Author:
Zhao Shijia,Wu Wei,Samant Saurabhi,Khan Behram,Kassab Ghassan S.,Watanabe Yusuke,Murasato Yoshinobu,Sharzehee Mohammadali,Makadia Janaki,Zolty Daniel,Panagopoulos Anastasios,Burzotta Francesco,Migliavacca Francesco,Johnson Thomas W.,Lefevre Thierry,Lassen Jens Flensted,Brilakis Emmanouil S.,Bhatt Deepak L.,Dangas George,Chiastra Claudio,Stankovic Goran,Louvard Yves,Chatzizisis Yiannis S.
Abstract
AbstractPatient-specific and lesion-specific computational simulation of bifurcation stenting is an attractive approach to achieve individualized pre-procedural planning that could improve outcomes. The objectives of this work were to describe and validate a novel platform for fully computational patient-specific coronary bifurcation stenting. Our computational stent simulation platform was trained using n = 4 patient-specific bench bifurcation models (n = 17 simulations), and n = 5 clinical bifurcation cases (training group, n = 23 simulations). The platform was blindly tested in n = 5 clinical bifurcation cases (testing group, n = 29 simulations). A variety of stent platforms and stent techniques with 1- or 2-stents was used. Post-stenting imaging with micro-computed tomography (μCT) for bench group and optical coherence tomography (OCT) for clinical groups were used as reference for the training and testing of computational coronary bifurcation stenting. There was a very high agreement for mean lumen diameter (MLD) between stent simulations and post-stenting μCT in bench cases yielding an overall bias of 0.03 (− 0.28 to 0.34) mm. Similarly, there was a high agreement for MLD between stent simulation and OCT in clinical training group [bias 0.08 (− 0.24 to 0.41) mm], and clinical testing group [bias 0.08 (− 0.29 to 0.46) mm]. Quantitatively and qualitatively stent size and shape in computational stenting was in high agreement with clinical cases, yielding an overall bias of < 0.15 mm. Patient-specific computational stenting of coronary bifurcations is a feasible and accurate approach. Future clinical studies are warranted to investigate the ability of computational stenting simulations to guide decision-making in the cardiac catheterization laboratory and improve clinical outcomes.
Funder
National Institutes of Health
Dr Vincent Miscia Cardiovascular Research Fund
Publisher
Springer Science and Business Media LLC
Cited by
25 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献