Objective To describe changes that occur in stent morphology and structure after its implantation in coronary bifurcation.Side branch (SB) compromise after stenting of main vessel in coronary bifurcation is a major in...Objective To describe changes that occur in stent morphology and structure after its implantation in coronary bifurcation.Side branch (SB) compromise after stenting of main vessel in coronary bifurcation is a major intraprocedural problem and for the long term,as a place of restenosis.Methods We created an elastic wall model (parent vessel diameter 3.5mm,daughter branches 3.5mm and 2.75mm)with 30,45 and 60 degree distal angulation between branches.After stent implantation,struts to the side branch were opened with 2.0mm and consequently 3.0mm diameter balloons.Subsequent balloon redilatations and kissing balloon inflations (KBI) were performed.All stages of the procedure were photographed with magnification up to 100 times.Results We found that the leading mechanism for side branch compromise was carina displacement,and discovered theoretical description for expected ostial stenosis severity.Based on our model we found that displacement of bifurcation flow divider cause SB stenosis with almost perfect coincidence with our theoretical predictions.Opening of stent cells through the proximal and distal stent struts always increased interslrut distance,but never achieved good apposition to the wall.Balloon diameter increase didn't give proportional enlargement in stent cell diameters.KBI leads to some small better stent positioning,correcting main vessel strut dislodgment from wall,but never gave full strut-wall contact.Distance between struts and wall was minimal only when the stent cell perfectly faced ostium of SB.This was also our observation that the shape of ostium of SB becomed eUiptically-bean shaped after stent implantation and generally kept that shape during consequent stages of experiment.Measured diameter and area stenosis were perfectly fitted and theoretically predicted from our concept Conclusion We have described stent-wall deformations in stent-balloon technique for treatment of coronary bifurcation demonstrating carina displacement as possibly main mechanism of side branch compromise after main vessel stenting.We have shown that KBI could not give full strut-wall contact if there is no perfect facing of stem cell and SB ostium.(J Geroatr Cardool 2008;5(1):43-49)展开更多
针对不同个性化需求的燃料电池测试台(fuel cell test bench,FCTB)难以评价和量化评估的问题,提出一种基于改进和声搜索算法的FCTB价值评估方法.针对不同FCTB的个性化需求,建立了FCTB综合评估指标体系;结合用户的个性化需求,采用模糊层...针对不同个性化需求的燃料电池测试台(fuel cell test bench,FCTB)难以评价和量化评估的问题,提出一种基于改进和声搜索算法的FCTB价值评估方法.针对不同FCTB的个性化需求,建立了FCTB综合评估指标体系;结合用户的个性化需求,采用模糊层次分析法分配指标权重,构建价值定量评估模型,将权重求取问题转换为约束优化问题;提出一种改进和声搜索算法对问题进行求解,通过设计解向量生成机制和参数自适应调整策略,用于提高传统和声搜索算法的求解效率和搜索能力.仿真结果表明,本文方法在计算效率和精度方面具有优势,并能够根据不同的需求特性实现对FCTB方案做出定量的价值评估.展开更多
文摘Objective To describe changes that occur in stent morphology and structure after its implantation in coronary bifurcation.Side branch (SB) compromise after stenting of main vessel in coronary bifurcation is a major intraprocedural problem and for the long term,as a place of restenosis.Methods We created an elastic wall model (parent vessel diameter 3.5mm,daughter branches 3.5mm and 2.75mm)with 30,45 and 60 degree distal angulation between branches.After stent implantation,struts to the side branch were opened with 2.0mm and consequently 3.0mm diameter balloons.Subsequent balloon redilatations and kissing balloon inflations (KBI) were performed.All stages of the procedure were photographed with magnification up to 100 times.Results We found that the leading mechanism for side branch compromise was carina displacement,and discovered theoretical description for expected ostial stenosis severity.Based on our model we found that displacement of bifurcation flow divider cause SB stenosis with almost perfect coincidence with our theoretical predictions.Opening of stent cells through the proximal and distal stent struts always increased interslrut distance,but never achieved good apposition to the wall.Balloon diameter increase didn't give proportional enlargement in stent cell diameters.KBI leads to some small better stent positioning,correcting main vessel strut dislodgment from wall,but never gave full strut-wall contact.Distance between struts and wall was minimal only when the stent cell perfectly faced ostium of SB.This was also our observation that the shape of ostium of SB becomed eUiptically-bean shaped after stent implantation and generally kept that shape during consequent stages of experiment.Measured diameter and area stenosis were perfectly fitted and theoretically predicted from our concept Conclusion We have described stent-wall deformations in stent-balloon technique for treatment of coronary bifurcation demonstrating carina displacement as possibly main mechanism of side branch compromise after main vessel stenting.We have shown that KBI could not give full strut-wall contact if there is no perfect facing of stem cell and SB ostium.(J Geroatr Cardool 2008;5(1):43-49)
文摘针对不同个性化需求的燃料电池测试台(fuel cell test bench,FCTB)难以评价和量化评估的问题,提出一种基于改进和声搜索算法的FCTB价值评估方法.针对不同FCTB的个性化需求,建立了FCTB综合评估指标体系;结合用户的个性化需求,采用模糊层次分析法分配指标权重,构建价值定量评估模型,将权重求取问题转换为约束优化问题;提出一种改进和声搜索算法对问题进行求解,通过设计解向量生成机制和参数自适应调整策略,用于提高传统和声搜索算法的求解效率和搜索能力.仿真结果表明,本文方法在计算效率和精度方面具有优势,并能够根据不同的需求特性实现对FCTB方案做出定量的价值评估.
