title: Patient-specific computer modelling of coronary bifurcation stenting: the John Doe programme.
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.
authors.affiliation: IBiTech-bioMMeda, iMinds medical IT, Ghent University, Ghent, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Mortier
authors.forename: Jolanda J
authors.initials: JJ
authors.lastname: Wentzel
authors.forename: Gianluca
authors.initials: G
authors.lastname: De Santis
authors.forename: Claudio
authors.initials: C
authors.lastname: Chiastra
authors.forename: Francesco
authors.initials: F
authors.lastname: Migliavacca
authors.forename: Matthieu
authors.initials: M
authors.lastname: De Beule
authors.forename: Yves
authors.initials: Y
authors.lastname: Louvard
authors.forename: Gabriele
authors.initials: G
authors.lastname: Dubini
mesh_terms: D000369:Aged, 80 and over; D003198:Computer Simulation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D061330:Multidetector Computed Tomography; D066230:Patient-Specific Modeling; D062645:Percutaneous Coronary Intervention; D015607:Stents; D025321:Surgery, Computer-Assisted; D018084:Ultrasonography, Interventional