In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 93, No. 2 ( 2019-02), p. 266-274
Abstract:
To evaluate the diagnostic performance of a novel computational algorithm based on three‐dimensional intravascular ultrasound (IVUS) imaging in estimating fractional flow reserve (IVUS FR ), compared to gold‐standard invasive measurements (FFR INVAS ). Background IVUS provides accurate anatomical evaluation of the lumen and vessel wall and has been validated as a useful tool to guide percutaneous coronary intervention. However, IVUS poorly represents the functional status (i.e., flow‐related information) of the imaged vessel. Methods Patients with known or suspected stable coronary disease scheduled for elective cardiac catheterization underwent FFR INVAS measurement and IVUS imaging in the same procedure to evaluate intermediate lesions. A processing methodology was applied on IVUS to generate a computational mesh condensing the geometric characteristics of the vessel. Computation of IVUS FR was obtained from patient‐level morphological definition of arterial districts and from territory‐specific boundary conditions. FFR INVAS measurements were dichotomized at the 0.80 threshold to define hemodynamically significant lesions. Results A total of 24 patients with 34 vessels were analyzed. IVUS FR significantly correlated ( r = 0.79; P 〈 0.001) and showed good agreement with FFR INVAS , with a mean difference of −0.008 ± 0.067 ( P = 0.47). IVUS FR presented an overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 89%, 92%, 80%, and 96%, respectively, to detect significant stenosis. Conclusion The computational processing of IVUS FR is a new method that allows the evaluation of the functional significance of coronary stenosis in an accurate way, enriching the anatomical information of grayscale IVUS.
Type of Medium:
Online Resource
ISSN:
1522-1946
,
1522-726X
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2001555-0
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