title: Optimal Revascularization Strategy on Medina 0,1,0 Left Main Bifurcation Lesions in Type 2 Diabetes.
abstract: Aim. Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. The implications of a diagnosis of DM are as severe as the diagnosis of coronary artery disease. For many patients with complex coronary artery disease, optimal revascularization strategy selection and optimal medical therapy are equally important. In this study, we compared the hemodynamic results of different stenting techniques for Medina 0,1,0 left main bifurcation lesions.Methods. We use idealized left main bifurcation models and computational fluid dynamics analysis to evaluate hemodynamic parameters which are known to affect the risk of restenosis and thrombosis at stented bifurcation. The surface integrals of time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) at bifurcation site were quantified.Results. Crossover stenting without final kissing balloon angioplasty provided the most favorable hemodynamic results (integrated values of TAWSS = 2.96 × 10-4N, OSI = 4.75 × 10-6m2) with bifurcation area subjected to OSI values >0.25, >0.35, and >0.45 calculated as 0.39 mm2, 0.06 mm2, and 0 mm2, respectively.Conclusion. Crossover stenting only offers hemodynamic advantages over other stenting techniques for Medina 0,1,0 left main bifurcation lesions and large bifurcation angle is associated with unfavorable flow profiles.
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Xuwei
authors: X
authors: Zheng
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Hongyu
authors: H
authors: Peng
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Donghui
authors: D
authors: Zhao
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Qin
authors: Q
authors: Ma
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Kun
authors: K
authors: Fu
authors: Soft Matter and Interdisciplinary Research Center, College of Physics, Chongqing University, Chongqing 401331, China.
authors: Guo
authors: G
authors: Chen
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Qian
authors: 0000-0002-8269-3060
authors: Q
authors: Fan
authors: Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
authors: Jinghua
authors: 0000-0003-3195-3798
authors: J
authors: Liu
mesh_terms: D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D057446:Hydrodynamics; D008955:Models, Cardiovascular; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015607:Stents; D013314:Stress, Mechanical