Virtual Functional Assessment of Coronary Stenoses Using Intravascular Ultrasound Imaging: A Proof-of-Concept Pilot Study - 12/03/19

Doi : 10.1016/j.hlc.2018.02.011

Panagiotis K. Siogkas, PhD ^a, Michail I. Papafaklis, MD, PhD ^b, Lampros Lakkas, MD ^b, Themis P. Exarchos, PhD ^a, Dimitri Karmpaliotis, MD, PhD ^c, Ziad A. Ali, MD, DPhil ^c, Gualtiero Pelosi, MD, PhD ^d, Oberdan Parodi, MD, PhD ^d, Christos S. Katsouras, MD ^b, Dimitrios I. Fotiadis, PhD ^a, Lampros K. Michalis, MD, MRCP ^b,^⁎
^a Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science, University of Ioannina, Ioannina, Greece
^b 2nd Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece
^c Columbia University, New York, NY, USA
^d Institute of Clinical Physiology, National Research Council, Pisa, Italy

^⁎Corresponding author at: Department of Cardiology, Medical School, University of Ioannina, University Avenue, Ioannina GR 45110, Greece.Department of CardiologyMedical SchoolUniversity of IoanninaUniversity AvenueIoanninaGR45110Greece

Résumé

Aims

We aimed to investigate the performance of virtual functional assessment of coronary stenoses using intravascular ultrasound (IVUS)-based three-dimensional (3D) coronary artery reconstruction against the invasively measured fractional flow reserve (FFR).

Methods and Results

Twenty-two (22) patients with either typical symptoms of stable angina or a positive stress test, who underwent IVUS and FFR, were included in this study. Five (5) patients presented FFR values lower than the 0.80 threshold, indicating ischaemia. IVUS-based 3D reconstruction and blood flow simulation were performed and the virtual functional assessment index (vFAI) was calculated. A strong correlation between IVUS-based vFAI and FFR was observed (Spearman correlation coefficient [r_s]=0.88, p<0.0001). There was a small overestimation of the FFR by the IVUS-based vFAI (mean difference=0.0196±0.037; p=0.023 for difference from zero). All cases with haemodynamically significant stenoses (FFR≤0.8) were correctly categorised by the IVUS-based vFAI (vFAI≤0.8).

Conclusion

The proposed approach allows the complete and comprehensive assessment of coronary stenoses providing anatomic and physiologic information, pre- and post-intervention, using only an IVUS catheter without the use of a pressure wire.

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Keywords : IVUS, Virtual functional assessment index, FFR

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Vol 28 - N° 4

P. e33-e36 - avril 2019 Retour au numéro

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Virtual Functional Assessment of Coronary Stenoses Using Intravascular Ultrasound Imaging: A Proof-of-Concept Pilot Study - 12/03/19

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Methods and Results

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