VALIDATION OF A DOPPLER GUIDE WIRE FOR INTRAVASCULAR MEASUREMENT OF CORONARY-ARTERY FLOW VELOCITY
VALIDATION OF A DOPPLER GUIDE WIRE FOR INTRAVASCULAR MEASUREMENT OF CORONARY-ARTERY FLOW VELOCITY
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DOI：
10.1161/01.cir.85.5.1899
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发表时间：
1992-05-01
期刊：
影响因子：
37.8
通讯作者：
SEGAL, J
中科院分区：
文献类型：
--
作者：
DOUCETTE, JW;CORL, PD;SEGAL, J
背景资料。改良的血管内超声多谱勒装置可辅助临床评价冠状动脉血流动力学。我们评估了一种新设备，该设备由集成在0.018英寸尖端的12兆赫压电换能器组成。目的：介绍一种灵活、可控制的血管成形术导丝。用脉动血流和在线电磁流量计在模型管中记录多普勒频谱。4根直管(内径0.79~4.76 mm)，频谱峰值速度(APV)的时间平均值与血流量(Q(EMF))呈线性相关(R2均大于或等于0.98)。用血管横截面积与平均血流速度的乘积计算多普勒定量血流估计值(Q(D))，平均血流速度估计为0.5xAPV。四管的Q(D)与Q(EMF)斜率接近1。APV在7.94 mm直管和弯曲节段的准确性较差。在4只犬中，左回旋支冠状动脉(LCx)从股动脉通过插管和直列式电磁流量计进行灌流。直径3.3~1.2 mm的近端和远端Lcx血管均可获得高质量的信号。APV与Q(EMF)呈线性关系(插管R2大于或等于0.99，Lcx近端R2=0.93~0.99，Lcx远端R2=0.86~0.99)。通过定量血管造影术计算Q(D)，以确定Lcx近端直径。所有狗的Q(D)对Q(EMF)的斜率在插管时为0.95，在Lcx近端为0.85。多普勒导丝测量小而直的冠状动脉中的相位流速模式和流速的线性变化。在冠状动脉造影术和血管成形术中，它应该有助于测量冠状动脉的时相血流速度。
Background. An improved intravascular ultrasonic Doppler device could aid the clinical assessment of coronary hemodynamics. We evaluated a new device consisting of a 12-MHz piezoelectric transducer integrated onto the tip of a 0.018-in. flexible, steerable angioplasty guide wire.Methods and Results. Doppler spectra were recorded in model tubes with pulsatile blood flow and in-line electromagnetic flowmeter. In four straight tubes (i.d., 0.79-4.76 mm), the time average of spectral peak velocity (APV) was linearly related to blood flow (Q(EMF)) (r2 greater-than-or-equal-to 0.98 for each tube). A Doppler-derived quantitative flow estimate (Q(D)) was calculated as the product of vessel cross-sectional area and mean velocity, with mean velocity estimated as 0.5 x APV. The slope of Q(D) versus Q(EMF) for the four tubes was near unity. APV was less accurate in a 7.94-mm straight tube and in tortuous segments. In four dogs, the left circumflex coronary artery (LCx) was perfused from the femoral artery via a cannula with in-line electromagnetic flowmeter. Good-quality signals were obtained in proximal and distal LCx vessels 3.3-1.2 mm in diameter. APV varied linearly with Q(EMF) (r2 greater-than-or-equal-to 0.99 in the cannula, r2 = 0.93-0.99 in proximal LCx, and r2 = 0.86-0.99 in distal LCx). Q(D) was calculated by quantitative angiography to determine proximal LCx diameter. For all dogs combined, the slope of Q(D) versus Q(EMF) was 0.95 in the cannula and 0.85 in the proximal LCx.Conclusions. The Doppler guide wire measures phasic flow velocity patterns and linearly tracks changes in flow rate in small, straight coronary arteries. It should facilitate measurement of phasic coronary flow velocity during coronary angiography and angioplasty.