Document Detail


Guidewire flow obstruction effect on pressure drop-flow relationship in moderate coronary artery stenosis.
MedLine Citation:
PMID:  16488224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the local hemodynamic effects of coronary artery balloon angioplasty, computational fluid dynamics was applied to representative stenoses geometry post-angioplasty (minimal lesion diameter d(m) = 1.8mm which produced 64% mean area stenoses) based on a group of patients and measured values of coronary flow reserve (CFR) returning to a normal range (3.6+/-0.3). The computations were at mean flow rates (Q) of 50, 100, 150 and 170 ml/min. The study indicates changes in the hemodynamic conditions due to insertion of a guidewire, which can be used to determine the mean pressure drop (Deltap ) and fall in distal mean coronary pressure (p(r)), and thus give quantitative estimate of uncertainty expected in diagnosis of moderate lesions. The guidewire to minimal lesion diameter ratio is 0.26, causing tighter "artifactual" mean area stenoses of 65.5%. During hyperemia, p(m) dropped to 72 mmHg as compared to 75 mmHg under patho-physiological condition without guidewire. Q(h) (subscript h: hyperemia) decreased from 180 without guidewire to 170 ml/min with the guidewire present. Thus, there was a significant approximately 43% increase in Deltap(h) and a approximately 51% increase in the hyperemic flow resistance (R(h) = Deltap(h)/Q(h)) over the patho-physiological condition. This could cause an overestimation of the severity of the moderate stenoses. Transient and steady flow guidewire surface shear stress was 35-50% higher than corresponding values for arterial wall shear stress. The non-dimensional data given in tabular form may be useful in interpretation of clinical guidewire measurements for moderate lesions of similar geometry and size.
Authors:
Abhijit Sinha Roy; Lloyd H Back; Rupak K Banerjee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of biomechanics     Volume:  39     ISSN:  0021-9290     ISO Abbreviation:  J Biomech     Publication Date:  2006  
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-06-29     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  853-64     Citation Subset:  IM    
Affiliation:
Department of Mechanical Engineering, University of Cincinnati, 688 Rhodes Hall, PO Box 210072, Cincinnati, OH 45221-0072, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*,  methods*
Blood Flow Velocity
Blood Pressure
Computer Simulation
Coronary Stenosis / physiopathology*,  surgery*
Humans
Models, Cardiovascular*
Prognosis
Severity of Illness Index
Surgery, Computer-Assisted / methods
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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