# Patient-Specific Simulations to Guide Coronary Bifurcation Stenting

> **NIH NIH R01** · UNIVERSITY OF NEBRASKA MEDICAL CENTER · 2022 · $767,652

## Abstract

PROTOCOL SUMMARY/ABSTRACT
Coronary artery disease is the leading cause of death in Western society. Stents are implanted in 70-90% of
the 1.3 million percutaneous coronary interventions performed annually in the USA, of which 20% involve
bifurcations. Coronary bifurcations remain one of the most challenging lesion subsets in interventional
cardiology, with a lower procedural success rate and increased rates of long-term adverse cardiac events,
ranging between 15-20% at six months to one year post-intervention. Despite the great interest in this complex
lesion subset, percutaneous treatment of coronary bifurcations is still a controversial subject and multiple
technical strategies have been proposed. Fundamental mechanical disturbances within the stent appear to be
major determinants of stent restenosis. No two bifurcations are identical, and no single treatment strategy
exists that can be applied to every bifurcation. The most important issue in bifurcation interventions is selecting
the most appropriate strategy for a specific bifurcation. Accordingly, we intend to investigate for the first time in
human the role of fluid stresses on stent restenosis. We will use a validated subject-specific finite element
analysis of arterial bifurcations rooted in clinical and experimental data to faithfully predict stent restenosis. The
overall objective of this proposal is to use an individualized approach to identify the optimal bifurcation
stenting technique for a specific bifurcation. Our central hypothesis is that subject-specific simulations of
bifurcation stenting optimize the local biomechanical environment and reduces stent restenosis. Our proposal
brings together extensive expertise, infrastructure and preliminary work in fluid and solid mechanics,
computational simulations and vascular biology. These findings will establish clinically-relevant hypotheses that
will serve as basis for our long term goal; a large, randomized controlled trial to show improved clinical
outcomes with patient-specific bifurcation stenting strategies. The proposed research is an example of how
precision medicine with pre-procedural planning can help optimize bifurcation stenting and improve clinical
outcomes. Patient-specific computational stenting simulations may shift the management paradigm of coronary
bifurcation interventions and provide a new dimension on how to improve the stenting and post-dilatation
techniques.

## Key facts

- **NIH application ID:** 10377931
- **Project number:** 5R01HL144690-04
- **Recipient organization:** UNIVERSITY OF NEBRASKA MEDICAL CENTER
- **Principal Investigator:** Ioannis S Chatzizisis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $767,652
- **Award type:** 5
- **Project period:** 2019-04-15 → 2023-01-17

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10377931

## Citation

> US National Institutes of Health, RePORTER application 10377931, Patient-Specific Simulations to Guide Coronary Bifurcation Stenting (5R01HL144690-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10377931. Licensed CC0.

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