Virtual Functional Assessment of Coronary Stenoses Using Intravascular Ultrasound Imaging: A Proof-of-Concept Pilot Study

Panagiotis K. Siogkas, Michail I. Papafaklis, Lampros Lakkas, Themis P. Exarchos, Dimitri Karmpaliotis, Ziad A. Ali, Gualtiero Pelosi, Oberdan Parodi, Christos S. Katsouras, Dimitrios I. Fotiadis, Lampros K. Michalis

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Aims: We aimed to investigate the performance of virtual functional assessment of coronary stenoses using intravascular ultrasound (IVUS)-based three-dimensional (3D) coronary artery reconstruction against the invasively measured fractional flow reserve (FFR). Methods and Results: Twenty-two (22) patients with either typical symptoms of stable angina or a positive stress test, who underwent IVUS and FFR, were included in this study. Five (5) patients presented FFR values lower than the 0.80 threshold, indicating ischaemia. IVUS-based 3D reconstruction and blood flow simulation were performed and the virtual functional assessment index (vFAI) was calculated. A strong correlation between IVUS-based vFAI and FFR was observed (Spearman correlation coefficient [r s ] = 0.88, p < 0.0001). There was a small overestimation of the FFR by the IVUS-based vFAI (mean difference = 0.0196 ± 0.037; p = 0.023 for difference from zero). All cases with haemodynamically significant stenoses (FFR ≤ 0.8) were correctly categorised by the IVUS-based vFAI (vFAI ≤ 0.8). Conclusion: The proposed approach allows the complete and comprehensive assessment of coronary stenoses providing anatomic and physiologic information, pre- and post-intervention, using only an IVUS catheter without the use of a pressure wire.

Original languageEnglish
Pages (from-to)e33-e36
JournalHeart Lung and Circulation
Volume28
Issue number4
DOIs
StatePublished - Apr 2019
Externally publishedYes

Keywords

  • FFR
  • IVUS
  • Virtual functional assessment index

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