Advancements in Coronary Bifurcation Stenting Techniques: Insights From Computational and Bench Testing Studies

IF 2.2 4区 医学 Q3 ENGINEERING, BIOMEDICAL International Journal for Numerical Methods in Biomedical Engineering Pub Date : 2025-03-14 DOI:10.1002/cnm.70000
Andrea Colombo, Claudio Chiastra, Diego Gallo, Poay Huan Loh, Socrates Dokos, Mingzi Zhang, Hamed Keramati, Dario Carbonaro, Francesco Migliavacca, Tapabrata Ray, Nigel Jepson, Susann Beier
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Abstract

Coronary bifurcation lesions present complex challenges in interventional cardiology, necessitating effective stenting techniques to achieve optimal results. This literature review comprehensively examines the application of computational and bench testing methods in coronary bifurcation stenting, offering insights into procedural aspects, stent design considerations, and patient-specific characteristics. Structural mechanics finite element analysis, computational fluid dynamics, and multi-objective optimization are valuable tools for evaluating stenting strategies, including provisional side branch stenting and two-stenting techniques. We highlight the impact of procedural factors, such as balloon positioning and rewiring techniques, and stent design features on the outcome of percutaneous coronary interventions with stents. We discuss the importance of patient-specific characteristics in deployment strategies, such as bifurcation angle and plaque properties. This understanding informs present and future research and clinical practice on bifurcation stenting. Computational simulations are a continuously maturing advance that has significantly enhanced stenting devices and techniques for coronary bifurcation lesions over the years. However, the accurate account of patient-specific vessel and lesion characteristics, both in terms of anatomical and accurate physiological behavior, and their large variation between patients, remains a significant challenge in the field. In this context, advancements in multi-objective optimization offer significant opportunities for refining stent design and procedural practices.

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来源期刊
International Journal for Numerical Methods in Biomedical Engineering
International Journal for Numerical Methods in Biomedical Engineering ENGINEERING, BIOMEDICAL-MATHEMATICAL & COMPUTATIONAL BIOLOGY
CiteScore
4.50
自引率
9.50%
发文量
103
审稿时长
3 months
期刊介绍: All differential equation based models for biomedical applications and their novel solutions (using either established numerical methods such as finite difference, finite element and finite volume methods or new numerical methods) are within the scope of this journal. Manuscripts with experimental and analytical themes are also welcome if a component of the paper deals with numerical methods. Special cases that may not involve differential equations such as image processing, meshing and artificial intelligence are within the scope. Any research that is broadly linked to the wellbeing of the human body, either directly or indirectly, is also within the scope of this journal.
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