Key result
HK model matches morphometric measurements of all coronary bifurcation types to guide percutaneous vessel reconstruction.
Why the study?
Determining the optimal diameter of a diseased bifurcation segment based on the dimensions of other segments is necessary to ensure optimal flow through coronary bifurcations.
Does the HK model accurately determine the optimal diameter of a diseased bifurcation segment compared to other models?
Does the HK model accurately determine the optimal diameter of a diseased bifurcation segment compared to other models?
The HK model provides a comprehensive, physically-based rule for determining the optimal diameter of diseased vessels during percutaneous reconstruction of coronary bifurcations.
May guide bifurcation diameter selection in PCI planning; leaves open prospective validation of clinical outcomes.
AIMS: The percutaneous repair of a diseased segment should consider the dimensions of other segments of a bifurcation in order to ensure the optimality of flow through the bifurcation. The question is, if the diameters of two segments of a bifurcation are known, can an optimal diameter of the third diseased segment be determined such that the bifurcation has an optimal geometry for flow transport? Various models (i.e., Murray, Finet, area-preservation and HK models) that express a diameter relationship of the three segments of a bifurcation have been proposed to answer the question. METHODS AND RESULTS: In this study the four models were compared with experimental measurements on epicardial coronary bifurcations of patients and swine. The HK model is found to be in agreement with morphometric measurements of all bifurcation types and is based on the minimum energy hypothesis while Murray and area-preservation models are in agreement with experimental measurements for bifurcations with daughter diameter ratio (i.e., small daughter diameter/large daughter diameter) ≤0.25 and Finet model is in agreement for bifurcations with daughter diameter ratio ≥0.75. CONCLUSIONS: The HK model provides a comprehensive rule for the percutaneous reconstruction of the diameters of diseased vessels and has a physical basis.
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Huo et al. (2012) studied Coronary bifurcation disease. HK model vs. Murray, Finet, and area-preservation models was evaluated on Agreement with morphometric measurements of bifurcation types. The HK model agreed with morphometric measurements of all bifurcation types, providing a comprehensive rule for percutaneous reconstruction of diseased vessel diameters.
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