Three-dimensional virtual surgery models for percutaneous coronary intervention (PCI) optimization strategies

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Fluid Dynamics

Background:

• Percutaneous coronary intervention (PCI) with stent implantation is standard for coronary artery disease.
• In-stent restenosis remains a significant challenge post-PCI.
• Stent placement alters wall shear stress (WSS), promoting restenosis in low WSS regions.

Purpose of the Study:

• To optimize stent positioning for reducing restenosis risk.
• To investigate the impact of stent placement on WSS distribution.
• To validate computational simulations with in vitro experiments.

Main Methods:

• Developed a digital 3-D coronary artery model from clinical data.
• Utilized computational fluid dynamics (CFD) for simulation.
• Created 3-D microfluidic models using microfabrication and 3-D printing.
• Performed "virtual surgeries" with real stents in microfluidic models.

Main Results:

• Hydrodynamic experiments validated simulation accuracy.
• Identified the "half-cross stenting" strategy as optimal for reducing restenosis.
• Demonstrated that improper stent placement exacerbates low WSS regions.

Conclusions:

• The "half-cross stenting" strategy significantly reduces restenosis risk.
• 3-D printing combined with clinical image reconstruction is a promising tool for cardiovascular research.
• This approach offers a novel method for optimizing interventional strategies and understanding angiocardiopathy.