A novel system for the reconstruction of a coronary artery lumen profile in real time: a preclinical validation

2009 ◽  
Vol 297 (1) ◽  
pp. H485-H492 ◽  
Author(s):  
Ghassan S. Kassab ◽  
Jenny S. Choy ◽  
Mark Svendsen ◽  
Anjan K. Sinha ◽  
Mouhamad Alloosh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Real Time ◽  
Vessel Diameter ◽  
Circumflex Artery ◽  
Cross Sectional ◽  
Catheterization Laboratory ◽  
Left Circumflex Artery ◽  
The Mean ◽  
The Difference ◽  
The Right

Accurate sizing of vessel diameter is important for understanding the physiology of blood vessels as well as the treatment of coronary and peripheral artery disease. The objective of this study was to validate a novel catheter-based system [the LumenRECON (LR) system] for the real-time reconstruction of lumen cross-sectional area (CSA) along the length of a vessel segment. A total of 22 swine (20 Yorkshire and 2 atherosclerotic Ossabaw swine) were used to evaluate the accuracy, reproducibility, and safety of the system compared with intravascular ultrasound (IVUS). The CSA of the right coronary artery, left anterior descending coronary artery, and left circumflex artery were determined by IVUS and the LR system over a 3- to 4-cm segment in 12 Yorkshire and 2 atherosclerotic Ossabaw swine and 2 postmortem atherosclerotic human hearts. In eight chronic animals, the effect of the LR catheter on the vessel wall was evaluated at 1 day and 2 wk (4 animals each) after the intervention. A Bland-Altman plot of the LR and IVUS data showed a mean difference between the two measurements of 0.055 mm in diameter, which was not statistically significant from zero, indicating a lack of bias in the comparison of the LR system with IVUS. The root mean square error of the two measurements was 10.2% of the mean IVUS diameter. The repeatability of the LR system was assessed using duplicate measurements. The mean of the difference between the two measurements was nearly zero, and the repeatability coefficient was within 4.5% of the mean of the two measurements. No injury or intimal hyperplasia was found acutely or chronically after the use of the LR system. This study establishes the accuracy, reproducibility, and safety of a nonimaging 2.7-Fr catheter for lumen sizing of coronary arteries. The system provides a continuous quantitative axial profile of the mean vessel lumen in real time and may have significant utility in vascular research and clinically in the catheterization laboratory.

scholarly journals Simultaneous stenting of the left main coronary stem and internal carotid artery in a hemodynamically unstable patient

2011 ◽  
Vol 68 (8) ◽  
pp. 712-715 ◽  
Author(s):  
Dragan Sagic ◽  
Zelimir Antonic ◽  
Milan Stanisic ◽  
Nenad Ilijevski ◽  
Predrag Milojevic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Stenting ◽  
Main Stem ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Unstable Patient ◽  
Left Main Stem ◽  
The Right

Introduction. Combined endovascular interventions on carotid and coronary arteries are rare. Stenting of the unprotected coronary left main stem is a high risk procedure. We presented hemodynamically unstable patient with combined carotid artery and left main stem coronary artery stenting. Case report. A 78-year-old female patient was admitted to our institution for right carotid endaterectomy. The patient had 80% stenosis of the right carotid artery and occlusion of the left carotid artery. Coronary angiography revealed 70% ostial left main stenosis, occlusion of the right coronary artery and the left circumflex artery, and 80% stenosis of the left anterior descending artery. Simultaneous carotid artery endaterectomy and coronary artery by-pass grafting were considered. Due to high perioperative risk, surgery was rejected, and the patient was treated endovascularly with stenting of arteries occluded. The procedure was completed without complications and the patient was hemodynamically stabilised. Conclusion. This report illustrates simultaneous coronary and carotid stenting as a successfull lifesaving procedure.

scholarly journals Extraction of morphometry and branching angles of porcine coronary arterial tree from CT images

2009 ◽  
Vol 297 (5) ◽  
pp. H1949-H1955 ◽  
Author(s):  
Thomas Wischgoll ◽  
Jenny S. Choy ◽  
Ghassan S. Kassab
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Topological Analysis ◽  
Minimum Energy ◽  
Power Laws ◽  
Ct Images ◽  
Arterial Tree ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

The morphometry (diameters, length, and angles) of coronary arteries is related to their function. A simple, easy, and accurate image-based method to seamlessly extract the morphometry for coronary arteries is of significant value for understanding the structure-function relation. Here, the morphometry of large (≥1 mm in diameter) coronary arteries was extracted from computed tomography (CT) images using a recently validated segmentation algorithm. The coronary arteries of seven pigs were filled with Microfil, and the cast hearts were imaged with CT. The centerlines of the extracted vessels, the vessel radii, and the vessel lengths were identified for over 700 vessel segments. The extraction algorithm was based on a topological analysis of a vector field generated by normal vectors of the extracted vessel wall. The diameters, lengths, and angles of the right coronary artery, left anterior descending coronary artery, and left circumflex artery of all vessels ≥1 mm in diameter were tabulated for the respective orders. It was found that bifurcations at orders 9–11 are planar (∼90%). The relations between volume and length and area and length were also examined and found to scale as power laws. Furthermore, the bifurcation angles follow the minimum energy hypothesis but with significant scatter. Some of the applications of the semiautomated extraction of morphometric data in applications to coronary physiology and pathophysiology are highlighted.

scholarly journals Histological study of proportion of cortex and medulla of the ovary in Bangladeshi women

2016 ◽  
Vol 44 (1) ◽  
pp. 8-10
Author(s):  
Hosna Ara Perven ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
Halima Afroz ◽  
...  
Keyword(s):  
Histological Study ◽  
Age Groups ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
The Right

This cross sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka from January to December 2009, to determine the proportion of cortex and medulla of the ovary in di_erent age group of Bangladeshi women. This study was based on collection of 140 ovaries of 70 unclaimed female dead bodies from the morgue of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including A (10-13 years), B (14-45 years) & C (46-52 years). Histological slides were prepared by using routine haematoxylin and eosin stain. Ten best prepared histological slides from each age group were examined to determine the thickness of the cortex and medulla & proportion of the thickness of the cortex and the medulla of the ovary were expressed in percentages. The mean proportion of the cortex and the medulla of the right ovary were found 80.83±0.58% and 19.17±0.58% in group A, 86.95±1.14% and 13.05±1.14% in group B, 70.53±1.53% and 29.47±1.53% in group C respectively. The mean proportion of the cortex and the medulla of the left ovary were found 80.63±0.58% and 19.37±0.58% in group A, 86.78±1.14% and 13.22±1.14% in group B, 70.41±1.50% and 29.59±1.50% in group C respectively. The difference in mean proportion of the cortex and the medulla was not signi_cant in between the ovaries. However, the difference in mean proportion of the cortex and the medulla of the ovary between group A & group B, group A & group C and group B & group C were statistically significant.Bangladesh Med J. 2015 Jan; 44 (1): 8-10

scholarly journals Safety and Efficacy of Guidezilla Extension Catheter for the Percutaneous Treatment of Complex Coronary Lesions

2020 ◽  
Vol 23 (2) ◽  
pp. E147-E150
Author(s):  
Tao Chen ◽  
Weihao Xu ◽  
Yulun Cai ◽  
Qi Wang ◽  
Jun Guo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Percutaneous Treatment ◽  
Target Lesion ◽  
Lesion Length ◽  
Circumflex Artery ◽  
Chronic Total Occlusions ◽  
Left Circumflex Artery ◽  
Coronary Lesions ◽  
Procedural Success ◽  
The Right

Background: The GuidezillaTM support extension catheter is designed to provide extra back-up support and efficient device delivery during complex percutaneous coronary interventions (PCIs), such as in treatment of severe calcification, tortuous chronic total occlusions (CTOs), and coronary anomalies. The aim of this study was to describe our initial experience with the GuidezillaTM extension catheter in the treatment of complex coronary artery lesions. Methods: This study retrospectively analyzed data from 165 PCI cases that used the GuidezillaTM guide extension catheter between March 2015 and August 2017. We collected patient clinical characteristics, target lesion characteristics, and procedural details. Results: Eighty-six percent of patients had complex Type C lesions, and 13.9% had Type B lesions. Lesion length ranged from 8 mm to 130 mm (≤ 20 mm, 15.4%; 20–40 mm, 35.8%; > 40 mm, 49.1%). The right coronary artery (59.2%) was the most common intervention vessel followed by the left ascending artery (30.6%) and the left circumflex artery (10.2%). CTO accounted for 38% of all lesions, followed by distortions (28%), heavy calcification (24%), proximal stent thrombosis (9%), and coronary artery origin anomalies (1%). A total of 142 patients underwent successful PCI using the GuidezillaTM extension catheter. The success rate was 86%. Conclusion: The GuidezillaTM guide extension catheter was an effective and safe technique in the transradial treatment of complex coronary lesions. Use of the GuidezillaTM guide extension catheter can shorten the procedure time and ensure overall procedural success with a reduced complication rate in cases where adequate progress using angioplasty devices has not been achieved.

Analysis of blood flow in the entire coronary arterial tree

2005 ◽  
Vol 289 (1) ◽  
pp. H439-H446 ◽  
Author(s):  
N. Mittal ◽  
Y. Zhou ◽  
C. Linares ◽  
S. Ung ◽  
B. Kaimovitz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Blood Flow ◽  
Flow Distribution ◽  
Model Parameters ◽  
Coronary Perfusion ◽  
Arterial Tree ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
The Right

A hemodynamic analysis of coronary blood flow must be based on the measured branching pattern and vascular geometry of the coronary vasculature. We recently developed a computer reconstruction of the entire coronary arterial tree of the porcine heart based on previously measured morphometric data. In the present study, we carried out an analysis of blood flow distribution through a network of millions of vessels that includes the entire coronary arterial tree down to the first capillary branch. The pressure and flow are computed throughout the coronary arterial tree based on conservation of mass and momentum and appropriate pressure boundary conditions. We found a power law relationship between the diameter and flow of each vessel branch. The exponent is ∼2.2, which deviates from Murray’s prediction of 3.0. Furthermore, we found the total arterial equivalent resistance to be 0.93, 0.77, and 1.28 mmHg·ml−1·s−1·g−1 for the right coronary artery, left anterior descending coronary artery, and left circumflex artery, respectively. The significance of the present study is that it yields a predictive model that incorporates some of the factors controlling coronary blood flow. The model of normal hearts will serve as a physiological reference state. Pathological states can then be studied in relation to changes in model parameters that alter coronary perfusion.

Arrhythmias

2014 ◽  
pp. 851-859
Author(s):  
Murali Chiravuri ◽  
Thomas M. Tadros ◽  
Usha B. Tedrow
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Superior Vena ◽  
Vena Cava ◽  
Av Node ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Sa Node ◽  
Bundle Of His ◽  
The Right

In the normal heart the sinoatrial (SA) node serves as the principal pacemaker and determines the heart rate. The SA node consists of groups of pacemaker cells marked by their ability to spontaneously depolarize and are located at the junction of the right atrium and the superior vena cava. The blood supply to the SA node is variable with the sinus nodal artery arising from the right coronary artery in 60% percent of cases and from the left circumflex artery in 40% of cases. Following depolarization of the SA nodal cells, the signal traverses the atrium before arriving at the atrioventricular (AV) node. The AV node is marked by its ability to delay impulse propagation, which allows for coordinated contraction of the atria and ventricles. The AV nodal artery arises from the right coronary artery in 90% of cases and from the left circumflex artery in 10% of cases. After exiting the AV node, the impulse is transmitted through the bundle of His, the right and left bundle branches, and ultimately exits the terminal Purkinje fibers of the conduction system into the myocardium near the apex of the heart.

Sign in / Sign up

Export Citation Format

Share Document