Vascular responses to aberrant WSS conditions reported in literature

Pathobiologic Responses to High WSS and Positive WSS Gradient^{^a}	Pathobiologic Responses to Low WSS and High OSI^{^b}
EC damage^24,45	Proinflammatory ECs that are “leaky” and “sticky”^21,62
EC turnover^25,72	Increased ROS⁶²
MMP production by mural cells²⁵	Increased inflammatory cell infiltration⁷⁰
ECM degradation³⁶	MMP production by macrophages⁶¹
Medial thinning³⁶	SMC proliferation and migration⁶³
Mural cell apoptosis²⁵	Thrombus formation^23,63

Note:—EC indicates endothelial cell; ROS, reactive oxygen species; MMP, matrix metalloproteinase; OSI, oscillatory shear index; SMC, smooth muscle cell.
↵a From the literature on intracranial aneurysm genesis.
↵b From the literature on atherogenesis.