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

• Type of Material: Article
• Authors: Wei Wu, University of Nebraska Medical Center; Behram Khan, University of Nebraska Medical Center; Mohammadali Sharzehee, University of Nebraska Medical Center; Shijia Zhao, University of Nebraska Medical Center; Saurabhi Samant, University of Nebraska Medical Center; Yusuke Watanabe, Teikyo University Hospital; Yoshinobu Murasato, National Hospital Organization Kyushu Medical Center; Timothy Mickley, Boston Scientific Inc; Andrew Bicek, Boston Scientific Inc; Richard Bliss, Medtronic Inc; Thomas Valenzuela, University of Minnesota, Minneapolis; Paul A Iaizzo, University of Minnesota, Minneapolis; Janaki Makadia, University of Nebraska Medical Center; Anastasios Panagopoulos, University of Nebraska Medical Center; Francesco Burzotta, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore; Habib Samady, Emory University; Emmanouil S Brilakis, Minneapolis Heart Institute; Georgios Dangas, Emory University; Yves Louvard, Institut Cardiovasculaire Paris Sud; Goran Stankovic, Clinical Center of Serbia; Gabriele Dubini, Politecnico di Milano; Francesco Migliavacca, Politecnico di Milano; Ghassan S Kassab, California Medical Innovation Institute; Elazer R Edelman, Massachusetts Institute of Technology; Claudio Chiastra, Politecnico di Torino; Yiannis S Chatzizisis, University of Nebraska Medical Center
• Language: English
• Date: 2021-06-10
• Publisher: NATURE RESEARCH
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-021-91458-y
• Title of Journal or Parent Work: SCIENTIFIC REPORTS
• Volume: 11
• Issue: 1
• Start Page: 12252
• End Page: 12252
• Grant/Funding Information: National Institutes of Health (R01 HL144690), Dr. Vincent Miscia Cardiovascular Research Fund.
• Keywords: Science & Technology; Science & Technology - Other Topics; SHEAR-STRESS; APPOSITION; Multidisciplinary Sciences
• Research Categories: Engineering, Biomedical

Abstract

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.