Hemodynamic performance of different stent strategies for coronary bifurcations. Evaluation with a mathematical model

Purpose: Best percutaneous treatment strategy for lesions in coronary bifurcations is an ongoing subject of debate. There is limited data that analyses the effect of the different bifurcation strategies on coronary flow. Our aim is to evaluate the influence of different bifurcation stenting strategies on hemodynamic parameters, both in the main vessel (MV) and side branch (SB).

Coronary Artery Tracking in 3D Cardiac CT Images Using Local Morphological Reconstruction Operators

Automatic segmentation and tracking of the coronary artery tree from Cardiac Multislice-CT images is an important goal to improve the diagnosis and treatment of coronary artery disease. This paper presents a semi-automatic algorithm (one input point per vessel) based on morphological grayscale local reconstructions in 3D images devoted to the extraction of the coronary artery tree. The algorithm has been evaluated in the framework of the Coronary Artery Tracking Challenge 2008 [1], obtaining consistent results in overlapping measurements (a mean of 70% of the vessel well tracked). Poor results in accuracy measurements suggest that future work should refine the centerline extraction. The algorithm can be efficiently implemented and its general strategy can be easily extrapolated to a completely automated centerline extraction or to a user interactive vessel extraction

Pulsatile flow in coronary bifurcations for different stenting techniques

The objective of this work is to analyze the local hem odynamic changes caused in a coronary bifurcation by three different stenting techniques: simple stenting of the main vessel, simple stenting of the main vessel with kissing balloon in the side branch and culotte. To carry out this study an idealized geometry of a coronary bifurcation is used, and two bifurcation angles, 45º and 90º, are chosen as representative of the wide variety of re al configurations. In order to quantify the influence of the stenting technique on the local blood flow, both numeri- cal simulations and experimental measurements are performed. First, steady simulations are carried out with the commercial code ANSYS-Fluent, and then, experimental measurements with PIV (Particle Image Velocimetry) obtained in the laboratory are used to validate the numerical simulation. The steady computational simulations show a good overall agreement with the experimental data. Second, pulsatile flow is considered to take into account the tran- sient effects. The time averaged wall shear stress, scillatory shear index and pressure drop obtained numerically are used to compare the behavior of the stenting techniques.