Computational estimation of the severity of coronary lesions with intravascular ultrasound images: A pilot study

Abstract

The fast and accurate hemodynamic functional assessment of the coronary vasculature is of utmost importance in clinical practice due to the fact that Cardiovascular Diseases have become the leading cause of death globally. In this work we propose a novel method that combines two of the most efficient methods of hemodynamic status assessment of coronary arteries, Intravascular UtraSound and virtual Functional Assessment Index, an index that correlates well to the measured Fractional Flow Reserve. One Left Anterior Descending segment was reconstructed both in a straight manner (using only IVUS images) as well as using the actual 3D geometry of the vessel (using IvUS images combined with the respective coronary angiographic images [2]). The generated vFAI values were almost identical (Straight=0.80, 3D=0.79), presenting a relative error of 1.27%, thus proving the efficacy of the proposed method. We also calculated the Endothelial Shear Stress for the two models under rest (i.e. flow rate of 1 ml/s), observing a similar trend throughout the artery, but with a statistically important relative error of 13.49%, as expected.

Functional Coronary Artery Assessment: a Systematic Literature Review

“…In this section, we discuss the results based on the search strategy presented in the previous section. and usability of each kind of exam [41,59,60,63]. In all cases, they were compared with at least one of the gold standard techniques or with outcome.…”

“…Once deaths caused by coronary heart disease or nonfatal myocardial infarction was 3 times more frequent in patients with adverse plaque [77], obtain plaque characteristics are essential to the correct CAD evaluation [10,74]. For this mean, the OCT, CCTA [2], IVUS [60,63], and angiography [19] are suggested as good sources of information. Unfortunately, current guidelines lack protocols to obtain high quality exams and make them available for larger studies and validation [77].…”

“…FFR already reduces the costs of angiography-guided only [29,53,55,66], but as it is performed less than the recommendation [30] it evidences the need of even more cost reduction. Non-invasive techniques have lower cost than invasive [10,13,27,29,34,47,63,76], reducing the hyperemia induction [55,76], procedural costs [47,55], discomfort [63], side effects [55] and time necessary to assess multi-vessel diseases [10]. FFR CT led to 30% lower cost than FFR alone, but require further investigation [53].…”