Protocol Adaptation of Optical Coherence Tomography in Lower Limb Arteries Revascularization

Dubosq, Maxime; Patterson, Benjamin O.; Azzaoui, Richard; Mesnard, Thomas; Préville, Agathe De; Sobocinski, Jonathan

doi:10.1016/j.avsg.2018.09.031

Cited by 6 publications

(4 citation statements)

References 9 publications

(12 reference statements)

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“…For peripheral arteries, computational fluid dynamic simulations of a patient’s geometry can furthermore be informed with a patient’s temporal flow profile obtained from duplex ultrasound [ 27 ]. Calcified plaques are difficult to quantify accurately using non-invasive imaging and may require intra-vascular ultrasonic or optical imaging [ 28 ] for accurate simulations. It would be of interest to investigate whether the observed adverse effect of eccentricity also holds for other stenotic degrees and whether a correlation between eccentricity index [ 20 ] and pressure gradient is present in patients.…”

Section: Discussionmentioning

confidence: 99%

Lesion Eccentricity Plays a Key Role in Determining the Pressure Gradient of Serial Stenotic Lesions: Results from a Computational Hemodynamics Study

van de Velde,

Groot Jebbink,

Jain

et al. 2024

Cardiovasc Intervent Radiol

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Purpose In arterial disease, the presence of two or more serial stenotic lesions is common. For mild lesions, it is difficult to predict whether their combined effect is hemodynamically significant. This study assessed the hemodynamic significance of idealized serial stenotic lesions by simulating their hemodynamic interaction in a computational flow model. Materials and Methods Flow was simulated with SimVascular software in 34 serial lesions, using moderate (15 mL/s) and high (30 mL/s) flow rates. Combinations of one concentric and two eccentric lesions, all 50% area reduction, were designed with variations in interstenotic distance and in relative direction of eccentricity. Fluid and fluid–structure simulations were performed to quantify the combined pressure gradient. Results At a moderate flow rate, the combined pressure gradient of two lesions ranged from 3.8 to 7.7 mmHg, which increased to a range of 12.5–24.3 mmHg for a high flow rate. Eccentricity caused an up to two-fold increase in pressure gradient relative to concentric lesions. At a high flow rate, the combined pressure gradient for serial eccentric lesions often exceeded the sum of the individual lesions. The relative direction of eccentricity altered the pressure gradient by 15–25%. The impact of flow pulsatility and wall deformability was minor. Conclusion This flow simulation study revealed that lesion eccentricity is an adverse factor in the hemodynamic significance of isolated stenotic lesions and in serial stenotic lesions. Two 50% lesions that are individually non-significant can combine more often than thought to hemodynamic significance in hyperemic conditions. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Lesion Eccentricity Plays a Key Role in Determining the Pressure Gradient of Serial Stenotic Lesions: Results from a Computational Hemodynamics Study

van de Velde,

Groot Jebbink,

Jain

et al. 2024

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…The technology uses a low-coherence light to create images from the optical scattering created from penetration of biologic tissue. 61 Like IVUS, the utility of OCT has focused mainly on luminal measurements, stent planning, and immediate feedback with direct visualization of the artery after intervention. 61 Although few studies have investigated OCT, perhaps the real utility of OCT compared with IVUS in the peripheral arterial system might be in determining plaque composition and morphology owing to the increased resolution of the images.…”

Section: Invasive Imaging Methodsmentioning

confidence: 99%

“… 61 Like IVUS, the utility of OCT has focused mainly on luminal measurements, stent planning, and immediate feedback with direct visualization of the artery after intervention. 61 Although few studies have investigated OCT, perhaps the real utility of OCT compared with IVUS in the peripheral arterial system might be in determining plaque composition and morphology owing to the increased resolution of the images. OCT data are severely limited in the peripheral arteries; however, it has been shown to accurately demonstrate plaque composition (confirmed by histologic findings) in the coronary arteries.…”

Section: Invasive Imaging Methodsmentioning

confidence: 99%