Quantitative methods to measure the hemodynamic consequences of various endovascular interventions including balloon angioplasty are limited. Catheters measuring translesional pressure drops during balloon angioplasty procedures can cause flow blockage and thus inaccurate estimates of pre- and post-intervention flow rates. The purpose of this investigation was to examine the influence of the presence and size of an angioplasty catheter on measured mean pressure gradients across human coronary artery stenoses. Analytical flow modeling and in vitro experimental evidence, coupled with angiographic data on the dimensions and shape of stenotic vessel segments before and after angioplasty, indicated significant flow blockage effects with the catheter present.
Quantitative hemodynamic assessment during various endovascular interventions including balloon angioplasty is lacking. Translesional pressure drops measured by angioplasty catheters can cause flow blockage and thus lead to inaccurate estimates of preintervention and postintervention flow rates. A new analytical model of the flow rate-pressure drop relation across vascular stenoses is utilized that is nonlinear yet relatively simple in principle, easily applicable in vivo, and compatible with the presence of catheters. The model incorporates in vitro experimental evidence, angiographic data on the dimensions and shapes of coronary arterial stenoses before and after balloon angioplasty, reported translesional pressure gradients, and measurements of coronary flow reserve. Reasonable estimates of mean coronary artery flow rates and translesional pressure drops in the absence of angioplasty catheters are obtained. Prior to angioplasty significant flow restriction across a 68% diameter stenosis exists during hyperemic flow conditions. Following successful balloon dilation, increased minimal cross-sectional area (residual 40% diameter stenosis) results in an improved flow rate-pressure drop relation. Despite minimal flow restriction during hyperemic conditions following angioplasty remodeling, residual luminal constriction leads to elevated wall shear stress levels within the entry region of the stenosis. The flow analysis described may be of clinical utility in evaluating the hemodynamic significance of the anatomic severity of stenoses in coronary and peripheral arteries before and after endovascular therapeutic interventions.
Number 6 fuel oil was heated, sprayed, and burned in an enclosure using a small commercial oil burner. Samples of residues that emerged from the flame were collected at various locations outside the flame and observed by a scanning electron microscope. Porous cenospheres, larger globules (of size 80 μm to 200 μm) that resemble soap bubbles formed from the very viscous liquid residue, and unburned oil drops were the types of particle collected. Qualitative relationships of the morphology of these particles to the temperature history to which they were subjected were made.
Flow visualization and wall pressure measurements were made in a polyurethane cast of a cadaver coronary artery with a significant "s" shaped reverse curvature. A sucrose solution was used to simulate the kinematic viscosity of blood, with flow rates in the physiologic range. Flow visualization demonstrated significant secondary flow patterns in the wall vicinity, which increased with increasing Reynolds number. Random dye dispersion was observed at a Reynolds number of about 400, but not at 200. Dye filament patterns in the transition between the first and second curved region were predominantly influenced by the second curved region at lower Reynolds numbers, and by the first curved region at higher Re. Local wall pressure measurements demonstrated a significant centrifugal effect with large radial pressure differences across the casting. Flow resistances for the casting were considerably greater than reference Poiseuille flow values, and increased further with pulsatile flow.
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