Abstract：Coronary stent implantation is a routine method of interventional therapy for coronary heart disease. How to predict and evaluate the surgical regimen before the surgery in order to optimize and improve has been a clinical concern. With the help of computer platform, the finite element numerical simulation method was used to simulate the virtual implantation of coronary stent, hence the realistic problems were transformed into a mathematical issue, which can be simulated in finite element method. The design of the coronary stent implantation was analyzed and optimized by computer calculation and simulation. Based on the research history and present situation of numerical simulation of coronary stent implantation at home and abroad, this paper introduced the research progress of virtual implantation of coronary stent, and summarizes the research results from the three aspects including the balloon model, vascular wall model and bifurcation model.From the results of these studies, the virtual implantation of coronary stent can assist the clinical selection of the best program, and has significance for leading the development of coronary interventional therapy.
基金资助:北京市科委项目(Z161100000116086) #中国生物医学工程学会会员(Member, Chinese Society of Biomedical Engineering)
通讯作者:
E-mail:llbl@sina.com
引用本文:
潘连强,蔺嫦燕. 冠脉支架虚拟置入技术的研究现状[J]. 中国生物医学工程学报, 2018, 37(3): 367-371.
Pan Lianqiang, Lin Changyan. Research Status of Virtual Implantation of Coronary Stent. Chinese Journal of Biomedical Engineering, 2018, 37(3): 367-371.
[1] Morlacchi S, Migliavacca F. Modeling stented coronary arteries: Where we are, where to go[J]. Annals of Biomedical Engineering, 2013, 41(7):1428-1444. [2] Karanasiou GS, Papafaklis MI, Conway C, et al. Stents: Biomechanics, biomaterials, and insights from computational modeling[J]. Annals of Biomedical Engineering, 2017, 45(4):853-872. [3] Martin D, Boyle FJ. Computational structural modelling of coronary stent deployment: A review[J]. Computer Methods in Biomechanics & Biomedical Engineering, 2011, 14(4):331-348. [4] Murphy J, Boyle F. Predicting neointimal hyperplasia in stented arteries using time-dependant computational fluid dynamics: a review[J]. Computers in Biology & Medicine, 2010, 40(4):408-418. [5] Beier S, Ormiston J, Webster M, et al. Impact of bifurcation angle and other anatomical characteristics on blood flow-A computational study of non-stented and stented coronary arteries[J]. Journal of Biomechanics, 2016, 49(9): 1570-1582. [6] De Beule M, Mortier P, Carlier SG, et al. Realistic finite element-based stent design: The impact of balloon folding[J]. Journal of Biomechanics, 2008, 41(2):383-389. [7] Gastaldi D, Sassi V, Petrini L, et al. Continuum damage model for bioresorbable magnesium alloy devices—Application to coronary stents[J]. Journal of the Mechanical Behavior of Biomedical Materials, 2011, 4(3): 352-365. [8] Zahedmanesh H, Kelly DJ, Lally C. Simulation of a balloon expandable stent in a realistic coronary artery—Determination of the optimum modelling strategy[J]. Journal of Biomechanics, 2010, 43(11): 2126-2132. [9] Mortier P, De Beule M, Carlier SG, et al. Numerical study of the uniformity of balloon-expandable stent deployment[J]. Journal of Biomechanical Engineering, 2008, 130(2): 021018. [10] Ragkousis GE, Curzen N, Bressloff NW. Computational modelling of multi-folded balloon delivery systems for coronary artery stenting: insights into patient-specific stent malapposition[J]. Annals of Biomedical Engineering, 2015, 43(8): 1786-1802. [11] Martin D, Boyle F. Finite element analysis of balloon-expandable coronary stent deployment: influence of angioplasty balloon configuration[J]. International Journal for Numerical Methods in Biomedical Engineering, 2013, 29(11):1161-1175. [12] Holzapfel GA, Sommer G, Gasser CT, et al. Determination of layer-specific mechanical properties of human coronary arteries with nonatherosclerotic intimal thickening and related constitutive modeling[J]. American Journal of Physiology-Heart and Circulatory Physiology, 2005, 289(5): H2048-H2058. [13] Akyildiz AC, Speelman L, Gijsen FJH. Mechanical properties of human atherosclerotic intima tissue[J]. Journal of Biomechanics, 2014, 47(4): 773-783. [14] Loree HM, Grodzinsky AJ, Park SY, et al. Static circumferential tangential modulus of human atherosclerotic tissue.[J]. Journal of Biomechanics, 1994, 27(2):195-204. [15] Morlacchi S, Pennati G, Petrini L, et al. Influence of plaque calcifications on coronary stent fracture: a numerical fatigue life analysis including cardiac wall movement[J]. Journal of Biomechanics, 2014, 47(4): 899-907. [16] Zhao S, Gu L, Froemming SR. Finite element analysis of the implantation of a self-expanding stent: impact of lesion calcification[J]. Journal of Medical Devices, 2012, 6(2): 021001. [17] Gastaldi D, Morlacchi S, Nichetti R, et al. Modelling of the provisional side-branch stenting approach for the treatment of atherosclerotic coronary bifurcations: Effects of stent positioning[J]. Biomechanics and Modeling in Mechanobiology, 2010, 9(5):551-561. [18] Xu J, Yang J, Huang N, et al. Mechanical response of cardiovascular stents under vascular dynamic bending[J]. Biomedical Engineering Online, 2016, 15(1):21\|21. [19] Iannaccone F, Chiastra C, Karanasos A, et al. Impact of plaque type and side branch geometry on side branch compromise after provisional stent implantation: A simulation study[J]. EuroIntervention, 2017, 13(2):e236-e245. [20] Chiastra C, Wu W, Dickerhoff B, et al. Computational replication of the patient-specific stenting procedure for coronary artery bifurcations: From OCT and CT imaging to structural and hemodynamics analyses[J]. Journal of Biomechanics, 2015, 49(11):2102-2111. [21] Imani M, Goudarzi AM, Ganji DD, et al. The comprehensive finite element model for stenting: The influence of stent design on the outcome after coronary stent placement[J]. Journal of Theoretical and Applied Mechanics, 2013, 51(3): 639-648. [22] Lassen JF, Holm NR, Stankovic G, et al. Percutaneous coronary intervention for coronary bifurcation disease: consensus from the first 10 years of the European Bifurcation Club meetings[J]. Eurointervention, 2014, 10(5):545-560. [23] Lassen JF, Holm NR, Banning A, et al. Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club[J]. Eurointervention, 2016, 12(1):38-46. [24] Morlacchi S, Colleoni SG, Cárdenes R, et al. Patient-specific simulations of stenting procedures in coronary bifurcations: Two clinical cases[J]. Medical Engineering & Physics, 2013, 35(9): 1272-1281. [25] Arokiaraj MC, Santis GD, Beule MD, et al. A novel tram stent method in the treatment of coronary bifurcation lesions - finite element study[J]. PLoS ONE, 2016, 11(3):e0149838. [26] Mortier P, Hikichi Y, Foin N, et al. Provisional stenting of coronary bifurcations: Insights into final kissing balloon post-dilation and stent design by computational modeling[J]. JACC CardiovascInterv, 2014, 7(3):325-333. [27] Mortier P, Wentzel JJ, De Santis G, et al. Patient-specific computer modelling of coronary bifurcation stenting: The John Doe programme[J]. EuroIntervention, 2015, 11: V35-V39. [28] Chiastra C, Morlacchi S, Gallo D, et al. Computational fluid dynamic simulations of image-based stented coronary bifurcation models[J]. Journal of the Royal Society Interface, 2013, 10(84):20130193. [29] Chen HY, Koo BK, Kassab GS. Impact of bifurcation dual stenting on endothelial shear stress[J]. Journal of Applied Physiology, 2015, 119(6): 627-632.
