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Proceedings Paper

In vivo reconstruction of coronary artery and bioresorbable stents from intracoronary optical coherence tomography
Author(s): Yingguang Li; Niels R. Holm; Zhenyu Fei; Jouke Dijkstra; Emil N. Holck; Evald Høj Christiansen; Johan H. C. Reiber; Shengxian Tu
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Paper Abstract

The implantation of bioresorbable scaffolds (BRS) alters the local hemodynamic environment. Computational fluid dynamics (CFD) allows evaluation of local flow pattern, shear stress (SS) and Pressure_distal/ Pressure_approximal (Pd/Pa). The accuracy of CFD results relies to a great extent on the reconstruction of the 3D geometrical model. The aim of this study was to develop a new approach for in vivo reconstruction of coronary tree and BRS by fusion of Optical Coherence Tomography (OCT) and X-ray angiography. Ten patients enrolled in the BIFSORB pilot study with BRS implanted in coronary bifurcations were included for analysis. All patients underwent OCT of the target vessel after BRS implantation in the main vessel. Coronary 3D reconstruction was performed creating two geometrical models: one was angiography model and the other was OCT model with the implanted BRS. CFD analysis was performed separately on these two models. The main vessel was divided into portions of 0.15 mm length and 0.15mm arc width for point-perpoint comparison of SS between the two models. Reconstruction of the implanted BRS in naturally bent shape was successful in all cases. SS was compared in the matched 205463 portions of the two models. The divergence of shear stress was higher in the OCT model (mean±SD: 2.27 ± 3.95 Pa, maximum: 142.48 Pa) than that in the angiography model (mean±SD: 2.05 ± 3.12 Pa, maximum: 83.63 Pa). Pd/Pa values were lower in the OCT model than in the angiography model for both main vessels and side branches (mean±SD: 0.979 ± 0.009 versus 0.984 ± 0.011, and 0.951 ± 0.068 versus 0.966 ± 0.051). Reconstruction of BRS in naturally bent shape after implantation is feasible. It allows detailed analysis of local flow pattern, including shear stress and Pd/Pa in vivo.

Paper Details

Date Published: 13 March 2018
PDF: 7 pages
Proc. SPIE 10576, Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling, 1057622 (13 March 2018); doi: 10.1117/12.2293711
Show Author Affiliations
Yingguang Li, Leiden Univ. Medical Ctr. (Netherlands)
Niels R. Holm, Aarhus Univ. Hospital (Denmark)
Zhenyu Fei, Shanghai Jiao Tong Univ. (China)
Jouke Dijkstra, Leiden Univ. Medical Ctr. (Netherlands)
Emil N. Holck, Aarhus Univ. Hospital (Denmark)
Evald Høj Christiansen, Aarhus Univ. Hospital (Denmark)
Johan H. C. Reiber, Leiden Univ. Medical Ctr. (Netherlands)
Shengxian Tu, Shanghai Jiao Tong Univ. (China)

Published in SPIE Proceedings Vol. 10576:
Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling
Baowei Fei; Robert J. Webster III, Editor(s)

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