August 10, 2016Current Science
A Parametric Study of the Effect of Arterial Wall Curvature on Non-Invasive Assessment of Stenosis Severity:Computational Fluid Dynamics Study
Key result
Increasing arterial wall curvature from 0 to 120 degrees significantly decreased computed fractional flow reserve by 5%, 8%, and 20% in 70%, 80%, and 90% area stenoses, respectively.
Why the study?
Does arterial wall curvature affect the non-invasive assessment of stenosis severity using FFR, CDP, and LFC in computational models?
Population
Computational simulation models of hyperemic blood flow in arteries with 70%, 80%, and 90% area stenoses
Comparison
Curved arterial wall models vs Straight arterial wall model (0° angle)
Design
Preclinical
Authors
Discussion
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Implication
Arterial curvature may artifactually lower computed FFR; leaves open relevance to invasive measurements or revascularization decisions.
Structured PICO
Does arterial wall curvature affect the non-invasive assessment of stenosis severity using FFR, CDP, and LFC in computational models?
P
Population
Computational fluid dynamics simulation of hyperemic blood flow in curved arteries with 70%, 80%, and 90% area stenoses.
E
Exposure
Curved arterial wall models (30°, 60°, 90°, and 120° angles)
C
Comparator
Straight arterial wall model (0° angle)
O
Outcome
Fractional flow reserve (FFR), pressure drop coefficient (CDP), and lesion flow coefficient (LFC)surrogate
Main Result
p-value: p=<0.05
Arterial wall curvature significantly alters FFR, CDP, and LFC in computational models, indicating that curvature should be considered in non-invasive stenosis assessment to prevent misjudgment of intermediate lesions.
Limitations
- Arterial wall compliance was not included in the study
- Multiple bends and dynamic curvature variations due to heart motion were not included
- Wall roughness, lesion eccentricity, diffused disease, and tandem lesions were not included
- Realistic coronary artery models were not used
Cite This Study
Govindaraju et al. (2016) studied Coronary artery stenosis. Arterial wall curvature vs. Straight artery (0 degrees curvature) was evaluated on Fractional flow reserve (FFR) (p=<0.05). Increasing arterial wall curvature from 0 to 120 degrees significantly decreased computed fractional flow reserve by 5%, 8%, and 20% in 70%, 80%, and 90% area stenoses, respectively.