Catheter-induced errors in pressure measurements in vessels: An in-vitro and numerical study

A. De Vecchi, R.E. Clough, N.R. Gaddum, M.C.M. Rutten, P. Lamata, T. Schaeffter, D.A. Nordsletten, N.P. Smith

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Abstract

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.

Original languageEnglish
Article number6748872
Pages (from-to)1844-1850
Number of pages7
JournalIEEE Transactions on Biomedical Engineering
Volume61
Issue number6
DOIs
Publication statusPublished - 2014

Fingerprint

Catheters
Pressure measurement
Wire
Numerical models
Pulsatile flow
Blood pressure
Computer simulation
Biomarkers
Measurement errors
Fluids
Geometry

Keywords

  • Arterial blood pressure
  • catheterization
  • computational fluid dynamics
  • in vitro
  • medical signal detection
  • pressure measurement
  • pulse wave analysis

Cite this

De Vecchi, A., Clough, R. E., Gaddum, N. R., Rutten, M. C. M., Lamata, P., Schaeffter, T., ... Smith, N. P. (2014). Catheter-induced errors in pressure measurements in vessels: An in-vitro and numerical study. IEEE Transactions on Biomedical Engineering, 61(6), 1844-1850. [6748872]. https://doi.org/10.1109/TBME.2014.2308594
De Vecchi, A. ; Clough, R.E. ; Gaddum, N.R. ; Rutten, M.C.M. ; Lamata, P. ; Schaeffter, T. ; Nordsletten, D.A. ; Smith, N.P. / Catheter-induced errors in pressure measurements in vessels : An in-vitro and numerical study. In: IEEE Transactions on Biomedical Engineering. 2014 ; Vol. 61, No. 6. pp. 1844-1850.
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title = "Catheter-induced errors in pressure measurements in vessels: An in-vitro and numerical study",
abstract = "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.",
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De Vecchi, A, Clough, RE, Gaddum, NR, Rutten, MCM, Lamata, P, Schaeffter, T, Nordsletten, DA & Smith, NP 2014, 'Catheter-induced errors in pressure measurements in vessels: An in-vitro and numerical study', IEEE Transactions on Biomedical Engineering, vol. 61, no. 6, 6748872, pp. 1844-1850. https://doi.org/10.1109/TBME.2014.2308594

Catheter-induced errors in pressure measurements in vessels : An in-vitro and numerical study. / De Vecchi, A.; Clough, R.E.; Gaddum, N.R.; Rutten, M.C.M.; Lamata, P.; Schaeffter, T.; Nordsletten, D.A.; Smith, N.P.

In: IEEE Transactions on Biomedical Engineering, Vol. 61, No. 6, 6748872, 2014, p. 1844-1850.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Catheter-induced errors in pressure measurements in vessels

T2 - An in-vitro and numerical study

AU - De Vecchi, A.

AU - Clough, R.E.

AU - Gaddum, N.R.

AU - Rutten, M.C.M.

AU - Lamata, P.

AU - Schaeffter, T.

AU - Nordsletten, D.A.

AU - Smith, N.P.

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

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KW - computational fluid dynamics

KW - in vitro

KW - medical signal detection

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