Noninvasive Vessel Pressure-Drop Mapping for Diffuse Lesion Treatment
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Solution Overview
Problem
Existing methods for diagnosing and treating coronary artery disease with multiple or diffuse lesions, such as tandem and diffuse lesions, are challenging due to the difficulty in accurately determining fractional flow reserve (FFR) and require invasive procedures and expert analysis of pressure measurements.
Innovation Solution
A non-invasive method using image analysis to predict a total pressure drop value in a blood vessel, calculate the contribution of vessel portions to this value, and simulate a new pressure drop by neutralizing specific contributions to identify which portions should be treated, without relying on invasive pressure measurements or pullback curves.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If invasive pressure measurements and pullback curves are used to assess FFR in vessels with multiple or diffuse lesions, then measurement precision is improved, but device complexity and loss of time increase
Solution Approach 1:
The patent replaces the mechanical invasive pressure wire system with a computational fluid dynamics (CFD) simulation system. The CFD model uses 3D vessel geometry from imaging data to numerically solve the Navier-Stokes equations, eliminating the need for physical pressure wires while maintaining FFR measurement capability.
Solution Approach 2:
The patent creates a virtual copy of the patient's vascular system through 3D reconstruction from imaging data (CTA, MRA, or angiography). This digital twin allows repeated CFD simulations without repeated invasive procedures, enabling precise FFR measurement through computational rather than mechanical means.
2Measurement precision
If invasive pressure wires are used to obtain iFR pullback curves, then measurement precision is improved, but loss of time increases
Solution Approach 1:
The patent performs preliminary 3D vessel reconstruction and mesh generation before the actual FFR calculation. By preparing the computational model in advance from existing imaging data, the subsequent CFD simulation can be executed quickly without time-consuming invasive wire placement and pullback procedures.
Solution Approach 2:
The patent substitutes the time-consuming mechanical pullback procedure with automated CFD simulation. Once the 3D model is created, the computational FFR calculation can be performed rapidly using standard algorithms, eliminating the need for manual wire withdrawal and real-time pressure recording.
3Measurement precision
If expert analysis of pressure measurements is required, then measurement precision is improved, but device complexity and loss of time increase
Solution Approach 1:
The patent implements self-service through automated CFD simulation that directly outputs FFR values and pressure gradient maps without requiring expert interpretation. The system automatically processes the 3D vessel geometry, applies boundary conditions, and generates diagnostic results, eliminating the need for expert manual analysis while maintaining precision.
Solution Approach 2:
The patent incorporates automated feedback mechanisms where the CFD simulation iteratively adjusts flow fields and pressure distributions based on the vessel geometry and boundary conditions. This automated feedback loop generates precise FFR values without requiring expert review, improving both accuracy and efficiency.
4Measurement precision
If flow interaction between tandem lesions is considered, then measurement precision is improved, but device complexity increases
Solution Approach 1:
The patent segments the vascular system into distinct anatomical regions (proximal and distal lesions) while maintaining their hemodynamic connectivity in the CFD model. This segmentation allows independent analysis of each lesion's contribution to pressure drop while capturing their interactive effects through the coupled fluid flow simulation.
Solution Approach 2:
The patent uses CFD simulation to replace complex analytical methods for handling flow interactions between multiple lesions. The numerical solver automatically captures non-linear flow interactions, turbulence, and pressure coupling between tandem lesions without requiring simplified analytical models, maintaining precision while managing complexity through computational power.
Data Source
AI summary
Non-invasively determining a treatment strategy for a blood vessel by obtaining a prediction of a total pressure drop value in the blood vessel based on features generated from a plurality of images of the blood vessel, the images representing all anatomic parts of the blood vessel, and calculating a contribution of one or more portion(s) of the blood vessel to the total pressure drop value. Based on the calculated contribution, a new simulated total pressure drop value of the blood vessel is calculated by neutralizing the contribution of the one or more portion(s) to the total pressure drop value to determine if the new simulated pressure drop improves, thereby indicating portions which should be treated to restore healthy pressure drop values.