Catheter-induced errors in pressure measurements in vessels: an in-vitro and numerical study.
Catheter-induced errors in pressure measurements in vessels: an in-vitro and numerical study.
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DOI：
10.1109/tbme.2014.2308594
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Smith NP
中科院分区：
文献类型：
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作者：
de Vecchi A;Clough RE;Gaddum NR;Rutten MC;Lamata P;Schaeffter T;Nordsletten DA;Smith NP
准确测量血压很重要，因为它是心血管疾病的生物标志物。诊断性导管插入术通常用于血管中的压力采集，尽管会出现显著的测量误差。为了研究这些误差，本研究比较了使用两种不同的技术在体外和数值模拟的压力测量。使用6 F充液导管和0.014”压力导丝在脉动流体模中采集压力，这被认为是当前的金标准。还进行了有和没有导管的实验装置的数值模拟。尽管导管-血管半径比较低，但与导丝相比，导管迹线显示出24%的峰值收缩压高估。数值模型复制了该差异，并表明高估的原因是由于导管的存在而导致的流动阻力增加。此外，在导丝中观察到的较高频率压力振荡和导管中不存在数值数据，导致后一种模式的脉搏波速度高估。这些结果表明，即使半径比在临床实践中被认为是可接受的，导管几何形状也会在峰值压力和波形形状方面产生显著的测量偏倚。导丝允许更准确的压力量化，与无导管的数值模型一致。
Accurate measurement of blood pressure is important because it is a biomarker for cardiovascular disease. Diagnostic catheterization is routinely used for pressure acquisition in vessels despite being subject to significant measurement errors. To investigate these errors, this study compares pressure measurement using two different techniques in vitro and numerical simulations. Pressure was acquired in a pulsatile flow phantom using a 6F fluid-filled catheter and a 0.014” pressure wire, which is considered the current gold standard. Numerical simulations of the experimental set-up with and without a catheter were also performed. Despite the low catheter-to-vessel radius ratio, the catheter traces showed a 24% peak systolic pressure overestimation compared to the wire. The numerical models replicated this difference and indicated the cause for overestimation was the increased flow resistance due to the presence of the catheter. Further, the higher frequency pressure oscillations observed in the wire and numerical data were absent in the catheter, resulting in an overestimation of the pulse wave velocity with the latter modality. These results show that catheter geometry produces significant measurement bias in both the peak pressure and the waveform shape even with radius ratios considered acceptable in clinical practice. The wire allows for more accurate pressure quantification, in agreement with the numerical model without a catheter.