Experimental Bench for Hemodynamic Study of Coronary Artery with Serial Stenoses: Fractional Flow Reserve Assessment

R Coppel,Al Gomez,G Finet,M Mauro,Ri Pettigrew,J Ohayon,M Lagache

doi:10.1080/10255842.2017.1382853

Abstract

Highlights

The measurement of Fractional Flow Reserve (FFR) becomes essential for an interventional cardiologist to decide whether or not an angioplasty or stenting procedure needs to be performed on his patient
The global FFRg is observed when introducing a second stenosis, the intermediate FFRi tends to increase slightly. These preliminary results are promising and validate the hemodynamic bench which will be used in the near future: 1) to highlight the existing relationships between the FFR amplitudes and geometrical parameters S1, S2 and distance separating the two lesions (Dss), 2) to mimic complex situations of coronary branches with several stenosis, and, 3) to test the hemodynamic perturbations induced by the presence of stents
Before each experiment the catheter was re-filled with water in order to avoid bubbles formation

Summary

Introduction

The measurement of Fractional Flow Reserve (FFR) becomes essential for an interventional cardiologist to decide whether or not an angioplasty or stenting procedure needs to be performed on his patient. The FFR is an invasive technique used in clinical routine for evaluating stenosis severity and functional significance of the coronary artery disease. FFR is calculated as the ratio of the distal trans-stenotic pressure to the proximal coronary or aortic pressure during induced hyperemia. Experimental, animal and clinical studies have demonstrated the usefulness of measuring FFR to assess the hemodynamic significance of two serial stenoses (Pijls et al 2000; D’Souza et al 2014). The effects of the distance separating the two lesions (Dss) and the combined severity of the two serial stenoses (S1, S2) on the global and intermediate FFR amplitudes remain unclear. The aim of this study was to develop an experimental hemodynamic bench to elucidate the influences of such geometrical parameters on the FFR assessment. The present work was focused on the influence of the severity of S1 and S2

Objectives

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Conclusion