Towards effects from stent implantation into coronary bifurcation stenosis: experiment and simulation

R. A. Gaifutdinov, Yu. O. Kuyanova, D. A. Khelimsky, O. Krestyaninov, A. A. Tulupov, D. Parshin
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Abstract

Coronary artery disease is a widespread cause of death and disability in the population. Angioplasty of the coronary arteries is one of the most common methods of eliminating the cause of ischemia – stenosis of the coronary arteries. As a result of stent installation, a change in the angle of vascular bifurcation occurs usually, as well as a redistribution of volumetric blood flow in the coronary artery system. Considering the high variability of the branching angioarchitecture of these arteries, as well as the structure of their environment, the problem of predicting the specific redistribution of blood flow in these arteries remains unsolved; the main ways of its implementation are computational and experimental hemodynamics. Material and methods. This paper uses an experimental approach to explore the effect of stent placement in a model of coronary artery stenosis, and also provides an analysis of the current level of awareness of the scientific community on this issue. Results and discussion. The experiment showed that the throughput of the model increases by 14 % compared to the model with stenosis, and the redistribution of flows in the model depends not on diameters but on the anatomy of a particular vascular network. The data of the performed mathematical modeling are generally consistent with the results of the experiment before stent installation, when the coronary tree consists of several load-bearing branches, but have quantitative differences for the distal branches of the coronary artery model in the presence of an installed stent. Conclusions. The results of the work can be used to accumulate an experimental data array on the restructuring of blood flow during angioplasty, and can also be used to verify the numerical hemodynamics of the coronary arteries during the virtual installation of a stent in them to resolve stenosis. 
冠状动脉分叉狭窄处植入支架的影响:实验与模拟
冠状动脉疾病是导致人们死亡和残疾的一个普遍原因。冠状动脉血管成形术是消除缺血原因--冠状动脉狭窄--的最常用方法之一。安装支架后,血管分叉角度通常会发生变化,冠状动脉系统中的容积血流也会重新分配。考虑到这些动脉的分支血管结构及其环境结构的高度可变性,预测这些动脉血流具体重新分布的问题仍未解决;实现这一问题的主要方法是计算和实验血液动力学。材料和方法。本文采用实验方法探讨了在冠状动脉狭窄模型中放置支架的影响,并对科学界目前对这一问题的认识水平进行了分析。结果与讨论。实验结果表明,与有狭窄的模型相比,该模型的吞吐量增加了 14%,模型中流量的重新分布不取决于直径,而是取决于特定血管网络的解剖结构。数学建模的数据与安装支架前的实验结果基本一致,当时冠状动脉树由多个承重分支组成,但在安装支架的情况下,冠状动脉模型的远端分支在数量上存在差异。结论。这项工作的结果可用于积累血管成形术期间血流重组的实验数据阵列,也可用于验证在冠状动脉中虚拟安装支架以解决狭窄问题时冠状动脉的数值血流动力学。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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