Effect of Occlusion Percentage and Lesion Length on Stenosed Coronary Artery: A Numerical Study

2020 ◽  
pp. 87-97
Author(s):  
Supratim Saha ◽  
T. Purushotham ◽  
K. Arul Prakash
Keyword(s):  
Coronary Artery ◽  
Numerical Study ◽  
Lesion Length ◽  
Stenosed Coronary Artery

A NUMERICAL STUDY OF THE BLOOD FLOW BEHAVIOR IN CORONARY ARTERY ANOMALIES FOR NORMAL AND DIABETIC PERSONS

2018 ◽  
Vol 18 (05) ◽  
pp. 1850051 ◽  
Author(s):  
RADWA M. ATTIA ◽  
MOHAMED A. A. ELDOSOKY ◽  
R. R. DARWISH
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Numerical Study ◽  
Heart Diseases ◽  
Flow Behavior ◽  
Suspected Coronary Artery Disease ◽  
Computational Fluid Dynamics Analysis ◽  
The Difference ◽  
Diabetic Person ◽  
Stenosed Coronary Artery

This work is developed to facilitate studying the flow of blood through a stenosed coronary artery of a diabetic person. It is Important in the diagnosis, risk assessment, and management of patients with known or suspected coronary artery disease where the major cause of death worldwide is the cardiovascular diseases. Two different cases of coronary artery were investigated to demonstrate the difference between blood flow in a normal and stenosed artery for both normal and diabetic persons. A 3D model was designed and meshed using ANSYS Program, the outputs of the computational fluid dynamics analysis were observed. This paper shows full and non-invasive visualization of the blood flow with high degree of precision that can be applied to the heart diseases. The results show that the disturbed flow patterns and oscillating velocity indicate that the vulnerability of plaque formation is high in case of diabetes. The increasing in blood viscosity causes a deviation in the wall shear stress especially in the presence of stenosis.

scholarly journals Numerical and experimental investigations of Fractional Flow Reserve (FFR) in a stenosed coronary artery

2019 ◽  
Vol 128 ◽  
pp. 02006 ◽  
Author(s):  
Supratim Saha ◽  
T. Purushotham ◽  
K. Arul Prakash
Keyword(s):  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Surgical Intervention ◽  
Patient Specific ◽  
Experimental Investigations ◽  
Lesion Length ◽  
Fractional Flow ◽  
Specific Data ◽  
Flow Reserve ◽  
Stenosed Coronary Artery

The coronary artery is numerically investigated based on CFD techniques for measuring the severity of stenosis. In mild cases, medication is often preferred whereas for severe cases surgical intervention is `required but most of the cases fall in between. Thus, it poses a problem for clinicians in choosing an appropriate action. The Fractional Flow Reserve (FFR) is a number which helps to predict the functional significance of stenosis in this scenario. In this study, various cases of occlusion percentranging between 40 to 70 are considered using different models for predicting FFR in the stenosed coronary artery. The lesion length is also varied between 1 cm and 5 cm based on patient–specific data. The experimental investigation of FFR in the coronary stenosis using silicon model is also carried out in this study and compared with numerical results. The effect of occlusion percentage and lesionlengthon the FFR value are quantified.

Differential impact of target vessel on the diagnostic performance of resting full-cycle ratio as non-hyperemic physiological assessment

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Takashima ◽  
H Ohashi ◽  
H Ando ◽  
A Suzuki ◽  
S Sakurai ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Functional Significance ◽  
Diagnostic Performance ◽  
Coronary Artery Stenosis ◽  
Stable Condition ◽  
Artery Stenosis ◽  
Lesion Length ◽  
Target Vessel ◽  
Roc Curve Analysis

Abstract Background Recently, wire-based resting indices have been recognized as gold standard for evaluating physiological lesion assessment. The resting full-cycle ratio (RFR) is a unique resting index which is calculated as the point of absolutely lowest distal pressure to aortic pressure during entire cardiac cycle. It is unclear whether the diagnostic performance of RFR for detecting functional coronary artery stenosis is similar in each coronary artery. The aim of this study is to compare the diagnostic performance of RFR based on target coronary vessel. Method This study was a prospectively enrolled observational study. A total of 156 consecutive patients with 220 intermediate lesions were enrolled in this study. The RFR was measured after adequately waiting for stable condition, while FFR was measured after intravenous administration of ATP (180mcg/kg/min). Lesions with FFR ≤0.80 were considered functionally significant coronary artery stenosis. Results In all lesions, reference diameter, diameter stenosis, lesion length, RFR, and FFR were 3.0±0.7mm, 45±13%, 13.0±8.8mm, 0.90±0.09, and 0.82±0.10, respectively. Functional significance was observed in 88 lesions (40%) of all lesions. RFR showed a significant correlation with FFR in overall lesions (r=0.774, p<0.001). The ROC curve analysis of RFR showed good accuracy for predicting functional significance (AUC 0.87, diagnostic accuracy 81%) in all subjects. Regarding each target vessel, there were similar and significant positive correlation between RFR and FFR (LAD; r=0.733, p<0.001, LCX; r=0.771, p<0.001, RCA; r=0.769, p<0.001, respectively). The prevalence of discordant between RFR and FFR was significantly different among 3 vessels (LAD 26%, LCX 12%, RCA 13%, respectively, p<0.05 for among 3 groups). Regarding the comparison of ROC curves according to lesion location, AUC was significantly lower in LAD than in LCX and RCA (LAD 0.780, LCX 0.947, RCA 0.926, p<0.01 for LAD compared to LCX, p<0.01 for LAD compared to RCA, respectively). Furthermore, the diagnostic accuracy was significantly different according to target vessel (LAD 74%, LCX 88%, RCA 87%, respectively, p<0.05 for among 3 vessels). Conclusion RFR demonstrated better diagnostic accuracy for evaluating functional lesion severity. The diagnostic performance of RFR was different based on target vessel. RFR is a unique and useful resting index, and it may detect functionally significant coronary stenosis that cannot be detected with other resting indices in daily practice. Funding Acknowledgement Type of funding source: None

Effect of shape of the stenosis on the hemodynamics of a stenosed coronary artery

2021 ◽  
Vol 33 (8) ◽  
pp. 081914
Author(s):  
Navid Freidoonimehr ◽  
Rey Chin ◽  
Anthony Zander ◽  
Maziar Arjomandi
Keyword(s):  
Coronary Artery ◽  
Stenosed Coronary Artery

Abstract 15233: The Lesion Length Gives a Better Effect on the Fractional Flow Reserve Than the Minimal Luminal Area in the Intermediate Coronary Artery Lesion

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoon Juneyoung ◽  
Xiongjie Jin ◽  
Kyong-Woo Seo ◽  
Jin-sun Park ◽  
Hyoung-Mo Yang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Lesion Length ◽  
Visual Estimation ◽  
Luminal Area ◽  
Artery Disease

Introduction: The pressure gradient of the circulation fluid in a stenosis area depends on minimal luminal area (MLA) of the stenosis, lesion length (LL), and the fluid velocity. However, the correlation of the LL and the MLA; the cutoff values are uncertain. Hypothesis: LL and MLA differently influences the FFR. Methods: We studied 117 patients with intermediate coronary artery disease who underwent FFR and IVUS measurement out of 302 patients in FAVOR study. This study was a prospective, 1:1 randomized, open label multicenter trial to demonstrate the clinical outcomes between FFR and IVUS-guided PCI. Inclusion criteria were as follows: 1)Angina or documented silent ischemia 2) De novo intermediate coronary artery disease (30-70% diameter stenosis) by visual estimation, 3) Reference vessel diameter ≥ 3.0mm by visual estimation. We excluded left main disease, MI, EF< 40%, and graft vessel. There were no significant differences in baseline clinical characteristics. The mean values are the QCA (54.3±14.0 %), MLA (3.6±1.4 mm2) and LL (20.6±1.4mm), respectively. We were performed the path analysis using AMOS 18, and estimated the ROC curve in SPSS 18. Results: Standardized estimates were the LL -0.47,QCA -0.28 and MLA -0.21 (R2=0.594, p<0.000) in path analysis. The model is recursive and statistically significant. The FFR was ≤0.80 in 47 lesions (31%). The optimal LL for an FFR of ≤0.80 was 15.8mm (90% sensitivity, 50% specificity, 44% positive predictive value, 87% negative predictive value, area under the curve: 0.75, 95% CI: 0.66 to 0.85; p < 0.001) and MLA 3.9mm (sensitivity 86%, specificity 59%, 35% positive predictive value , 94% negative predictive value, area under the curve: 0.78, 95% CI: 0.67 to 0.85; p < 0.001) Conclusions: The lesion length influenced more the FFR than MLA. The lesion length ≥ 15.8mm and MLA ≤ 3.9mm are risk zones, which need to be confirm the functional status with FFR because of the low positive predictive value

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