3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility

Wu, Wei; Samant, Saurabhi; Zwart, Gijs de; Zhao, Shijie; Khan, Behram; Ahmad, Mansoor; Bologna, Marco; Watanabe, Yusuke; Murasato, Yoshinobu; Burzotta, Francesco; Brilakis, Emmanouil S.; Dangas, George; Louvard, Yves; Stanković, Goran; Kassab, Ghassan S.; Migliavacca, Francesco; Chiastra, Claudio; Chatzizisis, Yiannis S.

doi:10.1038/s41598-020-74264-w

Cited by 24 publications

(35 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our methodology has several important technical aspects and innovations: First, it is based on a well-validated lumen reconstruction method 14 . The geometrically correct lumen reconstruction determines the location and orientation of the stent contours and struts points, and the relative location of the stent within the lumen.…”

Section: Discussionmentioning

confidence: 99%

“…We created four patient-specific silicone models of coronary artery lumen (Fig. 1 ), using our in-house technique as previously described 14 . We included both straight and curved coronary artery segments.…”

Section: Methodsmentioning

confidence: 99%

“…The technique for semi-automatic 3D reconstruction of the silicone lumen was previously described 14 and summarized in Table 2 . Briefly, the lumen centerline was generated from two different angiographic views (3D CAAS Workstation 8.2; and VMTK, Orobix, Bergamo, Italy) and served as the backbone of the lumen reconstruction.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

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

Khan

Sharzehee

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

The structural morphology of coronary stents (e.g. stent expansion, lumen scaffolding, strut apposition, tissue protrusion, side branch jailing, strut fracture), and the local hemodynamic environment after stent deployment are key determinants of procedural success and subsequent clinical outcomes. High-resolution intracoronary imaging has the potential to enable the geometrically accurate three-dimensional (3D) reconstruction of coronary stents. The aim of this work was to present a novel algorithm for 3D stent reconstruction of coronary artery stents based on optical coherence tomography (OCT) and angiography, and test experimentally its accuracy, reproducibility, clinical feasibility, and ability to perform computational fluid dynamics (CFD) studies. Our method has the following steps: 3D lumen reconstruction based on OCT and angiography, stent strut segmentation in OCT images, packaging, rotation and straightening of the segmented struts, planar unrolling of the segmented struts, planar stent wireframe reconstruction, rolling back of the planar stent wireframe to the 3D reconstructed lumen, and final stent volume reconstruction. We tested the accuracy and reproducibility of our method in stented patient-specific silicone models using micro-computed tomography (μCT) and stereoscopy as references. The clinical feasibility and CFD studies were performed in clinically stented coronary bifurcations. The experimental and clinical studies showed that our algorithm (1) can reproduce the complex spatial stent configuration with high precision and reproducibility, (2) is feasible in 3D reconstructing stents deployed in bifurcations, and (3) enables CFD studies to assess the local hemodynamic environment within the stent. Notably, the high accuracy of our algorithm was consistent across different stent designs and diameters. Our method coupled with patient-specific CFD studies can lay the ground for optimization of stenting procedures, patient-specific computational stenting simulations, and research and development of new stent scaffolds and stenting techniques.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Khan

Sharzehee

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our methodology has several important technical aspects and innovations: First, it is based on a well-validated lumen reconstruction method. 14 The geometrically correct lumen reconstruction determines the location and orientation of stent contours and struts points, as well as the relative location of the stent within the lumen. Second, our approach to unroll the stent contours and strut points and reconstruct the planar stent wireframe was a critical step, enabling faster and more accurate stent reconstruction.…”

Section: Discussionmentioning

confidence: 99%

3D Reconstruction of Coronary Artery Stents From Optical Coherence Tomography: Experimental Validation and Clinical Feasibility

Behram

Sharzehee

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

The structural morphology of stents (e.g. expansion, lumen scaffolding, strut apposition, tissue protrusion, side branch jailing, strut fracture), and the local hemodynamic environment after stent deployment in coronary arteries are key determinants of procedural success and subsequent clinical outcomes. High-resolution intracoronary imaging has the potential to enable the geometrically correct 3D reconstruction of coronary stents. The aim of this work was to present a novel algorithm for 3D stent reconstruction of coronary artery stents by OCT and angiography, and test experimentally its accuracy, reproducibility, clinical feasibility and ability to perform CFD studies. Our method has the following steps: 3D lumen reconstruction by OCT and angiography, stent strut segmentation on OCT images, packaging, rotation and straightening of the segmented struts, and planar unrolling of the segmented struts, planar stent wireframe reconstruction, rolling back of the planar stent wireframe to the 3D reconstructed lumen, and stent volume reconstruction. We tested the accuracy and reproducibility of our method in stented patient-specific silicone models using micro computed tomography and stereoscopy as reference. The clinical feasibility and CFD studies were performed in clinically stented coronary bifurcations. Our experimental and clinical studies showed that our proposed algorithm can reproduce the complex stent configuration in space with high precision and reproducibility. Furthermore, our studies showed that the algorithm is feasible in clinical cases with stents deployed in diseased, bifurcated coronary arteries, enabling CFD studies to assess the hemodynamic environment. Notably, the high accuracy of our algorithm was consistent across different stent designs and diameters. Our method coupled with patient-specific CFD studies can facilitate stenting optimization, training in stenting techniques, and stent research and development.

show abstract

“…Four bench models of patient-specific coronary artery bifurcations were created using an in-house developed technique 13 . The initial bifurcation geometries were 3D reconstructed from human coronary angiograms (CAAS, Pie Medical Imaging BV, Maastricht, The Netherlands).…”

Section: Methodsmentioning

confidence: 99%

Patient-specific computational simulation of coronary artery bifurcation stenting

Zhao

Samant

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

Patient-specific and lesion-specific computational simulation of bifurcation stenting is an attractive approach to achieve individualized pre-procedural planning that could improve outcomes. The objectives of this work were to describe and validate a novel platform for fully computational patient-specific coronary bifurcation stenting. Our computational stent simulation platform was trained using n = 4 patient-specific bench bifurcation models (n = 17 simulations), and n = 5 clinical bifurcation cases (training group, n = 23 simulations). The platform was blindly tested in n = 5 clinical bifurcation cases (testing group, n = 29 simulations). A variety of stent platforms and stent techniques with 1- or 2-stents was used. Post-stenting imaging with micro-computed tomography (μCT) for bench group and optical coherence tomography (OCT) for clinical groups were used as reference for the training and testing of computational coronary bifurcation stenting. There was a very high agreement for mean lumen diameter (MLD) between stent simulations and post-stenting μCT in bench cases yielding an overall bias of 0.03 (− 0.28 to 0.34) mm. Similarly, there was a high agreement for MLD between stent simulation and OCT in clinical training group [bias 0.08 (− 0.24 to 0.41) mm], and clinical testing group [bias 0.08 (− 0.29 to 0.46) mm]. Quantitatively and qualitatively stent size and shape in computational stenting was in high agreement with clinical cases, yielding an overall bias of < 0.15 mm. Patient-specific computational stenting of coronary bifurcations is a feasible and accurate approach. Future clinical studies are warranted to investigate the ability of computational stenting simulations to guide decision-making in the cardiac catheterization laboratory and improve clinical outcomes.

show abstract

3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility

Cited by 24 publications

References 32 publications

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

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

3D Reconstruction of Coronary Artery Stents From Optical Coherence Tomography: Experimental Validation and Clinical Feasibility

Patient-specific computational simulation of coronary artery bifurcation stenting

Contact Info

Product

Resources

About