sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20240103sibmed-1384Research ArticleСтатьиО влиянии установки внутрисосудистого стента в бифуркацию коронарной артерии со стенозом на перераспределение в ней кровотока: эксперимент и моделированиеTowards effects from stent implantation into coronary bifurcation stenosis: experiment and simulationhttps://orcid.org/0009-0006-7047-3382ГайфутдиновР. А.GaifutdinovR. A.

Гайфутдинов Ринат Айдарович 

630090, г. Новосибирск, пр. Академика Лаврентьева, 15

Rinat A. Gaifutdinov 

630090, Novosibirsk, Aсademika Lavrentieva ave., 15

r.gaifutdinov@g.nsu.ruhttps://orcid.org/0000-0003-0359-648XКуяноваЮ. О.KuyanovaYu. O.

Куянова Юлия Олеговна 

630090, г. Новосибирск, пр. Академика Лаврентьева, 15

Yulia O. Kuyanova 

630090, Novosibirsk, Aсademika Lavrentieva ave., 15

kuyanovaj@gmail.comhttps://orcid.org/0000-0001-5419-913XХелимскийД. А.KhelimskyD. A.

Хелимский Дмитрий Александрович, к.м.н. 

630055, г. Новосибирск, ул. Речкуновская, 15

Dmitry A. Khelimsky, candidate of medical sciences 

630055, Novosibirsk, Reshkunovskaya st., 15

https://orcid.org/0000-0001-5214-8996КрестьяниновО. В.KrestyaninovO. V.

Крестьянинов Олег Викторович, д.м.н. 

630055, г. Новосибирск, ул. Речкуновская, 15

Oleg V. Krestyaninov, doctor of medical sciences 

630055, Novosibirsk, Reshkunovskaya st., 15

https://orcid.org/0000-0002-1277-4113ТулуповА. А.TulupovA. A.

Тулупов Андрей Александрович, д.м.н., проф., чл.-корр. РАН 

630090, г. Новосибирск, пр. Академика Лаврентьева, 15;630090, г. Новосибирск, ул. Институтская, 3а

Andrey A. Tulupov, doctor of medical sciences, professor, corresponding member of the RAS 

630090, Novosibirsk, Aсademika Lavrentieva ave., 15;630090, Novosibirsk, Institutskaya st., 3а

taa@tomo.nsc.ruhttps://orcid.org/0000-0002-2496-3042ПаршинД. В.ParshinD. V.

Паршин Даниил Васильевич, к.ф.-м.н. 

630090, г. Новосибирск, пр. Академика Лаврентьева, 15

Daniil V. Parshin, candidate of physical and mathematical sciences 

630090, Novosibirsk, Aсademika Lavrentieva ave., 15

Институт гидродинамики им. М.А. Лаврентьева СО РАНРоссияLavrentyev Institute of Hydrodynamics of SB RASRussian FederationНациональный медицинский исследовательский центр им. Академика Е.Н. Мешалкина Минздрава РоссииРоссияMeshalkin National Medical Research Center of Minzdrav of RussiaRussian FederationИнститут гидродинамики им. М.А. Лаврентьева СО РАН; Институт «Международный томографический центр» СО РАНРоссияLavrentyev Institute of Hydrodynamics of SB RAS; International Tomography Center of SB RASRussian Federation2024270220244412331Copyright © Гайфутдинов Р.А., Куянова Ю.О., Хелимский Д.А., Крестьянинов О.В., Тулупов А.А., Паршин Д.В., 20242024Гайфутдинов Р.А., Куянова Ю.О., Хелимский Д.А., Крестьянинов О.В., Тулупов А.А., Паршин Д.В.Gaifutdinov R.A., Kuyanova Y.O., Khelimsky D.A., Krestyaninov O.V., Tulupov A.A., Parshin D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/1384

Ишемическая болезнь сердца является широко распространенной причиной смерти и инвалидизации в популяции. Стентирование коронарных артерий представляет собой один из наиболее распространенных способов устранения причины ишемии – стенозов коронарных артерий. В результате установки стента, как правило, происходит изменение угла сосудистой бифуркации, а также перераспределение объемного кровотока в системе коронарных артерий. Учитывая высокую вариабельность ветвистой ангиоархитектоники этих артерий, а также структуры их окружения, задача о предсказании конкретного перераспределения кровотока в этих артериях остается до сих пор не решенной; основными способами ее реализации является вычислительная и экспериментальная гемодинамика. Материал и методы. В данной работе в экспериментальном подходе исследовано влияние установки стента в модель стеноза коронарных артерий и выполнен анализ современного уровня осведомленности научного сообщества в этом вопросе. Результаты и их обсуждение. В ходе эксперимента показано, что пропускная способность модели увеличивается на 14 % по сравнению с моделью со стенозом, а перераспределение потоков в модели зависит не от диаметров, а от анатомии конкретной сосудистой сети. Данные проведенного математического моделирования в целом согласуются с результатами эксперимента до установки стента, когда коронарное дерево состоит из нескольких несущих ветвей, однако имеют количественные различия для дистальных ветвей модели коронарных артерий при наличии установленного стента. Заключение. Результаты работы могут быть использованы для накопления экспериментального массива данных о перестройке кровотока при ангиопластике и для верификации численной гемодинамики коронарных артерий при виртуальной установке в них стента для разрешения стеноза.

Coronary artery disease is a widespread cause of death and disability in the population. Angioplasty of the coronary arteries is one of the most common methods of eliminating the cause of ischemia – stenosis of the coronary arteries. As a result of stent installation, a change in the angle of vascular bifurcation occurs usually, as well as a redistribution of volumetric blood flow in the coronary artery system. Considering the high variability of the branching angioarchitecture of these arteries, as well as the structure of their environment, the problem of predicting the specific redistribution of blood flow in these arteries remains unsolved; the main ways of its implementation are computational and experimental hemodynamics. Material and methods. This paper uses an experimental approach to explore the effect of stent placement in a model of coronary artery stenosis, and also provides an analysis of the current level of awareness of the scientific community on this issue. Results and discussion. The experiment showed that the throughput of the model increases by 14 % compared to the model with stenosis, and the redistribution of flows in the model depends not on diameters but on the anatomy of a particular vascular network. The data of the performed mathematical modeling are generally consistent with the results of the experiment before stent installation, when the coronary tree consists of several load-bearing branches, but have quantitative differences for the distal branches of the coronary artery model in the presence of an installed stent. Conclusions. The results of the work can be used to accumulate an experimental data array on the restructuring of blood flow during angioplasty, and can also be used to verify the numerical hemodynamics of the coronary arteries during the virtual installation of a stent in them to resolve stenosis. 

ишемическая болезнь сердцаангиопластикастенозкоронарная бифуркацияангиоархитектоникаэкспериментальная гемодинамикасиликоновая модель сосудовcoronary heart diseaseangioplastystenosiscoronary bifurcationangioarchitectonicsexperimental hemodynamicssilicone model of blood vesselsРабота выполнена при поддержке Российского научного фонда, грант № 20-71-10034 (https://rscf.ru/project/20-71-10034/). Работа Д.А. Хелимского и О.В. Крестьянинова выполнялась в рамках договора о сотрудничестве между Институтом гидродинамики им. М.А. Лаврентьева СО РАН и Национальным медицинским исследовательским центром им. Академика Е.Н. Мешалкина Минздрава России.The study is supported by a grant from Russian Science Foundation 20-71-10034 (https://rscf.ru/ project/20-71-10034/). The work of D.A. Khelimsky and O.V. 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The authors declare that there are no conflicts of interest present.