Reconstruction of carotid stenosis hemodynamics based on guidewire pressure data and computational modeling.
Reconstruction of carotid stenosis hemodynamics based on guidewire pressure data and computational modeling.
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DOI：
10.1007/s11517-021-02463-2
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发表时间：
2022-05
影响因子：
3.2
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中科院分区：
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使用简化的颈动脉狭窄模型，对血管内导丝获得的流速和压力数据与计算流体动力学（CFD）数据进行了对比分析。该信息用于评估利用导丝压力数据为CFD流动提供入口条件的可行性，并研究狭窄长度与血流动力学行为之间的关系。制备不同直径和长度的颈动脉狭窄模型，并连接到血管脉动流模拟器。利用微导管导丝测量随时间变化的流速和压力，并与CFD数据进行比较。导丝和cfd生成的压力曲线在所有测量位置都非常匹配。导丝无法可靠地测量与较高CFD流速相关的区域的流速（r = 0.92）。CFD结果表明，随着狭窄长度的增加，狭窄内部和远端壁面剪应力增大，形成膨胀区。狭窄出口外立即发现低WSS。狭缝长度的增加，由于平动动能在湍流中耗散得更快，使得远端高速射流的长度延长最少，流速也增加。我们发现导丝获得的速度测量精度仅限于不受扰动流影响的区域。狭窄远端的WSS和湍流行为可能是评估动脉粥样硬化进展严重程度的重要标志，作为狭窄长度的函数。
A comparative analysis between intravascular guidewire-obtained and computational fluid dynamic (CFD) flow velocity and pressure data using simplified carotid stenosis models was performed. This information was used to evaluate the viability of using guidewire pressure data to provide inlet conditions for CFD flow, and to study the relationship between stenotic length and hemodynamic behavior. Carotid stenosis models differing in diameter and length were prepared and connected to a vascular pulsatile flow simulator. Time-dependent flow velocity and pressure measurements were taken by microcatheter guidewires and compared with CFD data. Guidewire and CFD-generated pressure profiles matched closely in all measurement locations. The guidewire was unable to reliably measure flow velocity at areas associated with higher CFD flow velocities (r = 0.92). CFD results showed that an increased length of stenosis generated expansive regions of elevated wall shear stress (WSS) within and distal to the stenosis. Low WSS was found immediately outside the stenosis outlet. An increase in stenotic length produced higher flow velocities with minimal lengthening of the distal high velocity flow jet due to faster dissipation of translational kinetic energy through turbulence. We found the accuracy of guidewire-obtained velocity measurements is limited to regions unaffected by disturbed flow. WSS and turbulence behavior distal to the stenosis may be important markers to evaluate the severity of atherosclerotic progression as a function of stenotic length.