No abstract

Objectives: To evaluate the diagnostic performance of a novel computational algorithm based on three-dimensional intravascular ultrasound (IVUS) imaging in estimating fractional flow reserve (IVUS FR ), compared to gold-standard invasive measurements (FFR INVAS ).Background: IVUS provides accurate anatomical evaluation of the lumen and vessel wall and has been validated as a useful tool to guide percutaneous coronary intervention. However, IVUS poorly represents the functional status (i.e., flow-related information) of the imaged vessel.Methods: Patients with known or suspected stable coronary disease scheduled for elective cardiac catheterization underwent FFR INVAS measurement and IVUS imaging in the same procedure to evaluate intermediate lesions. A processing methodology was applied on IVUS to generate a computational mesh condensing the geometric characteristics of the vessel. Computation of IVUS FR was obtained from patient-level morphological definition of arterial districts and from territory-specific boundary conditions. FFR INVAS measurements were dichotomized at the 0.80 threshold to define hemodynamically significant lesions.Results: A total of 24 patients with 34 vessels were analyzed. IVUS FR significantly correlated (r = 0.79; P < 0.001) and showed good agreement with FFR INVAS , with a mean difference of −0.008 AE 0.067 (P = 0.47). IVUS FR presented an overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 89%, 92%, 80%, and 96%, respectively, to detect significant stenosis. Conclusion:The computational processing of IVUS FR is a new method that allows the evaluation of the functional significance of coronary stenosis in an accurate way, enriching the anatomical information of grayscale IVUS. K E Y W O R D Scomputational fluid dynamics, coronary blood flow/physiology/microvascular function, coronary artery disease, fractional flow reserve, imaging intravascular ultrasound, interventional devices/innovation, quantitative coronary angiography, three-dimensional coronary models

No abstract

No abstract

No abstract

No abstract

The characterization of vascular geometry is a fundamental step towards the correct interpretation of coronary artery disease. In this work, we report a comprehensive comparison of the geometry featured by coronary vessels as obtained from coronary computed tomography angiography (CCTA) and the combination of intravascular ultrasound (IVUS) with bi‐plane angiography (AX) modalities. We analyzed 34 vessels from 28 patients with coronary disease, which were deferred to CCTA and IVUS procedures. We discuss agreement and discrepancies between several geometric indexes extracted from vascular geometries. Such an analysis allows us to understand to which extent the coronary vascular geometry can be reliable in the interpretation of geometric risk factors, and as a surrogate to characterize coronary artery disease.

No abstract