Patient-specific computational simulation of coronary artery bifurcation stenting

Shijia Zhao, Wei Wu, Saurabhi Samant, Behram Khan, Ghassan S Kassab, Yusuke Watanabe, Yoshinobu Murasato, Mohammadali Sharzehee, Janaki Makadia, Daniel Zolty, Anastasios Panagopoulos, Francesco Burzotta, Francesco Migliavacca, Thomas W Johnson, Thierry Lefevre, Jens Flensted Lassen, Emmanouil S Brilakis, Deepak L Bhatt, George Dangas, Claudio ChiastraGoran Stankovic, Yves Louvard, Yiannis S Chatzizisis

Abstract

Patient-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.

OriginalsprogEngelsk
Artikelnummer16486
TidsskriftScientific Reports
Vol/bind11
Udgave nummer1
Sider (fra-til)16486
ISSN2045-2322
DOI
StatusUdgivet - 13 aug. 2021

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