Patient-Specific Simulations to Guide Coronary Bifurcation Stenting

指导冠状动脉分叉支架置入的患者特异性模拟

• 批准号: 10810399
• 负责人: Ioannis S Chatzizisis
• 金额: $ 77.06万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-16 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10810399
• 关键词: Anatomy; Aorta; Atlases; Biology; Biomechanics; Blinded; Blood Vessels; Cardiac; Cardiology; Carotid Arteries; Cause of Death; Clinical; Complex; Computer Simulation; Coronary; Coronary Arteriosclerosis; Data; Dilatation - action; Dimensions; Environment; Event; Family suidae; Female; Finite Element Analysis; Goals; Human; Implant; Infrastructure; Intervention; Lesion; Liquid substance; Manufacturer; Mechanics; Modification; Multi-site clinical study; Outcome; Patients; Performance; Protocols documentation; Randomized, Controlled Trials; Research; Role; Sample Size; Side; Societies; Solid; Stents; Stress; Tail; Techniques; Testing; Time; Training and Education; Translating; Work; clinically relevant; design; hemodynamics; improved; improved outcome; innovation; interest; male; novel; percutaneous coronary intervention; personalized approach; porcine model; post intervention; precision medicine; prevent; prospective; randomized trial; restenosis; shear stress; simulation; structural heart disease; success; tool; treatment strategy; vascular bed

PROTOCOL SUMMARY/ABSTRACT Coronary artery disease is the leading cause of death in Western society. Stents are implanted in 70-90% of the 1.3 million percutaneous coronary interventions performed annually in the USA, of which 20% involve bifurcations. Coronary bifurcations remain one of the most challenging lesion subsets in interventional cardiology, with a lower procedural success rate and increased rates of long-term adverse cardiac events, ranging between 15-20% at six months to one year post-intervention. Despite the great interest in this complex lesion subset, percutaneous treatment of coronary bifurcations is still a controversial subject and multiple technical strategies have been proposed. Fundamental mechanical disturbances within the stent appear to be major determinants of stent restenosis. No two bifurcations are identical, and no single treatment strategy exists that can be applied to every bifurcation. The most important issue in bifurcation interventions is selecting the most appropriate strategy for a specific bifurcation. Accordingly, we intend to investigate for the first time in human the role of fluid stresses on stent restenosis. We will use a validated subject-specific finite element analysis of arterial bifurcations rooted in clinical and experimental data to faithfully predict stent restenosis. The overall objective of this proposal is to use an individualized approach to identify the optimal bifurcation stenting technique for a specific bifurcation. Our central hypothesis is that subject-specific simulations of bifurcation stenting optimize the local biomechanical environment and reduces stent restenosis. Our proposal brings together extensive expertise, infrastructure and preliminary work in fluid and solid mechanics, computational simulations and vascular biology. These findings will establish clinically-relevant hypotheses that will serve as basis for our long term goal; a large, randomized controlled trial to show improved clinical outcomes with patient-specific bifurcation stenting strategies. The proposed research is an example of how precision medicine with pre-procedural planning can help optimize bifurcation stenting and improve clinical outcomes. Patient-specific computational stenting simulations may shift the management paradigm of coronary bifurcation interventions and provide a new dimension on how to improve the stenting and post-dilatation techniques.

协议总结/文摘

项目成果

Role of triggering receptor expressed on myeloid cells-1 in the mechanotransduction signaling pathways that link low shear stress with inflammation.

• DOI: 10.1038/s41598-023-31763-w
• 发表时间: 2023-03-21
• 期刊: SCIENTIFIC REPORTS
• 影响因子: 4.6
• 作者: Liu, Martin;Panagopoulos, Anastasios Nikolaos;Oguz, Usama M. M.;Samant, Saurabhi;Vasa, Charu Hasini;Agrawal, Devendra K. K.;Chatzizisis, Yiannis S. S.
• 通讯作者: Chatzizisis, Yiannis S. S.

Three dimensional reconstruction of coronary artery stents from optical coherence tomography: experimental validation and clinical feasibility.

• DOI: 10.1038/s41598-021-91458-y
• 发表时间: 2021-06-10
• 期刊: Scientific reports
• 影响因子: 4.6
• 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
• 通讯作者: Chatzizisis YS

Real time reduced order model for angiography fractional flow reserve.

• DOI: 10.1016/j.cmpb.2022.106674
• 发表时间: 2022-04
• 期刊: Computer methods and programs in biomedicine
• 影响因子: 6.1
• 作者: Hashemi J;Patel B;Chatzizisis YS;Kassab GS
• 通讯作者: Kassab GS

First-in-Human Computational Preprocedural Planning of Left Main Interventions Using a New Everolimus-Eluting Stent.

• DOI: 10.1016/j.jaccas.2022.02.001
• 发表时间: 2022-03-16
• 期刊: JACC. Case reports
• 作者: Chatzizisis, Yiannis S;Makadia, Janaki;Zhao, Shijia;Panagopoulos, Anastasios;Sharzehee, Mohammadali;Khan, Behram;Samant, Saurabhi;Fayaz, Muhammad;Pandya, Jitendra;Akkad, Haysam;Pavlides, Gregory;O'Leary, Edward;Wu, Wei
• 通讯作者: Wu, Wei

Anatomical classification of chronic total occlusions in coronary bifurcations.

• DOI: 10.5603/cj.a2022.0115
• 发表时间: 2023
• 期刊: CARDIOLOGY JOURNAL
• 影响因子: 2.9
• 作者: Luis Gutierrez-Chico, Juan;Cortes, Carlos;Holm, Niels Ramsing;Christiansen, Evald Hoj;Lesiak, Maciej;Lauer, Bernward;Otto, Sylvia;Lavarra, Francesco;Sasi, Viktor;Chatzizisis, Yiannis S.;Rathore, Sudhir;Mashayekhi, Kambis
• 通讯作者: Mashayekhi, Kambis