Descripción
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Purpose: Best percutaneous treatment strategy for lesions in coronary bifurcations is an ongoing subject of debate. There is limited data that analyses the effect of the different bifurcation strategies on coronary flow. Our aim is to evaluate the influence of different bifurcation stenting strategies on hemodynamic parameters, both in the main vessel (MV) and side branch (SB). Methods: A computerized mathematical model based on finite volume analysis, was used to evaluate hemodynamic patterns in the following cases: bifurcation with no stenting, simple stenting in main vessel (SS), simple stent in main vessel and "kissing balloon" through the side branch (KB) and "Coulotte Technique" (CT). For each case a 45° and 90° bifurcation configuration was evaluated. Three parameters were measured in MV and SB: volumetric flow and pressure decrease, low shear stress area (<20%(<0.1 Pa) of the value proximal to bifurcation) and vorticity (index of turbulence). Low shear stress has been related to plaque formation and restenosis Results: Overall 90° bifurcations, regardless of the technique, had a worse haemodynamic behaviour (greater decrease in pressure and SB flow) compared to 45°(see table). SS is the technique that provides worst haemodynamic performance.CT technique preserves the best the flow in the SB but only in the 45° configuration, with no advantage over KB in 90°. This behaviour may be explained by differences in turbulence (Vorticity) however the area exposed to low shear stress was the greatest with the CT technique at 45°. Conclusions: In our model, the bifurcation angle has a great influence in the haemodynamic behaviour of different stenting techniques. SS technique has the worst results in terms of haemodynamics. However CT creates the largest area in contact with low shear stress | |
Internacional
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Si |
Nombre congreso
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European Society of Cardiology Congress 2011 |
Tipo de participación
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960 |
Lugar del congreso
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Paris (Francia) |
Revisores
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Si |
ISBN o ISSN
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0195-668x |
DOI
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Fecha inicio congreso
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27/08/2011 |
Fecha fin congreso
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31/08/2011 |
Desde la página
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1047 |
Hasta la página
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1047 |
Título de las actas
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European Heart Journal ( 2011 ) 32 ( Abstract Supplement ), 1047 |