ARUP; ISBN: 978-0-9562121-5-3 - CMBBE 2012 - Cardiff University

the SB with a 2.5 mm balloon; ii) opening of the MB access by deploying a 3 mm
balloon through the struts of the first device; iii) expansion of the second device across
ostium of the SB; iv) FKB procedure by simultaneously expanding a 3 mm balloon in
the MB and a 2.5 mm balloon in the SB.
3.2 Fluid dynamic model
The fluid domains were created starting from the final geometrical configurations of the
structural simulations [5]. In order to obtain accurate results on 3D complex geometries
in the shortest time compatible with computational resources available, a hybrid mesh
method is applied using ANSYS ICEM CFD 13 (Ansys Inc., Canonsburg, PA, USA)
[6]. This method uses both hexahedral and tetrahedral elements. Hexahedral elements
should be preferred because of higher accuracy and reduced number of elements for a
certain volume. Nevertheless, hexahedral elements are difficult to use in highly complex
A
B C
Figure 1. A) Uncrimped configurations of the investigated stents. Left: dedicated device (Tryton) Right:
standard device resembling the Multilink Vision. B) CAD model of a 45 degrees coronary bifurcation. In
the magnification area, the stratification of the arterial wall in the adventitia, media and intima layers is
shown. C) Deflating (top) and bending (bottom) procedures of a cylindrical angioplasty balloon.
A
1 2
3 4
5
Figure 2. Steps of the culotte technique performed with a dedicated and standard stent (A) and with two
standard devices (B): 1) positioning of the SB stent by inflating a 2.5 mm cylindrical balloon; 2) opening
of the MB access by crossing and deploying a 3 mm cylindrical balloon through the struts of the SB
device; 3) positioning and deployment of the second device in the MB across the bifurcation; 4) Final
Kissing Balloon procedure with a 3 mm balloon and a 2.5 mm balloon in the MB and SB respectively and
5) final configuration achieved. All the balloons are inflated at 15 atm.
B
1 2
3 4
5