Three dimensional reconstruction of coronary artery stents from optical coherence tomography: experimental validation and clinical feasibility.
Three dimensional reconstruction of coronary artery stents from optical coherence tomography: experimental validation and clinical feasibility.
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DOI：
10.1038/s41598-021-91458-y
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发表时间：
2021-06-10
影响因子：
4.6
通讯作者：
Chatzizisis YS
中科院分区：
文献类型：
--
作者：
Wu W;Khan B;Sharzehee M;Zhao S;Samant S;Watanabe Y;Murasato Y;Mickley T;Bicek A;Bliss R;Valenzuela T;Iaizzo PA;Makadia J;Panagopoulos A;Burzotta F;Samady H;Brilakis ES;Dangas GD;Louvard Y;Stankovic G;Dubini G;Migliavacca F;Kassab GS;Edelman ER;Chiastra C;Chatzizisis YS
冠状动脉支架的结构形态（如支架扩张、管腔支架、支架放置、组织突出、侧支夹持、支架断裂）和支架部署后的局部血流动力学环境是手术成功和随后临床结果的关键决定因素。高分辨率冠状动脉内成像具有实现冠状动脉支架几何精确三维重建的潜力。本工作的目的是提出一种基于光学相干断层扫描（OCT）和血管造影的冠状动脉支架三维重建新算法，并通过实验测试其准确性、可重复性、临床可行性以及进行计算流体动力学（CFD）研究的能力。我们的方法有以下几个步骤：基于OCT和血管造影的三维管腔重建，在OCT图像中分割支架支撑，对分割后的支板进行包装、旋转和矫直，对分割后的支板进行平面展开，重建平面支架线框，将平面支架线框回滚到三维重建的管腔，最后重建支架体积。我们使用微计算机断层扫描（μCT）和立体成像作为参考，在支架患者特异性硅胶模型中测试了我们方法的准确性和重复性。临床可行性和CFD研究在临床上支架冠状动脉分叉进行。实验和临床研究表明，我们的算法(1)可以高精度再现复杂的支架空间构型，(2)在分叉部署的支架三维重构中是可行的，(3)使CFD研究能够评估支架内局部血流动力学环境。值得注意的是，我们算法的高精度在不同的支架设计和直径上是一致的。我们的方法与针对患者的CFD研究相结合，可以为优化支架植入程序、针对患者的计算支架植入模拟以及研究和开发新的支架支架和支架植入技术奠定基础。
The structural morphology of coronary stents (e.g. stent expansion, lumen scaffolding, strut apposition, tissue protrusion, side branch jailing, strut fracture), and the local hemodynamic environment after stent deployment are key determinants of procedural success and subsequent clinical outcomes. High-resolution intracoronary imaging has the potential to enable the geometrically accurate three-dimensional (3D) reconstruction of coronary stents. The aim of this work was to present a novel algorithm for 3D stent reconstruction of coronary artery stents based on optical coherence tomography (OCT) and angiography, and test experimentally its accuracy, reproducibility, clinical feasibility, and ability to perform computational fluid dynamics (CFD) studies. Our method has the following steps: 3D lumen reconstruction based on OCT and angiography, stent strut segmentation in OCT images, packaging, rotation and straightening of the segmented struts, planar unrolling of the segmented struts, planar stent wireframe reconstruction, rolling back of the planar stent wireframe to the 3D reconstructed lumen, and final stent volume reconstruction. We tested the accuracy and reproducibility of our method in stented patient-specific silicone models using micro-computed tomography (μCT) and stereoscopy as references. The clinical feasibility and CFD studies were performed in clinically stented coronary bifurcations. The experimental and clinical studies showed that our algorithm (1) can reproduce the complex spatial stent configuration with high precision and reproducibility, (2) is feasible in 3D reconstructing stents deployed in bifurcations, and (3) enables CFD studies to assess the local hemodynamic environment within the stent. Notably, the high accuracy of our algorithm was consistent across different stent designs and diameters. Our method coupled with patient-specific CFD studies can lay the ground for optimization of stenting procedures, patient-specific computational stenting simulations, and research and development of new stent scaffolds and stenting techniques.
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影响因子：
4.6
作者：
Wu W;Samant S;de Zwart G;Zhao S;Khan B;Ahmad M;Bologna M;Watanabe Y;Murasato Y;Burzotta F;Brilakis ES;Dangas G;Louvard Y;Stankovic G;Kassab GS;Migliavacca F;Chiastra C;Chatzizisis YS
通讯作者：
Chatzizisis YS
影响因子：
37.8
作者：
Davies, JE;Whinnett, ZI;Mayet, J
通讯作者：
Mayet, J
影响因子：
3.7
作者：
O'Brien, Caroline C.;Kolandaivelu, Kumaran;Edelman, Elazer R.
通讯作者：
Edelman, Elazer R.
影响因子：
2.4
作者：
van der Giessen, Alina G.;Groen, Harald C.;Gijsen, Frank J. H.
通讯作者：
Gijsen, Frank J. H.
影响因子：
2.4
作者：
Chiastra, Claudio;Wu, Wei;LaDisa, John F., Jr.
通讯作者：
LaDisa, John F., Jr.