Effect of medical imaging modalities on the simulated blood flow through a 3D reconstructed stented coronary artery segment

Abstract

Computational fluid dynamics (CFD) studies play an important role in the analysis and prediction of atherosclerosis in coronary arteries. Haemodynamics, in particular endothelial shear stress (ESS), is believed to influence the unhealthy development of the endothelium. In this study, we compared the geometric variances of a patient-specific arterial segment using multiple medical imaging modalities and their effects on haemodynamics. Three-dimensional patient coronary artery reconstructions using standalone X-ray angiography are able to only approximate the artery cross-section as ellipses. On the other hand, intravascular optical coherence tomography (OCT) provides high resolution cross-sectional images of the lumen surface, which can be fused with angiography data to create detailed topographical features of the diseased/scaffold artery segment. The standalone angiography reconstruction is highly automated whereas the OCT-angiography fusion (OCT-A) reconstruction requires manual editing. High fidelity non-Newtonian, pulsatile CFD simulations performed on these 3-D models demonstrate substantial difference in ESS distributions. There is also a higher computational cost associated with performing the OCT-A simulation compared to the angiography simulation.