Patient-specific computational models to support interventional procedures: a case study of complex aortic re-coarctation

EuroIntervention. 2015 Oct;11(6):669-72. doi: 10.4244/EIJY15M09_03.


Aims: We report the application of patient-specific computational models to plan the treatment of complex aortic re-coarctation (rCoA) with a proximal aberrant right subclavian artery in a patient who had previously undergone bare metal stenting.

Methods and results: Clinically acquired images were used to set up patient-specific computational models for finite element (FE) and fluid dynamics (CFD) analyses. The 3D geometry was reconstructed from computed tomography and echocardiography images. Computer-generated deployment of a CP covered stent (NuMED, Hopkinton, NY, USA) at different diameters was tested using FE simulations. CFD analyses based on preoperative magnetic resonance flow measurements allowed assessment of rCoA pressure relief and right subclavian artery perfusion in the different scenarios. The simulations suggested an expansion diameter for the CP stent (8 zigs, length=28 mm) of between 16 and 18 mm to relieve the obstruction, cover the aneurysm and maintain satisfactory flow to the right subclavian artery. Following the modelling study, a 16 mm CP covered stent was successfully implanted.

Conclusions: Patient-specific models can be successfully used to plan re-stenting of complex rCoA, showing the benefits of integrating computational techniques into patient management.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aneurysm / complications*
  • Aneurysm / diagnosis
  • Aneurysm / physiopathology
  • Aortic Coarctation / complications
  • Aortic Coarctation / diagnosis
  • Aortic Coarctation / physiopathology
  • Aortic Coarctation / therapy*
  • Cardiovascular Abnormalities / complications*
  • Cardiovascular Abnormalities / diagnosis
  • Cardiovascular Abnormalities / physiopathology
  • Computer Simulation
  • Deglutition Disorders / complications*
  • Deglutition Disorders / diagnosis
  • Deglutition Disorders / physiopathology
  • Echocardiography
  • Endovascular Procedures* / instrumentation
  • Finite Element Analysis
  • Hemodynamics
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Male
  • Models, Cardiovascular
  • Multimodal Imaging / methods
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted
  • Recurrence
  • Stents
  • Subclavian Artery / abnormalities*
  • Subclavian Artery / physiopathology
  • Therapy, Computer-Assisted*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Supplementary concepts

  • Aberrant subclavian artery