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Optimization of Bifurcation Stenting

Dr Susann Beier, Institution: University of New South Wales

2019 Vanguard Grant

Years funded: 2020-2021


Heart disease is the most common cause of death globally and kills an Australian every 27 minutes. The narrowing of the blood vessels through disease develops over time and gradually restrict sufficient blood supply to the heart muscle which causes ischemia, heart attack and death. Disease narrowed coronary arteries can be treated by implanting a stent, a mesh wired scaffold which reopens the vessel. Artery branches or bifurcations are particularly prone to disease and require complex techniques using two stents.

Up to 160,000 stent patients develop complication after implant world-wide, ranging from an acute blockage through a blood clot formation to an excessive, unfavourable tissue growth in the stented region. Those complications are more likely to occur when there is residual blood flow disturbance caused by sub-optimal stent deployment such as incomplete opening, adverse distortion, or incomplete disease coverage. These challenges in stenting are well known and are especially common in arterial branches because patient specific variations in the arterial shape complicate stent implant and thus determine the success or failure of stenting. Here we propose a new method to explore a personalised treatment approach, whereby individual shape differences are accounted for.

We will analyse data from more than 600 patients to account for the significant shape variation found in a large population. These bifurcation shapes can be explored by using a combination of latest shape analysis, blood flow simulations, and 3D soft printing. Together these tools allow patient specific testing for stenting. This will reveal favourable two stent techniques with respect to individual bifurcation shapes and will directly impact clinical practice within two years of this project.

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