Analysis of the effect of guidewire position on stenosis diagnosis using computational fluid dynamics.
Blood flow simulation
CFD
Fractional flow reserve (FFR)
Guidewire
Non-Newtonian
Stenosis
Journal
Computers in biology and medicine
ISSN: 1879-0534
Titre abrégé: Comput Biol Med
Pays: United States
ID NLM: 1250250
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
29
01
2020
revised:
22
04
2020
accepted:
22
04
2020
entrez:
23
6
2020
pubmed:
23
6
2020
medline:
22
6
2021
Statut:
ppublish
Résumé
Fractional flow reserve is an accurate method for diagnosing stenosis. The difficulty in using this procedure lies in placing the guidewire precisely at the blood vessel centerline. Owing to the long distance between the insertion point and the stenosis, a guidewire inclination can occur. Therefore, the main objective of this study is to investigate how the measured pressure in a blood vessel varies with the guidewire position. A three-dimensional model of blood flow is developed and numerically simulated. Two positions and two inclination angles from the blood vessel centerline and three throat diameters are investigated. The predicted results are validated using the available experimental data. The predicted results and actual measurements are observed to agree well with each other. The pressure drop coefficient (CDP) increases because of guidewire insertion. When the guidewire is placed at inclined positions in moderate stenosis, the values of CDP are 66 and 68, depending on the inclination angle; the errors in CDP are 69% and 76%, respectively. At a high flow rate, the errors are reduced to 67% and 70%, respectively. The error in the CDP ranges from 42% to 61% when the guidewire is placed parallel to the centerline. For severe stenosis, the CDP is nearly the same at all positions and varies between 240 and 250; without a guidewire, the CDP is 163. The findings confirmed that practitioners should be aware of the guidewire position during the operation. The displacement of the guidewire should be estimated, and the corresponding error must be considered.
Sections du résumé
BACKGROUND
Fractional flow reserve is an accurate method for diagnosing stenosis. The difficulty in using this procedure lies in placing the guidewire precisely at the blood vessel centerline. Owing to the long distance between the insertion point and the stenosis, a guidewire inclination can occur. Therefore, the main objective of this study is to investigate how the measured pressure in a blood vessel varies with the guidewire position.
METHODS
A three-dimensional model of blood flow is developed and numerically simulated. Two positions and two inclination angles from the blood vessel centerline and three throat diameters are investigated. The predicted results are validated using the available experimental data. The predicted results and actual measurements are observed to agree well with each other.
RESULTS
The pressure drop coefficient (CDP) increases because of guidewire insertion. When the guidewire is placed at inclined positions in moderate stenosis, the values of CDP are 66 and 68, depending on the inclination angle; the errors in CDP are 69% and 76%, respectively. At a high flow rate, the errors are reduced to 67% and 70%, respectively. The error in the CDP ranges from 42% to 61% when the guidewire is placed parallel to the centerline. For severe stenosis, the CDP is nearly the same at all positions and varies between 240 and 250; without a guidewire, the CDP is 163.
CONCLUSIONS
The findings confirmed that practitioners should be aware of the guidewire position during the operation. The displacement of the guidewire should be estimated, and the corresponding error must be considered.
Identifiants
pubmed: 32568672
pii: S0010-4825(20)30147-5
doi: 10.1016/j.compbiomed.2020.103777
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103777Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.