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DOI: 10.1055/s-0030-1268905
Virtual coronary stenting – patient-specific simulation of stent implantation and blood flow characteristics for coronary intervention planning
Objective: For a personalised intervention of diseased coronary arteries, a suitable planning tool is required to support the clinician in stent selection and positioning based on the patient's vessel anatomy and plaque characterisation to ensure an optimum stent alignment and favourable haemodynamics.
Methods: A 3D reconstruction of the stenosed coronary arteries is based on imaging data obtained by IVUS (fused with X-ray angiografies) or CT imaging including a computer-aided characterization of plaque components. A virtual positioning and realistic deployment of the selected stent/balloon device inside the stenosed artery is performed by computer simulation. Resulting information on the stented artery is transferred to a flow module to calculate local and global coronary blood flow characteristics. Relevant intervention parameters such as stent type and length, artery elasticity, inflation pressure and haemodynamic conditions can be varied.
Results: The simulations predict and visualise the outcome of the stenting procedure, like the lumen dilatation, lesion coverage and stent alignment as well as predictors for artery traumatisation during percutaneous coronary intervention. The subsequent flow analysis reveals the effects of the stenting intervention both on the local haemodynamics, which greatly affects proliferation and restenosis, and on global flow parameters such as perfusion rates and pressure drop of the affected arteries.
Conclusions: A new simulation tool is presented which provides support to cardiologists for a personalised intervention planning of diseased coronary arteries, based on the patient's specific anatomy, plaque information, haemodynamic conditions and device specification.