Reconstruction Of Coronary Arteries Research Articles

Human Umbilical Cord (HUC) Vessels: A Novel Substitute for Arterial Bypass Grafting

Human Umbilical Cord (HUC) Vessels: A Novel Substitute for Arterial Bypass Grafting

Evaluation of the Efficacy of Computed Tomographic Coronary Angiography in Assessing Coronary Artery Morphology and Physiology: Rationale and Study Design

Computed tomographic coronary angiography (CTCA) is a non-invasive imaging modality, which allows plaque burden and composition assessment and detection of plaque characteristics associated with increased vulnerability. In addition, CTCA-based coronary artery reconstruction enables local haemodynamic forces assessment, which regulate plaque formation and vascular inflammation and prediction of lesions that are prone to progress and cause events. However, the use of CTCA for vulnerable plaque detection in the clinical arena remains limited. To unlock the full potential of CTCA and enable its broad use, further work is needed to develop user-friendly processing tools that will allow fast and accurate analysis of CTCA, computational fluid dynamic modelling, and evaluation of the local haemodynamic forces. The present study aims to develop a seamless platform that will overcome the limitations of CTCA and enable fast and accurate evaluation of plaque morphology and physiology. We will analyse imaging data from 70 patients with coronary artery disease who will undergo state-of-the-art CTCA and near-infrared spectroscopy-intravascular ultrasound imaging and develop and train algorithms that will take advantage of the intravascular imaging data to optimise vessel segmentation and plaque characterisation. Furthermore, we will design an advanced module that will enable reconstruction of coronary artery anatomy from CTCA, blood flow simulation, shear stress estimation, and comprehensive visualisation of vessel pathophysiology. These advances are expected to facilitate the broad use of CTCA, not only for risk stratification but also for the evaluation of the effect of emerging therapies on plaque evolution.

Outcomes of Surgical Patch Angioplasty of The Coronary Artery for Diffuse Coronary Artery Disease.

Introduction Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD. Methods A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery. Results Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (P<0.05). There were no differences in graft blood flow and postoperative levels of cardiac markers between the two groups (P>0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (P>0.05).Conclusion Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.

Simultaneous Morphological and Flow Imaging Enabled by Megahertz Intravascular Doppler Optical Coherence Tomography.

We demonstrate three-dimensional intravascular flow imaging compatible with routine clinical image acquisition workflow by means of megahertz (MHz) intravascular Doppler Optical Coherence Tomography (OCT). The OCT system relies on a 1.1 mm diameter motorized imaging catheter and a 1.5 MHz Fourier Domain Mode Locked (FDML) laser. Using a post processing method to compensate the drift of the FDML laser output, we can resolve the Doppler phase shift between two adjoining OCT A-line datasets. By interpretation of the velocity field as measured around the zero phase shift, the flow direction at specific angles can be qualitatively estimated. Imaging experiments were carried out in phantoms, micro channels, and swine coronary artery in vitro at a speed of 600 frames/s. The MHz wavelength sweep rate of the OCT system allows us to directly investigate flow velocity of up to 37.5 cm/s while computationally expensive phase-unwrapping has to be applied to measure such high speed using conventional OCT system. The MHz sweep rate also enables a volumetric Doppler imaging even with a fast pullback at 40 mm/s. We present the first simultaneously recorded 3D morphological images and Doppler flow profiles. Flow pattern estimation and three-dimensional structural reconstruction of entire coronary artery are achieved using a single OCT pullback dataset.

Risk factors for the return of mitral insufficiency after coronary artery bypass graft and reconstruction of the mitral valve in patients with ischemic cardiomyopathy

Aim. This study aimed to compare the surgical correction results for isolated coronary artery bypass graft (CABG) and CABG in combination with mitral valve (MV) repair for moderate ischemic mitral insufficiency (IMI) in patients with ischemic cardiomyopathy and to identify the risk factors for MI return.Methods. This single-centre prospective study enrolled 76 patients with ischemic cardiomyopathy and moderate MI with a left ventricular ejection fraction &lt; 35% who did not undergo left ventricular reconstruction. The patients were treated with isolated CABG or CABG in combination with MV repair. The mean age of the patients was 57.5 ± 8.6 years (range, 30–75 years), and 90% were men. Isolated annuloplasty was used with a rigid support ring brand with a ring size of 26–30 mm to correct mitral insufficiency in the CABG + MV repair group.Results. We found that isolated CABG or CABG + MV repair in patients with ischemic heart disease and severe systolic left ventricular dysfunction does not result in significant decrease in the MI in the long term compared with that at baseline. However, the degree of MI after CABG + MV repair is lower than the initial values, unlike that after isolated CABG 12 months postoperatively. In the observation period, of up to 36 months, the MI degree after isolated CABG corresponds to the initial values. The determination of the predictors of IMI progression in ischemic cardiomyopathy enabled us to determine the threshold values of the performance indicators of MV repair, and the evaluation of Echo predictors for annuloplasty preoperatively help select the surgical treatment strategies for patients with ischemic cardiomyopathy and moderate MI.Conclusion. Correction of IMI in patients with ischemic cardiomyopathy does not increase the number of complications in the early postoperative period compared to isolated CABG (p = 0.015). After isolated CABG in patients with ischemic cardiomyopathy and moderate MI, progression of mitral regurgitation (grade 3 mitral regurgitation, initially 0%; after 12 months, 31%; after 36 months, 71%; p &lt; 0.001) is observed even with initially moderate changes in the geometry of the mitral valve.Received 6 December 2018. Revised 25 March 2019. Accepted 28 March 2019.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

Florida sleeve technique for a right sinus of Valsalva aneurysm: a case report

BackgroundFlorida sleeve technique was reported by Hess et al. as a new technique of valve sparing aortic root replacement without the requirement of entire aortic root wall resection and coronary artery reconstruction. We present a rare case of an unruptured aneurysm of the right sinus of Valsalva that was successfully treated with resection of the aneurysm and the Florida sleeve technique.Case presentationA 72-year-old man was admitted for the treatment of an unruptured aneurysm of the right sinus of Valsalva. Computed tomography showed an aneurysm of the right sinus of Valsalva measuring > 40 mm and protruding into the right ventricular outflow tract. The aneurysm dilated up to 5 mm per year, and the left sinus of Valsalva and non-coronary sinus of Valsalva also showed dilation, and he underwent resection of only the right sinus of Valsalva aneurysm and valve sparing aortic root replacement with the Florida sleeve technique.ConclusionsWe performed valve-sparing aortic root replacement with the Florida sleeve technique. It could reduce surgical risks and prevent a dilatation of the residual sinus of Valsalva through coverage with a graft for a long term.

Optical coherence tomography-based patient-specific coronary artery reconstruction and fluid-structure interaction simulation.

Plaque rupture is related to the mechanical stress it suffered. The value and distribution of the mechanical stress in plaque could help on assessing plaque vulnerability. To look into the stress conditions in the coronary artery, a patient-specific coronary model was created by using optical coherence tomography (OCT) and angiography imaging data. The reconstructed coronary model consisted of the structure of the lumen, the arterial wall and plaque components. Benefited by the high resolution of OCT, detailed structures such as the thin fibrous cap could be observed and built into the geometry. On this reconstructed coronary model, a fully coupled fluid-structure interaction (FSI) simulation was performed. The principle stress in coronary plaque and the wall shear stress (WSS) were analyzed. The FSI simulation results show that the cap thickness had a significant effect on the stress, and the principle stress at the thin cap area was more than double of those at the locations with a larger thickness. WSS is thought as an important parameter to assess the potentially dangerous areas of the atherosclerosis-prone (caused by low WSS) and the plaque rupture (high WSS). From the WSS plots of our FSI model, the area with abnormal WSS value was detected around the position where a lipid core existed. The FSI simulation results were compared with the results from the conventional structure-only and the computational fluid dynamics (CFD)-only computational models to quantify the difference between the three models. We found little difference in the principle stress results between the FSI and the structure-only model, but a significant difference between the FSI and the CFD-only model when looking into the WSS. The WSS values at the two observation spots from the CFD-only model were higher than the values from the FSI model by 17.95% and 22.66% in average, respectively. Furthermore, the FSI model detected more areas of low WSS, because the fluid domain could expand circumferentially when pressure loaded on the flexible arterial. This study suggests that OCT-based FSI model may be useful for plaque vulnerability assessment and it may be critical to perform the FSI simulation if an accurate WSS value is required.

A new method for the 3D reconstruction of coronary bifurcations pre and post the angioplasty procedure using the QCA.

The aim of this study is to propose a new semi-automated method for three-dimensional (3D) reconstruction of coronary bifurcations arteries using X-ray Coronary Angiographies (CA). Considering two monoplane angiographic views as the input data, the method is based on a four-step approach. In the first step, the image pre-processing and the vessel segmentation is performed. In the second step the 3D centerline is reconstructed by implementing the back-projection algorithm. In the third step, the lumen borders are reconstructed around the centerline to result to the fourth step, during which the 3D point cloud of the side branch is adjusted to the main branch, to produce the final 3D model of the coronary bifurcation artery. Imaging data from seven patients (pre and post-stenting) were reconstructed in the 3D space. The validation of the proposed methodology was based on the comparison of the 3D model with the 2D CA. Blood flow simulations were performed both for the vessels before and after the angioplasty procedure. Decreased Endothelial Shear Stress (ESS) values were observed for the vessels after the Percutaneous Transluminal Coronary Intervention (PTCI).

Automatic Segmentation and Reconstruction of Coronary Arteries Based on Sphere Model and Hessian Matrix using CCTA Images

Cardiovascular disease (CVD) is the most common cause of death in the world. Accurate coronary arteries segmentation is the basis for heart disease diagnose. But in coronary computed tomography angiography(CCTA) images, the complex structure of coronary vessels and the low contrast of thin vessels cause difficulty in coronary arteries segmentation. In this paper, an automatic segmentation algorithm is proposed to extract vessels from CCTA. Firstly, the hessian matrix is used to enhance vessels in CCTA images, and then, the moving sphere model we proposed is used to extract centerline of coronary arteries. Experimental results showed that the proposed model provides good-quality segmentation.

Three-dimensional evaluation of the spatial morphology of stented coronary artery segments in relation to restenosis

To investigate the correlations between the three-dimensional (3D) parameters of target coronary artery segments and restenosis after stent implantation. Sixty-four patients after single, cobalt chromium platform stent (27 BM stents and 37 DES) implantation were investigated retrospectively 12 ± 6 months after the index procedure. 3D coronary artery reconstruction was performed before and after the stent implantation using appropriate projections by a dedicated reconstruction software. The curve of the target segment was characterized by the ratio of the vessel length measured at midline (arc: A) and the distance between the edge points of the stent (chord: C): A/C ratio (ACr). Age, diabetes and hyperlipidaemia were taken into account for the statistical evaluation. 22 patients were diagnosed with ISR, while 42 patients without any restenosis served as controls. The two groups did not differ regarding major cardiovascular risk factors, proportion of the treated vessels or the type of stents. Higher initial ACr values were associated with greater straightening of the vessel curvature in all groups (p < 0.001). Significant negative correlations were found in cases of proximal or distal edge bending angles (p < 0.001). Pre-stent edge bending angles < 7° often showed an increase after the stent implantation, while in case of higher initial values, the bending angles generally decreased. Using multivariate logistic regression modelling we found that the pre-stent ACr was an independent predictor of in-stent restenosis (odds ratio for 1% increase of the ACr: 1.08; p = 0.012). Changes of angles at the stent edges following stent implantation correlate with the initial local bending angles. The ACr predispose to chronic shear stress in the vessel wall, which may contribute to the pathological intimal proliferation.

Reconstruction of anomalous left coronary artery from pulmonary artery in an adult patient: a case report

BackgroundAnomalous left coronary artery from the pulmonary artery is a congenital heart disease in which myocardial ischemia occurs within 1 year of birth. Adults have been reported to survive owing to the development of collateral perfusion from right coronary artery. In these cases, however, revascularization is necessary to prevent sudden cardiac death.Case presentationA 62-year-old female gradually started experiencing dyspnea during exercise. Coronary computed tomography revealed that the left coronary artery arose from the main pulmonary artery. The patient was subsequently diagnosed with adult-type, anomalous left coronary artery from the pulmonary artery. She underwent a surgery, in which a 6-mm vascular prosthesis was passed through the main pulmonary artery to anastomose the left coronary artery and ascending aorta.ConclusionOur reconstructive technique using vascular prosthesis is effective for anomalous left coronary artery from pulmonary artery in adults.

High Precision Implicit Modeling for Patient-Specific Coronary Arteries

High precision geometric reconstruction of patient-specific coronary arteries plays a crucial role in visual diagnosis, treatment decision-making, and the evaluation of the therapeutic effect of interventions in coronary artery diseases. It is also a fundamental task and a basic requirement in the numerical simulation of coronary blood flow dynamics. In this paper, a new implicit modeling technique for the geometric reconstruction of patient-specific coronary arteries has been developed. In the proposed method, the coronary arteries geometry is reconstructed segment by segment using radial basis functions with ellipsoid constraint from the point cloud obtained with a volumetric vascular image segmentation method, and the individually reconstructed coronary branches are then combined using a shape-preserving implicit blending operation to form a complete coronary artery surface. The experiment results and validations indicate that the reconstructed vascular shapes are of high smoothness and faithfulness.

On the Image-Based Non-Invasive Diagnosis of Cardiovascular Diseases

Cardiovascular diseases are the leading cause of human deaths worldwide. Traditional diagnostic tools of cardiovascular diseases are either based on 2D static medical images, or invasive, bringing troubles to both patients and doctors. Our team is committed to the development of image-based non-invasive diagnostic system for cardiovascular diseases. We have made progress mainly in the following areas: 1) 4D flow technology for heart and large blood vessels. According to MRI 4D Flow data, three-dimensional velocity fields within blood vessels were constructed. Divergence-fee smoothing (DFS) was proposed to eliminate the high frequency noise in the hemodynamic flow field, and make the smoothed velocity field to satisfy the divergence-free condition. The vascular wall shear stress, pressure and other physiological indicators were obtained, their accuracy can meet the need of clinical applications. 2) Accurate noninvasive diagnostic techniques for coronary arterial disease. According to coronary CTA imaging data, 3D reconstruction of coronary arteries was achieved coronary stenosis and plaque lesion were identified and analyzed. Coronary microcirculation was modeled using a 0d model; the coronary artery FFR were computed through the Fast FFR technique, which was based on the reduced-order computational fluid dynamics (CFD). The Fast FFR technique can compute the FFR within 5 minutes. Similar techniques have been used in the preoperative evaluation of intraluminal artery bypass. 3) In vitro evaluation of artificial heart valves and blood-contacting artificial organs. High-fidelity CFD and PIV technique were developed to study the flow field in the artificial heart valve and blood pumps. In vitro platform for experimentally and numerically evaluate the blood damage were also developed.

Comparison of Blood Flow in Normal and Plaque Coronary Models Using Numerical Simulation

In the present paper, simulation of blood flow in human heart is performed using angiography images of a healthy person. Computational fluid dynamics (CFD) is used as a vital tool to carry out the numerical simulation of many biomedical problems. Artery blockage is the most common cause of coronary artery disease. Blockage presence inside the artery breaks the continuity of blood supply to the other part of body. Therefore, 50% plaque is created in the left coronary artery to study the flow behavior of blood Three dimensional reconstruction of coronary artery has been performed using commercial image processing software MIMICS. Five inlet velocities 0.10, 0.20, 0.50, 0.70 and 0.80 m/s are taken corresponding to different flow condition of blood in human heart. . Velocity and Wall shear stress are computed and compared for the two geometrical models (Normal Vs. Blockage model). The CFD prediction of blood flow in coronary artery is useful for diagnosis, prognosis and prevention from coronary artery diseases (CAD).

Validation of right coronary artery lumen area from cardiac computed tomography against intravascular ultrasound

Quantification of coronary artery disease (CAD) from cardiac computed tomography angiography (CTA) is important both structurally (lumen area stenosis) and functionally (combined with computational fluid dynamics to determine fractional flow reserve) for assessment of ischemic stenosis and to guide treatment. Hence, it is important to have CTA image processing technique for segmentation and reconstruction of coronary arteries. In this study, we developed segmentation and reconstruction techniques, based on fast marching and Runge–Kutta methods for centerline extraction, and surface mesh generation. The accuracy of the reconstructed models was validated with direct intravascular ultrasound (IVUS) measurements in 1950 cross sections within 4 arteries. High correlation was found between CTA and IVUS measurements for lumen areas ( $$r=0.993$$ , $$p<0.001$$ ). Receiver-operating characteristic (ROC) curves showed excellent accuracies for detection of different cutoff values of cross-lumen area (5 $$\text {mm}^2$$ , 6 $$\text {mm}^2$$ , 7 $$\text {mm}^2$$ and 8 $$\text {mm}^2$$ , all ROC values >0.99). We conclude that our technique has sufficient accuracy for quantifying coronary lumen area. The accuracy and efficiency demonstrated that our approach can facilitate quantitative evaluation of coronary stenosis and potentially help in real-time assessment of CAD.

The midterm results of coronary endarterectomy in patients with diffuse coronary artery disease

BackgroundDiffuse coronary artery disease is a challenge for both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Coronary artery endarterectomy (CE) coupled with CABG is an alternative method to achieve complete revascularization. The mid- and long-term results of CE are largely questionable. The aim is to evaluate the early and mid-term graft patency of concomitant coronary artery endarterectomy and CABG.MethodsA total of 304 patients who had undergone concomitant CE and CABG for diffuse coronary artery disease were identified from our database. A total of 238 patients (1) with complete operative records, (2) with good graft flow during surgery, (3) who were discharged, (4) with a one-year/ three-year follow-up were included in our study. The follow-up information was obtained directly from our out-patient department and by telephone contact. The categorical and continuous values were analyzed by Chi Square test and student’s test respectively.ResultsCE was performed on 238 patients who represented a total of 269 target coronary vessels. The mean age of the patients was 67.8 ± 6.8 years old; male to female patient ratio was 170:68. The mean intensive care unit stay was 1.7 ± 8 days, and mean post-operative length of hospital stay was 11 ± 3 days. The average follow up time was 41.8 ± 21.4 months. At follow-up, the overall graft patency was 78.4% at one year and 69.8% at three years. The left coronary graft patency rate was significantly higher than the right coronary graft patency rate (87.4% vs 73.1% at one-year and 78.2% vs 64.8% at three years). There was no significant difference in graft patency rates between the on-pump CE + CABG vs off-pump CE + CABG groups at one year (80.0% vs 76.9%) and at three years (92.3% vs 91.7%). At the one-year follow up, 92.3% of grafts showed grade A patency in the on-pump group versus 91.7% in the off-pump group; 7.7% of grafts showed grade B patency in the on-pump group versus 8.3% in the off-pump group. At the three-year follow up, 80.6% of grafts showed grade A patency in the on-pump group versus 77.4% in the off-pump group; 19.4% of grafts showed grade B patency in the on-pump group versus 22.6% in the off -pump group. The Predictors of better graft patency are use of LIMA graft, CE on LAD, and intra-operative graft flow meter and PI.ConclusionsIn patients with diffuse coronary disease, CE is a safe and feasible technique for a select group of patients with excellent mid-term survival rates and graft patency rates. CE produces better overall results when performed on the LAD, and grafted over with the LIMA. Similar outcomes are obtained with both on-pump and off-pump surgery. For a select group of patients, coronary endarterectomy (CE) offers an alternative choice of coronary artery reconstruction and complete coronary revascularization.

Virtual Functional Assessment of Coronary Stenoses Using Intravascular Ultrasound Imaging: A Proof-of-Concept Pilot Study

We aimed to investigate the performance of virtual functional assessment of coronary stenoses using intravascular ultrasound (IVUS)-based three-dimensional (3D) coronary artery reconstruction against the invasively measured fractional flow reserve (FFR). Twenty-two (22) patients with either typical symptoms of stable angina or a positive stress test, who underwent IVUS and FFR, were included in this study. Five (5) patients presented FFR values lower than the 0.80 threshold, indicating ischaemia. IVUS-based 3D reconstruction and blood flow simulation were performed and the virtual functional assessment index (vFAI) was calculated. A strong correlation between IVUS-based vFAI and FFR was observed (Spearman correlation coefficient [rs]=0.88, p<0.0001). There was a small overestimation of the FFR by the IVUS-based vFAI (mean difference=0.0196±0.037; p=0.023 for difference from zero). All cases with haemodynamically significant stenoses (FFR≤0.8) were correctly categorised by the IVUS-based vFAI (vFAI≤0.8). The proposed approach allows the complete and comprehensive assessment of coronary stenoses providing anatomic and physiologic information, pre- and post-intervention, using only an IVUS catheter without the use of a pressure wire.

3D reconstruction of coronary arteries from 2D angiographic projections using non-uniform rational basis splines (NURBS) for accurate modelling of coronary stenoses.

ObjectiveAssessment of coronary stenosis severity is crucial in clinical practice. This study proposes a novel method to generate 3D models of stenotic coronary arteries, directly from 2D coronary images, and suitable for immediate assessment of the stenosis severity.MethodsFrom multiple 2D X-ray coronary arteriogram projections, 2D vessels were extracted. A 3D centreline was reconstructed as intersection of surfaces from corresponding branches. Next, 3D luminal contours were generated in a two-step process: first, a Non-Uniform Rational B-Spline (NURBS) circular contour was designed and, second, its control points were adjusted to interpolate computed 3D boundary points. Finally, a 3D surface was generated as an interpolation across the control points of the contours and used in the analysis of the severity of a lesion. To evaluate the method, we compared 3D reconstructed lesions with Optical Coherence Tomography (OCT), an invasive imaging modality that enables high-resolution endoluminal visualization of lesion anatomy.ResultsValidation was performed on routine clinical data. Analysis of paired cross-sectional area discrepancies indicated that the proposed method more closely represented OCT contours than conventional approaches in luminal surface reconstruction, with overall root-mean-square errors ranging from 0.213mm2 to 1.013mm2, and maximum error of 1.837mm2. Comparison of volume reduction due to a lesion with corresponding FFR measurement suggests that the method may help in estimating the physiological significance of a lesion.ConclusionThe algorithm accurately reconstructed 3D models of lesioned arteries and enabled quantitative assessment of stenoses. The proposed method has the potential to allow immediate analysis of the stenoses in clinical practice, thereby providing incremental diagnostic and prognostic information to guide treatments in real time and without the need for invasive techniques.

3D Coronary Artery Reconstruction by 2D Motion Compensation Based on Mutual Information

Background3D reconstruction of the coronary arteries can provide more information in the interventional surgery. Motion compensation is one kind of the 3D reconstruction method. MethodsWe propose a novel and complete 2D motion compensated reconstruction method. The main components include initial reconstruction, forward projection, registration and compensated reconstruction. We apply the mutual information (MI) and rigidity penalty (RP) as registration measure. The advanced adaptive stochastic gradient descent (ASGD) is adopted to optimize this cost function. We generate the maximum forward projection by the simplified distance driven (SDD) projector. The compensated reconstruction adopts the MAP iterative reconstruction algorithm which is based on L0 prior. ResultsComparing with the ECG-gating reconstruction and other reference method, the evaluation indicates that the proposed 2D motion compensation leads to a better 3D reconstruction for both the rest and stronger motion phases. The algorithm compensates the residual motion and reduces the artifact largely. As the gating window width increases, the overall image noise decreases and the contrast of the vessels improves. ConclusionsThe proposed method improved the 3D reconstruction quality and reduced the artifact level. The considerable improvement in the image quality results from motion compensation increases the clinical usability of 3D coronary artery.

3D reconstruction of coronary arteries and atherosclerotic plaques based on computed tomography angiography images

The purpose of this study is to present a new semi-automated methodology for three-dimensional (3D) reconstruction of coronary arteries and their plaque morphology using Computed Tomography Angiography (CTA) images. The methodology is summarized in seven stages: pre-processing of the acquired CTA images, extraction of the vessel tree centerline, estimation of a weight function for lumen, outer wall and calcified plaque, lumen segmentation, outer wall segmentation, plaque detection, and finally 3D surfaces construction. The methodology was evaluated using both expert manual annotations and estimations of a recently presented Intravascular Ultrasound (IVUS) reconstruction method. As far as the manual annotation validation process is concerned, the mean value of the comparison metrics for the 3D segmentation were 0.749 and 1.746 for the Dice coefficient and Hausdorff distance, respectively. On the other hand, the correlation coefficients for the degree of stenosis 1, the degree of stenosis 2, the plaque burden, the minimal lumen area and the minimal lumen diameter, when comparing the derived from the proposed methodology 3D models with the IVUS reconstructed models, were 0.79, 0.77, 0.75, 0.85, 0.81, respectively. The proposed methodology is an innovative approach for reconstruction of coronary arteries, since it provides 3D models of the lumen, the outer wall and the CP plaques, using the minimal user interaction. Its first implementation demonstrated that it provides an accurate reconstruction of coronary arteries and thus, it may have a wide clinical applicability