Zheng Xuwei, Peng Hongyu, Zhao Donghui, Ma Qin, Fu Kun, Chen Guo, Fan Qian, Liu Jinghua
Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China.
Soft Matter and Interdisciplinary Research Center, College of Physics, Chongqing University, Chongqing 401331, China.
J Diabetes Res. 2016;2016:1702454. doi: 10.1155/2016/1702454. Epub 2016 Sep 29.
. Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. The implications of a diagnosis of DM are as severe as the diagnosis of coronary artery disease. For many patients with complex coronary artery disease, optimal revascularization strategy selection and optimal medical therapy are equally important. In this study, we compared the hemodynamic results of different stenting techniques for Medina 0,1,0 left main bifurcation lesions. . We use idealized left main bifurcation models and computational fluid dynamics analysis to evaluate hemodynamic parameters which are known to affect the risk of restenosis and thrombosis at stented bifurcation. The surface integrals of time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) at bifurcation site were quantified. . Crossover stenting without final kissing balloon angioplasty provided the most favorable hemodynamic results (integrated values of TAWSS = 2.96 × 10 N, OSI = 4.75 × 10 m) with bifurcation area subjected to OSI values >0.25, >0.35, and >0.45 calculated as 0.39 mm, 0.06 mm, and 0 mm, respectively. . Crossover stenting only offers hemodynamic advantages over other stenting techniques for Medina 0,1,0 left main bifurcation lesions and large bifurcation angle is associated with unfavorable flow profiles.
糖尿病（DM）是心血管疾病的主要危险因素。糖尿病诊断的影响与冠状动脉疾病的诊断一样严重。对于许多患有复杂冠状动脉疾病的患者，选择最佳的血运重建策略和最佳的药物治疗同样重要。在本研究中，我们比较了不同支架置入技术治疗Medina 0，1，0型左主干分叉病变的血流动力学结果。我们使用理想化的左主干分叉模型和计算流体动力学分析来评估已知会影响支架置入分叉处再狭窄和血栓形成风险的血流动力学参数。对分叉部位的时间平均壁面切应力（TAWSS）和振荡切变指数（OSI）的表面积分进行了量化。不进行最终球囊对吻扩张的交叉支架置入术提供了最有利的血流动力学结果（TAWSS积分值 = 2.96 × 10 N，OSI = 4.75 × 10 m），分叉区域OSI值>0.25、>0.35和>0.45时对应的面积分别计算为0.39 mm、0.06 mm和0 mm。交叉支架置入术仅在治疗Medina 0，1，0型左主干分叉病变方面比其他支架置入技术具有血流动力学优势，且大分叉角度与不良血流分布相关。
