John Doe, an 81-year-old patient with a significant distal left main (LM) stenosis, was treated using a provisional stenting approach. As part of a European Bifurcation Club (EBC) project, the complete stenting procedure was repeated using computational modelling.
First, a tailored three-dimensional (3D) reconstruction of the bifurcation anatomy was created by fusion of multi-slice computed tomography (CT) imaging and intra- vascular ultrasound.
Second, finite element analysis was employed to deploy and post-dilate the stent virtually within the generated patient-specific anatomical bifurcation model.
Finally, blood flow was modelled using computational fluid dynamics.
This proof-of-concept study demonstrated the feasibility of such patient-specific simulations for bifurcation stenting and has provided unique insights into the bifurcation anatomy, the technical aspects of LM bifurcation stenting, and the positive impact of adequate post-dilatation on blood flow patterns.
Potential clinical applications such as virtual trials and preoperative planning seem feasible but require a thorough clinical validation of the predictive power of these computer simulations.
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