A geometry-based model for non-invasive estimation of pressure gradients over iliac artery stenoses

S.G.H. Heinen (Corresponding author), D.A.F. van den Heuvel, J.P.P.M. de Vries, F.N. van de Vosse, T. Delhaas, W. Huberts

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The aim of this study was to develop and verify a model that provides an accurate estimation of the trans-lesion hyperemic pressure gradient in iliac artery stenoses in seconds by only using patient-specific geometric properties obtained from 3-dimensional rotational angiography (3DRA). Twenty-one patients with symptomatic peripheral arterial disease (PAD), iliac artery stenoses and an ultrasound based peak systolic velocity ratio between 2.5 and 5.0 underwent 3DRA and intra-arterial pressure measurements under hyperemic conditions. For each lesion, geometric properties were extracted from the 3DRA images using quantitative vascular analysis software. Hyperemic blood flow was estimated based on stenosis geometry using an empirical relation. The geometrical properties and hyperemic flow were used to estimate the pressure gradient by means of the geometry-based model. The predicted pressure gradients were compared with in vivo measured intra-arterial pressure measurements performed under hyperemic conditions. The developed geometry-based model showed good agreement with the measured hyperemic pressure gradients resulting in a concordance correlation coefficient of 0.86. The mean bias ± 2SD between the geometry-based model and in vivo measurements was comparable to results found by evaluating the actual computational fluid dynamics model (−1.0 ± 14.7 mmHg vs −0.9 ± 12.7 mmHg). The developed model estimates the trans-lesional pressure gradient in seconds without the need for an additional computational fluid dynamics software package. The results justify further study to assess the potential use of a geometry-based model approach to estimate pressure gradient on non-invasive CTA or MRA, thereby reducing the need for diagnostic angiography in patients suffering from PAD.

LanguageEnglish
Pages67-75
JournalJournal of Biomechanics
Volume92
Early online date24 May 2019
DOIs
StatePublished - 19 Jul 2019

Fingerprint

Iliac Artery
Pressure gradient
Pathologic Constriction
Angiography
Pressure
Geometry
Peripheral Arterial Disease
Hydrodynamics
Pressure measurement
Arterial Pressure
Computational fluid dynamics
Software
Software packages
Blood Vessels
Dynamic models
Blood
Ultrasonics

Keywords

  • Angiography
  • Blood pressure measurement
  • Diagnostic method
  • Peripheral artery disease
  • Stenosis

Cite this

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title = "A geometry-based model for non-invasive estimation of pressure gradients over iliac artery stenoses",
abstract = "The aim of this study was to develop and verify a model that provides an accurate estimation of the trans-lesion hyperemic pressure gradient in iliac artery stenoses in seconds by only using patient-specific geometric properties obtained from 3-dimensional rotational angiography (3DRA). Twenty-one patients with symptomatic peripheral arterial disease (PAD), iliac artery stenoses and an ultrasound based peak systolic velocity ratio between 2.5 and 5.0 underwent 3DRA and intra-arterial pressure measurements under hyperemic conditions. For each lesion, geometric properties were extracted from the 3DRA images using quantitative vascular analysis software. Hyperemic blood flow was estimated based on stenosis geometry using an empirical relation. The geometrical properties and hyperemic flow were used to estimate the pressure gradient by means of the geometry-based model. The predicted pressure gradients were compared with in vivo measured intra-arterial pressure measurements performed under hyperemic conditions. The developed geometry-based model showed good agreement with the measured hyperemic pressure gradients resulting in a concordance correlation coefficient of 0.86. The mean bias ± 2SD between the geometry-based model and in vivo measurements was comparable to results found by evaluating the actual computational fluid dynamics model (−1.0 ± 14.7 mmHg vs −0.9 ± 12.7 mmHg). The developed model estimates the trans-lesional pressure gradient in seconds without the need for an additional computational fluid dynamics software package. The results justify further study to assess the potential use of a geometry-based model approach to estimate pressure gradient on non-invasive CTA or MRA, thereby reducing the need for diagnostic angiography in patients suffering from PAD.",
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A geometry-based model for non-invasive estimation of pressure gradients over iliac artery stenoses. / Heinen, S.G.H. (Corresponding author); van den Heuvel, D.A.F.; de Vries, J.P.P.M.; van de Vosse, F.N.; Delhaas, T.; Huberts, W.

In: Journal of Biomechanics, Vol. 92, 19.07.2019, p. 67-75.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Heinen,S.G.H.

AU - van den Heuvel,D.A.F.

AU - de Vries,J.P.P.M.

AU - van de Vosse,F.N.

AU - Delhaas,T.

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N2 - The aim of this study was to develop and verify a model that provides an accurate estimation of the trans-lesion hyperemic pressure gradient in iliac artery stenoses in seconds by only using patient-specific geometric properties obtained from 3-dimensional rotational angiography (3DRA). Twenty-one patients with symptomatic peripheral arterial disease (PAD), iliac artery stenoses and an ultrasound based peak systolic velocity ratio between 2.5 and 5.0 underwent 3DRA and intra-arterial pressure measurements under hyperemic conditions. For each lesion, geometric properties were extracted from the 3DRA images using quantitative vascular analysis software. Hyperemic blood flow was estimated based on stenosis geometry using an empirical relation. The geometrical properties and hyperemic flow were used to estimate the pressure gradient by means of the geometry-based model. The predicted pressure gradients were compared with in vivo measured intra-arterial pressure measurements performed under hyperemic conditions. The developed geometry-based model showed good agreement with the measured hyperemic pressure gradients resulting in a concordance correlation coefficient of 0.86. The mean bias ± 2SD between the geometry-based model and in vivo measurements was comparable to results found by evaluating the actual computational fluid dynamics model (−1.0 ± 14.7 mmHg vs −0.9 ± 12.7 mmHg). The developed model estimates the trans-lesional pressure gradient in seconds without the need for an additional computational fluid dynamics software package. The results justify further study to assess the potential use of a geometry-based model approach to estimate pressure gradient on non-invasive CTA or MRA, thereby reducing the need for diagnostic angiography in patients suffering from PAD.

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