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Chiastra C, Zuin M, Rigatelli G, D’Ascenzo F, De Ferrari GM, Collet C, Chatzizisis YS, Gallo D, Morbiducci U. Computational fluid dynamics as supporting technology for coronary artery disease diagnosis and treatment: an international survey. Front Cardiovasc Med 2023; 10:1216796. [PMID: 37719972 PMCID: PMC10501454 DOI: 10.3389/fcvm.2023.1216796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background Computational fluid dynamics (CFD) is emerging as an effective technology able to improve procedural outcomes and enhance clinical decision-making in patients with coronary artery disease (CAD). The present study aims to assess the state of knowledge, use and clinical acceptability of CFD in the diagnosis and treatment of CAD. Methods We realized a 20-questions international, anonymous, cross-sectional survey to cardiologists to test their knowledge and confidence on CFD as a technology applied to patients suffering from CAD. Responses were recorded between May 18, 2022, and June 12, 2022. Results A total of 466 interventional cardiologists (mean age 48.4 ± 8.3 years, males 362), from 42 different countries completed the survey, for a response rate of 45.9%. Of these, 66.6% declared to be familiar with the term CFD, especially for optimization of existing interventional techniques (16.1%) and assessment of hemodynamic quantities related with CAD (13.7%). About 30% of respondents correctly answered to the questions exploring their knowledge on the pathophysiological role of some CFD-derived quantities such as wall shear stress and helical flow in coronary arteries. Among respondents, 85.9% would consider patient-specific CFD-based analysis in daily interventional practice while 94.2% declared to be interested in receiving a brief foundation course on the basic CFD principles. Finally, 87.7% of respondents declared to be interested in a cath-lab software able to conduct affordable CFD-based analyses at the point-of-care. Conclusions Interventional cardiologists reported to be profoundly interested in adopting CFD simulations as a technology supporting decision making in the treatment of CAD in daily practice.
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Affiliation(s)
- Claudio Chiastra
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Gianluca Rigatelli
- Interventional Cardiology Unit, Department of Cardiology, Madre Teresa Hospital, Padova, Italy
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, Turin, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, Turin, Italy
| | | | - Yiannis S. Chatzizisis
- Division of Cardiovascular Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Diego Gallo
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Umberto Morbiducci
- PoliToMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
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Li J, Cao H, Li M, Shu L, Lin C. A study of balloon type on calcified coronary lesion predilation: A finite element analysis. Proc Inst Mech Eng H 2023; 237:443-450. [PMID: 36927166 PMCID: PMC10020853 DOI: 10.1177/09544119231157853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Calcified coronary lesions have been one of the more difficult types of lesion for interventional treatment, and angioplasty is required to break the calcification before stent implantation so that the stent can expand smoothly, however, it remains unclear which type of angioplasty is optimal for different calcified lesions. In this study, a finite element approach was used to model normal balloons, cutting balloons, and AngioSculpt balloons. In addition, calcified lesions of different degrees, thicknesses, and lengths were modeled according to Intravascular ultrasound (IVUS) calcification grade. The above three balloons were used to pretreat calcified lesions, and the brittle fracture module for calcification was used to detect fracture success, to facilitate virtual stent implantation after predilation. The simulation results showed that with a thickness of less than 0.3 mm, balloons were unable to deal with calcified plaques in lesions of less than 120°, for 180° calcified lesions the cutting balloon fractured the calcified material at 1.2 MPa, the AngioSculpt balloon produced multiple fractures at 0.8 MPa for 270° calcified plaques, but was unable to fracture calcified lesions with a thickness of 0.4 mm. Based on these results, we conclude that the length of the lesion did not affect calcification fracture, while the thickness of the lesion did. In calcified lesions of approximately 180°, the cutting balloon showed the best predilation results, while the AngioSculpt balloon was optimal for 270°. In annular calcification, all three balloons were unable to fracture the lesion.
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Affiliation(s)
- Jiasong Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Beijing, China
| | - Hongshuai Cao
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Meng Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lixia Shu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Changyan Lin
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Beijing, China
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3
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Development of 3D printable bioresorbable drug eluting coronary stents: An experimental and computational investigation. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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4
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Wu W, Samant S, de Zwart G, Zhao S, Khan B, Ahmad M, Bologna M, Watanabe Y, Murasato Y, Burzotta F, Brilakis ES, Dangas G, Louvard Y, Stankovic G, Kassab GS, Migliavacca F, Chiastra C, Chatzizisis YS. 3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility. Sci Rep 2020; 10:18049. [PMID: 33093499 PMCID: PMC7582159 DOI: 10.1038/s41598-020-74264-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/10/2020] [Indexed: 11/09/2022] Open
Abstract
The three-dimensional (3D) representation of the bifurcation anatomy and disease burden is essential for better understanding of the anatomical complexity of bifurcation disease and planning of stenting strategies. We propose a novel methodology for 3D reconstruction of coronary artery bifurcations based on the integration of angiography, which provides the backbone of the bifurcation, with optical coherence tomography (OCT), which provides the vessel shape. Our methodology introduces several technical novelties to tackle the OCT frame misalignment, correct positioning of the OCT frames at the carina, lumen surface reconstruction, and merging of bifurcation lumens. The accuracy and reproducibility of the methodology were tested in n = 5 patient-specific silicone bifurcations compared to contrast-enhanced micro-computed tomography (µCT), which was used as reference. The feasibility and time-efficiency of the method were explored in n = 7 diseased patient bifurcations of varying anatomical complexity. The OCT-based reconstructed bifurcation models were found to have remarkably high agreement compared to the µCT reference models, yielding r2 values between 0.91 and 0.98 for the normalized lumen areas, and mean differences of 0.005 for lumen shape and 0.004 degrees for bifurcation angles. Likewise, the reproducibility of our methodology was remarkably high. Our methodology successfully reconstructed all the patient bifurcations yielding favorable processing times (average lumen reconstruction time < 60 min). Overall, our method is an easily applicable, time-efficient, and user-friendly tool that allows accurate and reproducible 3D reconstruction of coronary bifurcations. Our technique can be used in the clinical setting to provide information about the bifurcation anatomy and plaque burden, thereby enabling planning, education, and decision making on bifurcation stenting.
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Affiliation(s)
- Wei Wu
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA
| | - Saurabhi Samant
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA
| | - Gijs de Zwart
- StudioGijs, Daendelsstraat 40, 5018 ES, Tilburg, The Netherlands
| | - Shijia Zhao
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA
| | - Behram Khan
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA
| | - Mansoor Ahmad
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA
| | - Marco Bologna
- Biosignals, Bioimaging and Bioinformatics Laboratory (B3-Lab), Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133, Milan, Italy
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University Hospital, Tokyo, 173-0003, Japan
| | - Yoshinobu Murasato
- Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, 810-0065, Japan
| | - Francesco Burzotta
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | | | - George Dangas
- Department of Cardiovascular Medicine, Mount Sinai Hospital, New York City, 10029, USA
| | - Yves Louvard
- Institut Cardiovasculaire Paris Sud, 91300, Massy, France
| | - Goran Stankovic
- Department of Cardiology, Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Ghassan S Kassab
- California Medical Innovation Institute, San Diego, CA, 92121, USA
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Department of Chemistry, Materials and Chemical Engineering "Giulio Natta, Politecnico di Milano, 20133, Milan, Italy
| | - Claudio Chiastra
- PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129, Turin, Italy
| | - Yiannis S Chatzizisis
- Cardiovasclar Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, 68105, USA.
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Lassen JF, Iles TL. Applications of computational simulation in bifurcation stenting: past, present and future. EUROINTERVENTION 2020; 16:e698-e700. [DOI: 10.4244/eijv16i9a128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Rigatelli G, Zuin M, Chiastra C, Burzotta F. Biomechanical Evaluation of Different Balloon Positions for Proximal Optimization Technique in Left Main Bifurcation Stenting. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:1533-1538. [PMID: 32473906 DOI: 10.1016/j.carrev.2020.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Proximal optimization technique (POT) is a key step during left main (LM) bifurcation stenting. However, after crossover stenting, the ideal position of POT balloon is unclear. We sought to evaluate the biomechanical impact of different POT balloon positions during LM cross-over stenting procedure. METHODS We reconstructed the patient-specific LM bifurcation anatomy, using coronary computed tomography angiography data of 5 consecutive patients (3 males, mean age 66.3 ± 21.6 years) with complex LM bifurcation disease, defined as Medina 1,1,1, evaluated between 1st January 2018 to 1st June 2018 at our center. Finite element analyses were carried out to virtually perform the stenting procedure. POT was virtually performed in a mid (marker just at the carina cut plane), proximal (distal marker 1 mm before the carina) and distal (distal marker 1 mm after the carina) position in each investigated case. Final left circumflex obstruction (SBO%), strut malapposition, elliptical ratio and stent malapposition were evaluated. RESULTS The use of both proximal and distal POT resulted in a smaller LM diameter compared to the mid POT. SBO was significantly higher in both proximal and distal configurations compared to mid POT: 38.3 ± 5.1 and 29.3 ± 3.1 versus 18.3 ± 3.6%, respectively. Similarly stent malapposition was higher in both proximal and distal configurations compared to mid POT: 1.3 ± 0.4 and 0.82 ± 1.8 versus 0.78 ± 1.2, respectively. CONCLUSIONS Mid POT offers the best results in terms of LCx opening maintaining slightly smaller but still acceptable LM and LAD diameters compared to alternative POT configuration.
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Affiliation(s)
- Gianluca Rigatelli
- Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy.
| | - Marco Zuin
- Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy; University of Ferrara, School of Medicine, Ferrara, Italy
| | - Claudio Chiastra
- PoliTo(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Francesco Burzotta
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Genuardi L, Chatzizisis YS, Chiastra C, Sgueglia G, Samady H, Kassab GS, Migliavacca F, Trani C, Burzotta F. Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions. Cardiol J 2020; 28:321-329. [PMID: 32052855 DOI: 10.5603/cj.a2020.0024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/10/2020] [Accepted: 01/25/2020] [Indexed: 12/14/2022] Open
Abstract
Although the coronary arteries are uniformly exposed to systemic cardiovascular risk factors, atherosclerosis development has a non-random distribution, which follows the local mechanical stresses including flow-related hemodynamic forces. Among these, wall shear stress plays an essential role and it represents the major flow-related factor affecting the distribution of atherosclerosis in coronary bifurcations. Furthermore, an emerging body of evidence suggests that hemodynamic factors such as low and oscillating wall shear stress may facilitate the development of in-stent restenosis and stent thrombosis after successful drug-eluting stent implantation. Drug-eluting stent implantation represents the gold standard for bifurcation interventions. In this specific setting of interventions on bifurcated lesions, the impact of fluid dynamics is expected to play a major role and constitutes substantial opportunity for future technical improvement. In the present review, available data is summarized regarding the role of local fluid dynamics in the clinical outcome of patients with bifurcated lesions.
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Affiliation(s)
- Lorenzo Genuardi
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy
| | - Yiannis S Chatzizisis
- Cardiovascular Biology and Biomechanics Laboratory, Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA., Omaha, United States
| | - Claudio Chiastra
- Laboratory of Biological Structure Mechanics (LaBS), Chemistry, Materials and Chemical engineering "Giulio Natta" Department, Politecnico di Milano, Milan, Italy, Milan, Italy
| | - Gregory Sgueglia
- Division of Cardiology, Sant'Eugenio Hospital, Rome, Italy, Rome, Italy
| | - Habib Samady
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA, Atlanta, United States
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, USA, San Diego, United States
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics (LaBS), Chemistry, Materials and Chemical engineering "Giulio Natta" Department, Politecnico di Milano, Milan, Italy, Milan, Italy
| | - Carlo Trani
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy
| | - Francesco Burzotta
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy, L.go A. Gemelli, 8, 00168 Rome, Italy.
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8
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Zuin M, Rigatelli G, Chiastra C. Optimal Site for Proximal Optimization Technique in Complex Coronary Bifurcation Stenting: A Computational Fluid Dynamics Study. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 21:826-832. [PMID: 31866275 DOI: 10.1016/j.carrev.2019.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/22/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND/PURPOSE The optimal position of the balloon distal radio-opaque marker during the post optimization technique (POT) remains debated. We analyzed three potential different balloon positions for the final POT in two different two-stenting techniques, to compare the hemodynamic effects in terms of wall shear stress (WSS) in patients with complex left main (LM) coronary bifurcation. METHODS/MATERIALS We reconstructed the patient-specific coronary bifurcation anatomy using the coronary computed tomography angiography (CCTA) data of 8 consecutive patients (6 males, mean age 68.2± 18.6 years) affected by complex LM bifurcation disease. Subsequently a virtual bench test was performed in each patient using two different double stenting techniques represented by the DK and Nano crush using the reconstruction of Orsiro stents (Biotronik IC, Bulack, Switzerland). RESULTS A significant reduction in the mean WSS values in all the lesion's sites was observed when the final POT was performed 1 mm distally the carina cut plane in both techniques. Moreover, a significant improvement in the mean WSS values of the entire SB (e.g. LCX) was obtained performing the POT 1 mm distally to the carina cut plane. The proximal POT resulted in larger area of lower WSS values at the carina using both the Nano crush and the DK crush techniques. CONCLUSIONS In patients with complex LM bifurcation disease the use of a final POT performed 1 mm distally to the carina cut plane might results in more favorable WSS patterns (i.e. higher WSS values) along all stented segments and, especially, along the entire LCX lesions.
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Affiliation(s)
- Marco Zuin
- Section of Internal and Cardiopulmonary Medicine, University of Ferrara, Faculty of Medicine Ferrara, Italy; Department of Cardiovascular Diagnosis and Endoluminal Interventions, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Gianluca Rigatelli
- Department of Cardiovascular Diagnosis and Endoluminal Interventions, Santa Maria della Misericordia Hospital, Rovigo, Italy.
| | - Claudio Chiastra
- PoliToBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
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Cai W, Chen L, Zhang L, Tu S, Fan L, Chen Z, Luo Y, Zheng X. Branch ostial optimization treatment and optimized provisional t-stenting with polymeric bioresorbable scaffolds: Ex-vivo morphologic and hemodynamic examination. Medicine (Baltimore) 2018; 97:e12972. [PMID: 30412122 PMCID: PMC6221742 DOI: 10.1097/md.0000000000012972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The optimal side-branch (SB) ostium treatment after provisional side-branch scaffolding remains a subject of debate in bioresorbable vascular scaffold (BVS) era. In this study, we evaluated a novel optimized provisional T-stenting technique (OPT) and assessed its feasibility by comparison with T and small protrusion technique (TAP).Two provisional SB scaffolding techniques (OPT, n = 5; TAP, n = 5) were performed using polymeric BVS in a bifurcated phantom. The sequential intermediate snuggling balloon dilation, also called ostial optimal technique, was added to OPT but not TAP to dilate the side-branch ostium while the final snuggling balloon dilation applied for both procedures. Microcomputed tomography (microCT) and optical coherence tomography (OCT) were performed to assess morphology, and computational fluid dynamics (CFD) was performed to assess hemodynamics in the scaffolded bifurcations. Compared with TAP in microCT analysis, OPT created shorter neo-carina length than TAP (0.34 ± 0.10 mm vs 1.02 ± 0.26 mm, P < .01), longer valgus struts length (2.49 ± 0.27 mm vs 1.78 ± 0.33 mm, P < .01) with larger MB ostial area (9.46 ± 0.04 mm vs 8.34 ± 0.09 mm, P < .01). OCT found that OPT significantly decreased the struts mal-apposition (13.20 ± 0.16% vs 1.94 ± 0.54%, P < .01). CFD revealed that OPT generated more favorable flow pattern than TAP, as indicated by less percent (4.68 ± 1.40% vs 8.88 ± 1.21%, P < .01) of low wall shear stress (<0.4 Pa) along the lateral walls.By using BVSs for bifurcation intervention, the sequential intermediate snuggling balloon dilation is feasible for optimizing ostial SB and facilitating subsequent SB scaffolding. Results show OPT is better than TAP for bifurcated morphology and hemodynamics in this ex-vivo study.
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Affiliation(s)
- Wei Cai
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Lianglong Chen
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Linlin Zhang
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Sheng Tu
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Lin Fan
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Zhaoyang Chen
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Yukun Luo
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
| | - Xingchun Zheng
- Department of Cardiology, Fujian Medical University Union Hospital
- Provincial Institute of Coronary Artery Disease, Fujian, PR of China
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Biomechanical Impact of Wrong Positioning of a Dedicated Stent for Coronary Bifurcations: A Virtual Bench Testing Study. Cardiovasc Eng Technol 2018; 9:415-426. [DOI: 10.1007/s13239-018-0359-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/01/2018] [Indexed: 10/16/2022]
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11
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Grundeken MJ, Chiastra C, Wu W, Wykrzykowska JJ, De Winter RJ, Dubini G, Migliavacca F. Differences in rotational positioning and subsequent distal main branch rewiring of the Tryton stent: An optical coherence tomography and computational study. Catheter Cardiovasc Interv 2018. [DOI: 10.1002/ccd.27567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maik J. Grundeken
- Department of Cardiology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Claudio Chiastra
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,”; Politecnico di Milano; Milan Italy
| | - Wei Wu
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,”; Politecnico di Milano; Milan Italy
- Department of Mechanical Engineering; University of Texas at San Antonio; San Antonio TX
| | - Joanna J. Wykrzykowska
- Department of Cardiology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Robbert J. De Winter
- Department of Cardiology; Academic Medical Center, University of Amsterdam; Amsterdam The Netherlands
| | - Gabriele Dubini
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,”; Politecnico di Milano; Milan Italy
| | - Francesco Migliavacca
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,”; Politecnico di Milano; Milan Italy
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12
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Iannaccone F, Chiastra C, Karanasos A, Migliavacca F, Gijsen F, Segers P, Mortier P, Verhegghe B, Dubini G, De Beule M, Regar E, Wentzel J. Impact of plaque type and side branch geometry on side branch compromise after provisional stent implantation: a simulation study. EUROINTERVENTION 2017; 13:e236-e245. [DOI: 10.4244/eij-d-16-00498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Effects of bifurcation-specific and conventional stents on coronary bifurcation flow. An experimental and numerical study. J Biomech 2017; 54:64-72. [DOI: 10.1016/j.jbiomech.2017.01.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 01/09/2023]
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Louvard Y, Lefevre T, Chevalier B, Garot P. Bifurcation Lesion Stenting. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yves Louvard
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy and Hôpital Privé Claude Galien; Quincy France
| | - Thierry Lefevre
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy and Hôpital Privé Claude Galien; Quincy France
| | - Bernard Chevalier
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy and Hôpital Privé Claude Galien; Quincy France
| | - Philippe Garot
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy and Hôpital Privé Claude Galien; Quincy France
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15
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Behaviour of two typical stents towards a new stent evolution. Med Biol Eng Comput 2016; 55:1019-1037. [PMID: 27669700 DOI: 10.1007/s11517-016-1574-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/15/2016] [Indexed: 11/27/2022]
Abstract
This study explores the analysis of a new stent geometry from two typical stents used to treat the coronary artery disease. Two different finite element methods are applied with different boundary conditions to investigate the stenosis region. Computational fluid dynamics (CFD) models including fluid-structure interaction are used to assess the haemodynamic impact of two types of coronary stents implantation: (1) type 1-based on a strut-link stent geometry and (2) type 2-a continuous helical stent. Using data from a recent clinical stenosis, flow disturbances and consequent shear stress alterations introduced by the stent treatment are investigated. A relationship between stenosis and the induced flow fields for the two types of stent designs is analysed as well as the correlation between haemodynamics and vessel wall biomechanical factors during the initiation and development of stenosis formation in the coronary artery. Both stents exhibit a good performance in reducing the obstruction artery. However, stent type 1 presents higher radial deformation than the type 2. This deformation can be seen as a limitation with a long-term clinical impact.
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Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses. J Biomech 2016; 49:2102-2111. [DOI: 10.1016/j.jbiomech.2015.11.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 01/26/2023]
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Antoniadis AP, Mortier P, Kassab G, Dubini G, Foin N, Murasato Y, Giannopoulos AA, Tu S, Iwasaki K, Hikichi Y, Migliavacca F, Chiastra C, Wentzel JJ, Gijsen F, Reiber JH, Barlis P, Serruys PW, Bhatt DL, Stankovic G, Edelman ER, Giannoglou GD, Louvard Y, Chatzizisis YS. Biomechanical Modeling to Improve Coronary Artery Bifurcation Stenting. JACC Cardiovasc Interv 2015; 8:1281-1296. [DOI: 10.1016/j.jcin.2015.06.015] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/05/2015] [Accepted: 06/18/2015] [Indexed: 02/04/2023]
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