Stent deformation, physical stress, and drug elution obtained with provisional stenting, conventional culotte and Tryton-based culotte to treat bifurcations: a virtual simulation study

Francesco Burzotta, Simona Morlacchi, Stefano Morlacchi, Claudio Chiastra, Elena Cutrì, Paolo Zunino, Luca Formaggia, Gabriele Dubini, Francesco Migliavacca

Risultato della ricerca: Contributo in rivistaArticolo in rivista

17 Citazioni (Scopus)

Abstract

AIMS: This study sought to investigate the possible influence of different bifurcation stenting techniques on stent deformation, physical stress, and drug elution using a virtual tool that includes structural, fluid dynamics and drug-eluting numerical models. METHODS AND RESULTS: A virtual bench test based on explicit dynamics modelling was used to simulate procedures on bifurcated coronary vessels performed according to three different stenting techniques: provisional side branch stenting, culotte, and Tryton-based culotte. Geometrical configurations obtained after virtual stenting simulations were used to perform fluid dynamics and drug elution analyses. The results showed that substantially different patterns of mechanical deformation, shear stress and theoretical drug elution were obtained using the different techniques. Compared with conventional culotte, the dedicated Tryton seems to facilitate the intervention in terms of improved access to the main branch and to lower its biomechanical influence on the coronary bifurcation in terms of mechanical and haemodynamic parameters. However, since the Tryton stent is a bare metal stent, the drug elution obtained is lower. CONCLUSIONS: Numerical models might successfully complement the information on stenting procedures obtained with traditional approaches such as in vitro bench testing or clinical trials. Devices dedicated to bifurcations may facilitate procedure completion and may result in specific patterns of mechanical stress, regional blood flow and drug elution.
Lingua originaleEnglish
pagine (da-a)1441-1453
Numero di pagine13
RivistaEuroIntervention
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Angioplasty, Balloon, Coronary
  • Cardiovascular Agents
  • Computer Simulation
  • Coronary Artery Disease
  • Drug-Eluting Stents
  • Finite Element Analysis
  • Humans
  • Materials Testing
  • Models, Anatomic
  • Models, Cardiovascular
  • Numerical Analysis, Computer-Assisted
  • Prosthesis Design
  • Stress, Mechanical

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