| Sequential structural and fluid dynamic numerical simulations of a stented bifurcated coronary artery. | |
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MedLine Citation:
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PMID: 22206427 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Despite their success, stenting procedures are still associated to some clinical problems like sub-acute thrombosis and in-stent restenosis. Several clinical studies associate these phenomena to a combination of both structural and hemodynamic alterations caused by stent implantation. Recently, numerical models have been widely used in the literature to investigate stenting procedures but always from either a purely structural or fluid dynamic point of view. The aim of this work is the implementation of sequential structural and fluid dynamic numerical models to provide a better understanding of stenting procedures in coronary bifurcations. In particular, the realistic geometrical configurations obtained with structural simulations were used to create the fluid domains employed within transient fluid dynamic analyses. This sequential approach was applied to investigate the final kissing balloon (FKB) inflation during the provisional side branch technique. Mechanical stresses in the arterial wall and the stent as well as wall shear stresses along the arterial wall were examined before and after the FKB deployment. FKB provoked average mechanical stresses in the arterial wall almost 2.5 times higher with respect to those induced by inflation of the stent in the main branch only. Results also enlightened FKB benefits in terms of improved local blood flow pattern for the side branch access. As a drawback, the FKB generates a larger region of low wall shear stress. In particular, after FKB the percentage of area characterized by wall shear stresses lower than 0.5 Pa was 79.0%, while before the FKB it was 62.3%. For these reasons, a new tapered balloon dedicated to bifurcations was proposed. The inclusion of the modified balloon has reduced the mechanical stresses in the proximal arterial vessel to 40% and the low wall shear stress coverage area to 71.3%. In conclusion, these results show the relevance of the adopted sequential approach to study the wall mechanics and the hemodynamics created by stent deployment. |
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Authors:
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Stefano Morlacchi; Claudio Chiastra; Dario Gastaldi; Giancarlo Pennati; Gabriele Dubini; Francesco Migliavacca |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of biomechanical engineering Volume: 133 ISSN: 1528-8951 ISO Abbreviation: J Biomech Eng Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7909584 Medline TA: J Biomech Eng Country: United States |
Other Details:
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Languages: eng Pagination: 121010 Citation Subset: IM |
Affiliation:
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Laboratory of Biological Structure Mechanics, Structural Engineering Department, Politecnico di Milano, 20133 Milan, Italy; Department of Bioengineering, Politecnico di Milano, 20133 Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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