Coronary atlas for better stent design

University of Auckland
14 October 2014

Coronary atlas for better stent design

A project to create the world’s first statistical atlas of the anatomy of coronary arteries will result in improved design of coronary stents.

(Note: ‘stents’ are small metal inserts that hold arteries open to treat heart attacks and angina).

The main researcher, Dr Pau Medrano-Gracia was recently awarded a $200,000 Senior Fellowship over two years by the Green Lane Research Educational Fund Board to create the atlas at the University of Auckland.

The successful research team includes Professor John Ormiston, Associate Professor Mark Webster, Associate Professor Brett Cowan, doctoral student, Susann Beier, Professor Alistair Young and Dr Chris Ellis.

Blockages in the coronary arteries can cause reduced blood supply to the heart, heart attack and sudden death and more than two million stents are used worldwide each year as treatment.

“Due to the wide variation in the size and shape of the coronary arteries, selection from a limited range of standard stents may not be ideal in an individual patient, especially where vessels branch.” says Dr Medrano-Gracia.

“It’s exciting that the Green Lane Fund has provided funding to look at improving the treatment of coronary heart disease“ he says, “So far we have studied normal arteries, but this funding will enable us to look in detail at patients with atherosclerosis.”

He says that some stent implants result in re-stenosis where the arteries become blocked again and sometimes clots can form in stents. This result suggests that there are improvements that can be made in stent design, especially in the way they alter blood flow through the treated artery.

“We want to define the average coronary anatomy of the general population, but as everyone has arteries of different size and shape, we have needed to use advanced statistical modelling techniques to generate the average models,” says Dr Medrano-Gracia. “It’s important to have that information, because stents can then have their designs optimised for different populations.”

The coronary atlas will also allow accurate 3D replicas of a patient’s coronary arteries to be made from plastic or silicon, known as ‘models’, using high resolution 3D printing.
“We can work from the average to patient specific models, as part of the move to more personalised medicine,” says Dr Medrano-Gracia.

Dr Medrano-Gracia has been active in research since 2006 when he started investigating anonymising methods for large datasets by means of artificial neural networks in the Polytechnic University of Catalonia in Barcelona. In 2008, he was invited to join the Department of Computer Science in the University of Auckland as an honorary research fellow where he also worked as a teaching assistant.

The following year he was accepted into the medical imaging doctoral programme where he developed statistical models of cardiac shape and function within the Cardiac Atlas Project until completion in 2012.

Since then, Dr Medrano-Gracia has been working as a post-doctoral research fellow developing anatomical models of the coronary arteries in collaboration with the Auckland MRI Research Group (Department of Anatomy with Radiology) at the University of Auckland and the Auckland Heart Group.

The preliminary work on this was first funded by the Auckland Heart Group Charitable Trust and then by the Green Lane Research and Educational Fund Board.

In the past two months, he has presented his recently published paper on ‘Construction of a Coronary Artery Atlas from CT Angiography’ to the leading bio-engineering conference, Medical Imaging Computing and Computer Assisted Interventions (MICCAI) Conference in Boston, USA, and to the Australia New Zealand Endovascular Therapies (ANZET) Conference of interventional cardiologists in Melbourne.

ENDS

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