Patient-specific computational simulation of coronary artery bifurcation stenting

• Published in: Scientific reports 2021-08, Vol.11 (1), p.16486-16486, Article 16486
• Main Authors: 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.
• Format: Article
• Language: English
• Subjects: 639/166/985; 692/4019/2776; Bias; Catheterization; Computed tomography; Computer applications; Coronary artery; Decision making; Humanities and Social Sciences; Implants; multidisciplinary; Patients; Science; Science (multidisciplinary); Simulation; Stents; Training
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-95026-2

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