International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Simulation of Balloon-Expandable Coronary Stent Apposition with Plastic Beam Elements

International audienceThe treatment of the coronary artery disease by balloon-expandable stent apposition is a fully endovascular procedure. As a consequence, limited imaging data is available to cardiologists, who could benefit from additional per-operative information. This study aims at providing a relevant prediction tool for stent apposition, in the form of a mechanically precise simulation, fast enough to be compatible with clinical routine. Our method consists in a finite element discretisation of the stent using 1D connected beam elements, with nonlinear plastic behaviour. The artery wall is modelled as a surface mesh interacting with the stent. As a proof of concept, the simulation is compared to micro-CT scans, which were acquired during the apposition of a stent in a silicone coronary phantom. Our results show that the simulation is able to accurately reproduce the stent final geometry, in a computational time greatly lower than for classic 3D finite element codes. Although this first validation step is preliminary, our work is to be extended towards more realistic scenarios, notably with the introduction of a personalised artery model and the corresponding in vivo validation