1 / 13

Percutaneous coronary intervention (PCI)

Percutaneous coronary intervention (PCI). Coronary artery stenting. Dr Neil W. Bressloff. Coronary Artery Disease. Coronary Artery Disease (CAD) is a condition caused by the accumulation of plaque (usually atheromatous or fibrous plaque) on the inner walls of the artery.

griffie
Download Presentation

Percutaneous coronary intervention (PCI)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Percutaneous coronary intervention (PCI) Coronary artery stenting Dr Neil W. Bressloff

  2. Coronary Artery Disease • Coronary Artery Disease (CAD) is a condition caused by the accumulation of plaque (usually atheromatous or fibrous plaque) on the inner walls of the artery. Coronary Arteries(1) Plaque in a coronary artery(2) Angiogram showing stenotic region(3) • GNU Free Documentation License - http://commons.wikimedia.org/wiki/Commons:GNU_Free_Documentation_License • Creative Commons License - http://creativecommons.org/licenses/by-sa/2.5/ • Antonio Colombo and Goran Stankovic. Colombo’s Tips & Tricks with Drug-Eluting Stents. Taylor and Francis Group, 2005.

  3. Stents as a treatment to CAD • Stents are a most common treatment for CAD • They are tubular structures (often meshes) which are inserted in the stenotic region through a balloon catheter and then expanded through plastic deformation. • Stents are primarily inserted to provide a scaffolding feature. • Drug eluting stents (DES) are coated with an anti-proliferative drug. • National heart lung and blood institute (nlhbi). • http://www.nhlbi.nih.gov/health/dci/Diseases/Angioplasty/Angioplasty All.html. Stenting procedure(1)

  4. Key challenge with using stents • Restenosis - reduction in lumen size as a result of formation of the neointima within 12 months of the stent-implant • Thrombosis - formation of a blood clot, thrombus, inside a blood vessel. Restenosis(1) Thrombosis(2) • Rossella Balossino. A computational study of minimally-invasive devices for the treatment of coronary disease. PhD thesis, Politecnico di Milano. • David Faxon. Restenosis: a guide to therapy. Informa Health Care, illustrated edition, 2001.

  5. Geometry Construction • Representative models of the ART stent and Bx VELOCITY are constructed using Rhinoceros 4.0 ART stent – Flat model Bx VELOCITY – Flat model ART stent Bx VELOCITY stent

  6. Meshing • Tool used for meshing and CFD runs: Star CCM+ 3.06.006

  7. Velocity profiles- the ART stent

  8. Velocity profiles – Bx VELOCITY stent

  9. Haemodynamics and drug releaseNIR stent CD-Adapco 2010 calendar

  10. Stent ExpansionCYPHER stent

  11. Drug elutionBVS stent (in expanded state)

  12. FlexibilityBVS B stent (Abbott Vascular)

  13. Multi-objective design Balloon expansion; structural integrity Haemodynamics: re-endothelialisation Optimal design: patient specific Systematic design search and optimisation: Towards a novel, fully biodegradable drug eluting coronary stent Recover and maintain healthy blood flow but then disappear Drug elution: control of restenosis Flexibility

More Related