Patient-specific computer modelling of coronary bifurcation stenting: the John Doe programme

EuroIntervention. 2015:11 Suppl V:V35-9. doi: 10.4244/EIJV11SVA8.

Abstract

John Doe, an 81-year-old patient with a significant distal left main (LM) stenosis, was treated using a provisional stenting approach. As part of an European Bifurcation Club (EBC) project, the complete stenting procedure was repeated using computational modelling. First, a tailored three-dimensional (3D) reconstruction of the bifurcation anatomy was created by fusion of multislice computed tomography (CT) imaging and intravascular ultrasound. Second, finite element analysis was employed to deploy and post-dilate the stent virtually within the generated patient-specific anatomical bifurcation model. Finally, blood flow was modelled using computational fluid dynamics. This proof-of-concept study demonstrated the feasibility of such patient-specific simulations for bifurcation stenting and has provided unique insights into the bifurcation anatomy, the technical aspects of LM bifurcation stenting, and the positive impact of adequate post-dilatation on blood flow patterns. Potential clinical applications such as virtual trials and preoperative planning seem feasible but require a thorough clinical validation of the predictive power of these computer simulations.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • Aged, 80 and over
  • Computer Simulation
  • Coronary Angiography
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / surgery*
  • Feasibility Studies
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Multidetector Computed Tomography
  • Patient-Specific Modeling*
  • Percutaneous Coronary Intervention
  • Stents*
  • Surgery, Computer-Assisted
  • Ultrasonography, Interventional