloading from SE/CC complex during the early development stages should be replaced by a dominant apoplastic unloading pathway from SE/CC complex in concordance.

Research on unloading nonlinear mechanical characteristics of jointed rock masses

Geological environments of rock mass projects are always very complicated, and further investigations on rock mechanical characteristics are needed. There are considerable distinctions in rock mechanical characteristics under unloading and loading conditions. A series of tests are conducted to study the stress-strain relationship of rock masses under loading and unloading conditions. Also, the anisotropy, the size effect, and the rheological property of unloading rock mass are investigated. The tests presented in the paper include model test and granite rheological test, which are conducted considering geological condition, rock mass structure, in-situ stress field of the permanent shiplock of the Three Gorges Project. The main differences between loading and unloading rock masses are stress paths, yield criteria, deformation and strength parameters, etc.. Different structural plane directions affect unloading rock mass evidently. With increasing size, the tensile strength, the compressive strength, the deformation modulus, the Poisson’s ratio and the anisotropy of rock mass all decrease. For sandstone samples with parallel bedding planes, the cohesion c increases but the internal friction angle ? decreases under unloading condition when compared with the values under loading condition. While for samples with vertical bedding planes, the trend is adverse. The rheological property of rocks has close relationship with the tensile stresses of rock masses. When the sandstone samples are tested under high stress condition, their rheological properties are very obvious with the unloading of confining pressure, and three typical rheological stages are shown. Rheological rate changes with the variations in axial stress and confining pressure.

Dynamic characteristics of high stressed red sandstone subjected to unloading and impact loads

In the process of deep projects excavation,deep rock often experiences a full stress process from high stress to unloading and then to impact disturbance failure.To study the dynamic characteristics of three-dimensional high stressed red sandstone subjected to unloading and impact loads,impact compression tests were conducted on red sandstone under confining pressure unloading conditions using a modified split Hopkinson pressure bar.Impact disturbance tests of uniaxial pre-stressed rock were also conducted(without considering confining pressure unloading effect).The results demonstrate that the impact compression strength of red sandstone shows an obvious strain rate effect.With an approximately equal strain rate,the dynamic strength of red sandstone under confining unloading conditions is less than that in the uniaxial pre-stressed impact compression test.Confining pressure unloading produces a strength-weakening effect,and the dynamic strength weakening factor(DSWF)is also defined.The results also indicate that the strain rate of the rock and the incident energy change in a logarithmic relation.With similar incident energies,unloading results in a higher strain rate in pre-stressed rock.According to the experimental analysis,unloading does not affect the failure mode,but reduces the dynamic strength of pre-stressed rock.The influence of confining pressure unloading on the shear strength parameters(cohesion and friction angle)is discussed.Under the same external energy impact compression,prestressed rock subjected to unloading is more likely to be destroyed.Thus,the effect of unloading on the rock mechanical characteristics should be considered in deep rock project excavation design.

Unloading responses of pre-flawed rock specimens under different unloading rates

Based on the stress redistribution analysis of rock mass during the deep underground excavation, the unloading process of pre-flawed rock material was simulated by distinct element method (DEM). The effects of unloading rate and flaw inclination angle on unloading strengths and cracking properties of pre-flawed rock specimens are numerically revealed. The results indicate that the unloading failure strength of pre-flawed specimen exhibits a power-function increase trend with the increase of unloading period. Moreover, combined with the stress state analysis on the flaws, it is found that the unloading failure strength increases with the increase of flaw inclination angle. The cracking distribution of pre-flawed specimens under the unloading condition closely depends on the flaw inclination angle, and three typical types of flaw coalescence are observed. Furthermore, at a faster unloading rate, the pre-flawed specimen experiences a sharper and quicker unloading failure process, resulting in more splitting cracks in the specimens.

Effect of fatigue loading-confining stress unloading rate on marble mechanical behaviors: An insight into fracture evolution analyses

Rocks in underground works usually experience rather complex stress disturbance.For this,their fracture mechanism is significantly different from rocks subjected to conventional triaxial compression conditions.The effects of stress disturbances on rock geomechanical behaviors under fatigue loading conditions and triaxial unloading conditions have been reported in previous studies.However,little is known about the dependence of the unloading rate on fatigue loading and confining stress unloading(FL-CSU)conditions that influence rock failure.In this paper,we aimed at investigating the fracture behaviors of marble under FL-CSU conditions using the post-test X-ray computed tomography(CT)scanning technique and the GCTS RTR 2000 rock mechanics system.Results show that damage accumulation at the fatigue stage can influence the final fracture behaviors of marble.The stored elastic energy for rock samples under FL-CSU tests is relatively larger compared to those under conventional triaxial tests,and the dissipated energy used to drive damage evolution and crack propagation is larger for FL-CSU tests.In FL-CSU tests,as the unloading rate increases,the dissipated energy grows and elastic energy reduces.CT scanning after the test reveals the impacts of the unloading rate on the crack pattern and a fracture degree index is therein defined in this context to represent the crack dimension.It shows that the crack pattern after FL-CSU tests depends on the unloading rate,and the fracture degree is in agreement with the analysis of both the energy dissipation and the amount of energy released.The effect of unloading rate on fracture evolution characteristics of marble is revealed by a series of FL-CSU tests.

Deformation and damage properties of rock-like materials subjected to multi-level loading-unloading cycles

In the process of engineering construction such as tunnels and slopes,rock mass is frequently subjected to multiple levels of loading and unloading,while previous research ignores the impact of unloading rate on the stability of rock mass.A number of uniaxial multi-level cyclic loading-unloading experiments were conducted to better understand the effect of unloading rate on the deformation behavior,energy evolution,and damage properties of rock-like material.The experimental results demonstrated that the unloading rate and relative cyclic number clearly influence the deformation behavior and energy evo-lution of rock-like samples.In particular,as the relative cyclic number rises,the total strain and reversible strain both increase linearly,while the total energy density,elastic energy density,and dissipated energy density all rise nonlinearly.In contrast,the irreversible strain first decreases quickly,then stabilizes,and finally rises slowly.As the unloading rate increases,the total strain and reversible strain both increase,while the irreversible strain decreases.The dissipated energy damage was examined in light of the aforementioned experimental findings.The accuracy of the proposed damage model,which takes into account the impact of the unloading rate and relative cyclic number,is then confirmed by examining the consistency between the model predicted and the experimental results.The proposed damage model will make it easier to foresee how the multi-level loading-unloading cycles will affect the rock-like materials.

Investigation on the Load/Unload Response Ratio With Coda Q-1 as Response

The load/unload response ratio YQ with the geophysical parameter coda Q-1 of the crust as response is denned in this study.The variation in YQ-1 before and after the Northridge earthquake of January 17,1994(California)has been investigated by using the data of coda Q-1 with frequencies of 1.5,3.0,6.0,12.0,and 24.0 Hz in the Southern California from 1987 to 1994.It can be found that YQ-1 for coda waves with all frequencies,the frequency of 12.0 Hz excluded,ascended to a certain extent prior to the occurrence of the rnainshock and returned to normality after the main shock.

Active Tectonics and Erosional Unloading at the Eastern Margin of the Tibetan Plateau

The eastern margin of the Tibetan Plateau is marked by an extremely steep mountain front with relief of over 5 km. This topography,coupled with abundant Mesozoic thrusts within the margin,explains why tectonic maps of the India-Asia collision typically show the eastern margin as a major thrust zone. Actually,it does not like that. Field observations suggest that the margin is better characterized as a zone of NNE-directed dextral shear with extensive strike-slip faulting and secondary thrusting. The high relief and steep gradients are partially explained by erosional unloading of an elastic lithosphere;the pre-erosion inherited topography may be the inherited Mesozoic thrust belt landscape modified by a component of Cenozoic tectonic shortening.

Space-time evolution rules of acoustic emission location of unloaded coal sample at different loading rates

By using MTS815 rock mechanics test system,a series of acoustic emission(AE) location experiments were performed under unloading confining pressure,increasing the axial stress.The AE space-time evolution regularities and energy releasing characteristics during deformation and failure process of coal of different loading rates are compared,the influence mechanism of loading rates on the microscopic crack evolution were studied,combining the AE characteristics and the macroscopic failure modes of the specimens,and the precursory characteristics of coal failure were also analyzed quantitatively.The results indicate that as the loading rate is higher,the AE activity and the main fracture will begin earlier.The destruction of coal body is mainly the function of shear strain at lower loading rate and tension strain at higher rate,and will transform from brittleness to ductility at critical velocities.When the deformation of the coal is mainly plasticity,the amplitude of the AE ringing counting rate increases largely and the AE energy curves appear an obvious ''step'',which can be defined as the first failure precursor point.Statics of AE information shows that the strongest AE activity begins when the axial stress level was 92-98%,which can be defined as the other failure precursor point.As the loading rate is smaller,the coal more easily reaches the latter precursor point after the first one,so attention should be aroused to prevent dynamic disaster in coal mining when the AE activity reaches the first precursor point.