Computational Fluid Dynamics Coronary Flow Analysis
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Solution Overview
Problem
Current methods for assessing the functional severity of coronary artery stenoses, such as Fractional Flow Reserve (FFR), are invasive, costly, and require additional procedures like hyperemia induction, while also being computationally complex and unable to account for patient-specific factors like myocardial microvasculature status and collateral flow.
Innovation Solution
A method using a multi-scale 1D/0D model coupled with a reduced 3D reconstruction, allowing for non-invasive estimation of coronary blood flow and fractional flow reserve (vFFR) during interventions, with reduced computational complexity and the ability to incorporate patient-specific information such as myocardial status and collateral flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional X-ray angiography is used for anatomical assessment, then geometric features of stenosis can be quantified, but functional severity cannot be accurately determined
Solution Approach 1:
The patent introduces computational fluid dynamics (CFD) simulations as an intermediary between anatomical imaging and functional assessment. The CFD model acts as a mediator that translates geometric features from X-ray angiography into functional parameters like pressure gradients and blood flow, enabling non-invasive functional severity determination without direct pressure measurements
Solution Approach 2:
The patent replaces the mechanical invasive pressure wire system with a computational mechanics approach. Instead of physically inserting a pressure-transducing wire to measure pressure differences, the system uses CFD simulations to computationally determine pressure gradients and flow characteristics based on anatomical geometry
2Measurement precision
If FFR measurement with pressure wire is performed, then functional severity can be accurately assessed, but the procedure becomes invasive and costly
Solution Approach 1:
The patent creates a virtual copy of the coronary artery system using 3D reconstructions from angiographic images. This digital replica is then used for CFD simulations to estimate FFR, replacing the need for physical pressure wire insertion while maintaining the ability to assess functional severity
Solution Approach 2:
The patent substitutes the mechanical pressure wire measurement system with a computational simulation system. The CFD-based virtual FFR (vFFR) approach replaces direct pressure measurements with computational pressure gradient calculations, eliminating invasive catheterization requirements
3Measurement precision
If sophisticated CFD models are used for vFFR, then patient-specific functional assessment can be achieved, but computational complexity increases significantly
Solution Approach 1:
The patent segments the coronary artery system into distinct geometric regions based on angiographic images. By dividing the complex vascular tree into manageable segments with specific boundary conditions, the CFD simulations can be performed more efficiently while still capturing patient-specific functional characteristics
Solution Approach 2:
The patent applies local quality by using patient-specific geometric features extracted from angiographic images at specific locations in the coronary arteries. The CFD model incorporates local anatomical variations such as stenosis geometry and vessel diameter changes to improve functional assessment accuracy without requiring full 3D reconstruction of the entire cardiovascular system
4Measurement precision
If FFR measurement is performed to assess intermediate lesions, then treatment decisions can be guided, but additional costs and procedure time are incurred
Solution Approach 1:
The patent performs preliminary action by calculating vFFR values during the angiographic procedure itself, using the anatomical images already acquired for diagnostic purposes. This allows functional assessment to be integrated into the existing workflow rather than requiring separate measurement procedures, reducing additional procedure time
Data Source
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Figure 3A
Figure 3B~3C
AI summary
Method for quantitative flow analysis of a tree of conduits perfusing an organ from at least two bi-dimensional images, the method comprising the following steps: a) making a 3D reconstruction of at least part of the tree from said at least two bi-dimensional images; b) identifying a segment of interest within the 3D reconstruction either automatically or semi-automatically upon user input; c) making calculations based on the 3D reconstruction to determine geometrical features of the conduits such as diameters, lengths, curvatures, centrelines or the like; d) receiving indication from the user to input a multi-scale functional model of the tree to be considered for the flow analysis and to input the location of the segment of interest within such model; e) adjusting the part of the functional model related to the segment of interest using geometrical features of the 3D reconstruction; f) performing quantitative flow analysis based on the functional model so obtained. A corresponding apparatus and computer program are also disclosed.