NDLI: Assessing the hemodynamic influence between multiple lesions in a realistic right coronary artery segment: A computational study

Content Provider	IEEE Xplore Digital Library
Author	Siogkas, P.K. Sakellarios, A.I. Papafaklis, M.I. Stefanou, K.A. Athanasiou, L.M. Exarchos, T.P. Naka, K.K. Michalis, L.K. Fotiadis, D.I.
Copyright Year	2014
Description	Author affiliation: Med. Sch., Cardiovascular Div., Harvard Univ., Boston, MA, USA (Papafaklis, M.I.) \|\| Biomed. Res. Inst. - FORTH, Ioannina, Greece (Stefanou, K.A.; Exarchos, T.P.) \|\| Dept. of Cardiology in Med. Sch., Univ. of Ioannina, Ioannina, Greece (Naka, K.K.; Michalis, L.K.) \|\| Dept. of Mater. Sci. & Eng., Univ. of Ioannina, Ioannina, Greece (Siogkas, P.K.; Sakellarios, A.I.; Athanasiou, L.M.; Fotiadis, D.I.)
Abstract	Coronary artery disease is the primary cause of morbidity and mortality worldwide. Therefore, detailed assessment of lesions in the coronary vasculature is critical in current clinical practice. Fractional flow reserve (FFR) has been proven as an efficient method for assessing the hemodynamic severity of a coronary stenosis. However, functional assessment of a coronary segment with multiple stenoses (> 2) remains complex for guiding the strategy of percutaneous coronary intervention due to the hemodynamic interplay between adjacent stenoses. In this work, we created four 3-dimensional (3D) arterial models that derive from a healthy patient-specific right coronary artery segment. The initial healthy model was reconstructed using fusion of intravascular ultrasound (IVUS) and biplane angiographic patient data. The healthy 3D model presented a measured FFR value of 0.96 (pressure-wire) and a simulated FFR value of 0.98. We then created diseased models with two artificial sequential stenoses of 90% lumen area reduction or with the proximal and distal stenosis separately. We calculated the FFR value for each case: 0.65 for the case with the two stenoses, 0.73 for the case with the distal stenosis and 0.90 for the case with the proximal stenosis. This leads to the conclusion that although both stenoses had the same degree of lumen area stenosis, there was a large difference in hemodynamic severity, thereby indicating that angiographic lumen assessment by itself is often not adequate for accurate assessment of coronary lesions.
Sponsorship	IEEE Eng. Med. Biol. Soc.
Starting Page	5643
Ending Page	5646
File Size	769908
Page Count	4
File Format	PDF
ISBN	9781424479290
ISSN	1557170X
DOI	10.1109/EMBC.2014.6944907
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2014-08-26
Publisher Place	USA
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Three-dimensional displays Solid modeling Arteries Hemodynamics Computational modeling Image reconstruction
Content Type	Text
Resource Type	Article
Subject	Signal Processing Biomedical Engineering Health Informatics Computer Vision and Pattern Recognition

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