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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Article number16486
JournalScientific reports
Volume11
Issue number1
DOIs
StatePublished - Dec 2021
Externally publishedYes

ASJC Scopus subject areas

  • General

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