Four-Dimensional Coronary Artery Analysis for Non-Invasive FFR
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Solution Overview
Problem
Current methods for assessing vascular function, such as Fractional Flow Reserve (FFR) measurements, are invasive and lack real-time diagnostic capabilities, particularly in guiding revascularization decisions for coronary stenosis.
Innovation Solution
A method for vascular assessment that involves receiving a vascular model of the cardiac vasculature, determining flow characteristics through stenotic segments, generating modified vascular models with altered flow characteristics, and calculating a flow index to predict the effect of intervention on stenosis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If FFR measurement technique is used, then functional significance of coronary stenoses can be assessed, but the procedure becomes invasive and time-consuming
Solution Approach 1:
The patent creates a virtual copy of the patient's coronary vasculature through 3D reconstruction from angiographic images. This virtual model allows FFR calculation without requiring actual invasive wire insertion, thus maintaining measurement precision while eliminating the invasive procedure aspect
Solution Approach 2:
The patent replaces the mechanical FFR measurement system (guidewire with pressure transducer) with a computational fluid dynamics system. The CFD simulation uses mathematical models of blood flow through the 3D reconstructed vasculature to calculate pressure gradients and flow characteristics, eliminating the need for mechanical intrusion into the vascular system
2Ease of operation
If FFR measurement is performed, then revascularization guidance is provided, but real-time diagnostic capability is lost
Solution Approach 1:
The patent performs preliminary 3D reconstruction of the coronary vasculature from angiographic images before the revascularization decision needs to be made. This pre-processing creates a ready-to-use virtual model that can immediately provide FFR calculations and flow characteristics when needed, eliminating delays associated with performing invasive measurements at the moment of decision-making
Solution Approach 2:
The patent implements a feedback loop where the 3D reconstructed model is used to calculate FFR and other flow characteristics, which then provide immediate feedback on the functional significance of stenoses. This feedback can be obtained in real-time during catheterization without requiring additional invasive wire insertion, enabling immediate revascularization guidance
3Device complexity
If 3D vascular model is created from 2D angiographic images, then non-invasive assessment is achieved, but measurement precision may be compromised
Solution Approach 1:
The patent introduces 3D reconstruction as an intermediary step between 2D angiographic images and FFR measurement. This 3D model serves as a mediator that captures the spatial relationships and geometric characteristics of the coronary vasculature, enabling accurate CFD simulations and flow characteristic calculations without direct invasive measurement
Solution Approach 2:
The patent transforms the measurement approach by changing from direct pressure/flow measurements to geometric parameter extraction from 3D models. By reconstructing the 3D vasculature geometry from 2D images, the system can calculate flow characteristics through computational fluid dynamics, achieving both non-invasive assessment and maintained measurement precision through accurate geometric representation
Data Source
AI summary
Systems and methods for four-dimensional analysis of a patient's coronary arteries and myocardial wall. An example method includes accessing angiographic x-ray images of one or more arteries, with the x-ray images depicting the arteries from respective angles, with each x-ray image being associated with a cardiac phase of cardiac phases, and with the cardiac phases being included in a cardiac cycle. A three-dimensional model of the arteries is generated for each cardiac phase based on a subset of the x-ray images which are associated with the cardiac phase. A four-dimensional representation of the arteries is generated throughout the cardiac cycle based on the three-dimensional models for the cardiac phase. Information associated with the four-dimensional presentation is presented.