Yingguang Li1, Zehang Li2, Emil N Holck3, Bo Xu4, Antonios Karanasos5, Zhenyu Fei6, Yunxiao Chang2, Miao Chu2, Jouke Dijkstra1, Evald H Christiansen3, Johan H C Reiber1, Niels R Holm3, Shengxian Tu2. 1. Division of Image Processing, Department of Radiology, Leiden University Medical Center. 2. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University. 3. Department of Cardiology, Aarhus University Hospital. 4. National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital. 5. Thoraxcenter, Erasmus MC. 6. Department of Biomedical Engineering, University of Michigan.
Abstract
BACKGROUND: Development of methods for accurate reconstruction of bioresorbable scaffolds (BRS) and assessing local hemodynamics is crucial for investigation of vascular healing after BRS implantation.Methods and Results: Patients with BRS that crossed over in a coronary bifurcation were included for analysis. Reconstructions of the coronary lumen and BRS were performed by fusion of optical coherence tomography and coronary angiography generating a tree model (TM) and a hybrid model with BRS (TM-BRS). A virtual BRS model with thinner struts was created and all 3 models were analyzed using computational fluid dynamics to derive: (1) time-average shear stress (TASS), (2) TASS gradient (TASSG), which represents SS heterogeneity, and (3) fractional flow reserve (FFR). Reconstruction of the BRS was successful in all 10 patients. TASS and TASSG were both higher by TM-BRS than by TM in main vessels (difference 0.27±4.30 Pa and 10.18±27.28 Pa/mm, P<0.001), with a remarkable difference at side branch ostia (difference 13.51±17.40 Pa and 81.65±105.19 Pa/mm, P<0.001). With thinner struts, TASS was lower on the strut surface but higher at the inter-strut zones, whereas TASSG was lower in both regions (P<0.001 for all). Computational FFR was lower by TM-BRS than by TM for both main vessels and side branches (P<0.001). CONCLUSIONS: Neglecting BRS reconstruction leads to significantly lower SS and SS heterogeneity, which is most pronounced at side branch ostia. Thinner struts can marginally reduce SS heterogeneity.
BACKGROUND: Development of methods for accurate reconstruction of bioresorbable scaffolds (BRS) and assessing local hemodynamics is crucial for investigation of vascular healing after BRS implantation.Methods and Results:Patients with BRS that crossed over in a coronary bifurcation were included for analysis. Reconstructions of the coronary lumen and BRS were performed by fusion of optical coherence tomography and coronary angiography generating a tree model (TM) and a hybrid model with BRS (TM-BRS). A virtual BRS model with thinner struts was created and all 3 models were analyzed using computational fluid dynamics to derive: (1) time-average shear stress (TASS), (2) TASS gradient (TASSG), which represents SS heterogeneity, and (3) fractional flow reserve (FFR). Reconstruction of the BRS was successful in all 10 patients. TASS and TASSG were both higher by TM-BRS than by TM in main vessels (difference 0.27±4.30 Pa and 10.18±27.28 Pa/mm, P<0.001), with a remarkable difference at side branch ostia (difference 13.51±17.40 Pa and 81.65±105.19 Pa/mm, P<0.001). With thinner struts, TASS was lower on the strut surface but higher at the inter-strut zones, whereas TASSG was lower in both regions (P<0.001 for all). Computational FFR was lower by TM-BRS than by TM for both main vessels and side branches (P<0.001). CONCLUSIONS: Neglecting BRS reconstruction leads to significantly lower SS and SS heterogeneity, which is most pronounced at side branch ostia. Thinner struts can marginally reduce SS heterogeneity.
Authors: Miao Chu; Juan Luis Gutiérrez-Chico; Yingguang Li; Emil N Holck; Su Zhang; Jiayue Huang; Zehang Li; Lianglong Chen; Evald H Christiansen; Jouke Dijkstra; Niels R Holm; Shengxian Tu Journal: Int J Cardiovasc Imaging Date: 2019-10-30 Impact factor: 2.357
Authors: Yakup Kilic; Hannah Safi; Retesh Bajaj; Patrick W Serruys; Pieter Kitslaar; Anantharaman Ramasamy; Vincenzo Tufaro; Yoshinobu Onuma; Anthony Mathur; Ryo Torii; Andreas Baumbach; Christos V Bourantas Journal: Front Cardiovasc Med Date: 2020-03-31