John Doe, an 81-year-old patient with a significant distal left main (LM) stenosis, was treated using a provisional stenting approach. As part of an European Bifurcation Club (EBC) project, the complete stenting procedure was repeated using computational modelling. First, a tailored three-dimensional (3D) reconstruction of the bifurcation anatomy was created by fusion of multislice computed tomography (CT) imaging and intravascular ultrasound. Second, finite element analysis was employed to deploy and post-dilate the stent virtually within the generated patient-specific anatomical bifurcation model. Finally, blood flow was modelled using computational fluid dynamics. This proof-of-concept study demonstrated the feasibility of such patient-specific simulations for bifurcation stenting and has provided unique insights into the bifurcation anatomy, the technical aspects of LM bifurcation stenting, and the positive impact of adequate post-dilatation on blood flow patterns. Potential clinical applications such as virtual trials and preoperative planning seem feasible but require a thorough clinical validation of the predictive power of these computer simulations.

Patient-specific computer modelling of coronary bifurcation stenting: The John Doe programme

CHIASTRA, CLAUDIO;MIGLIAVACCA, FRANCESCO;DUBINI, GABRIELE ANGELO
2015-01-01

Abstract

John Doe, an 81-year-old patient with a significant distal left main (LM) stenosis, was treated using a provisional stenting approach. As part of an European Bifurcation Club (EBC) project, the complete stenting procedure was repeated using computational modelling. First, a tailored three-dimensional (3D) reconstruction of the bifurcation anatomy was created by fusion of multislice computed tomography (CT) imaging and intravascular ultrasound. Second, finite element analysis was employed to deploy and post-dilate the stent virtually within the generated patient-specific anatomical bifurcation model. Finally, blood flow was modelled using computational fluid dynamics. This proof-of-concept study demonstrated the feasibility of such patient-specific simulations for bifurcation stenting and has provided unique insights into the bifurcation anatomy, the technical aspects of LM bifurcation stenting, and the positive impact of adequate post-dilatation on blood flow patterns. Potential clinical applications such as virtual trials and preoperative planning seem feasible but require a thorough clinical validation of the predictive power of these computer simulations.
2015
Cardiology and Cardiovascular Medicine
File in questo prodotto:
File Dimensione Formato  
2015-John-Doe-EurointerventionV_issue-article_8.pdf

Accesso riservato

: Publisher’s version
Dimensione 837.72 kB
Formato Adobe PDF
837.72 kB Adobe PDF   Visualizza/Apri
Patient-specific computer modelling of coronary bifurcation_11311-968825_Migliavacca.pdf

accesso aperto

: Post-Print (DRAFT o Author’s Accepted Manuscript-AAM)
Dimensione 1.01 MB
Formato Adobe PDF
1.01 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11311/968825
Citazioni
  • ???jsp.display-item.citation.pmc??? 10
  • Scopus 26
  • ???jsp.display-item.citation.isi??? ND
social impact