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The effect of coronary bifurcation and blood flow modelling in prediction of atherosclerotic plaque development: a Serial Computed Tomographic Coronary Angiographic study.

Research paper by Antonis A Sakellarios, Christos V CV Bourantas, Stella-Lida SL Papadopoulou, Pieter H PH Kitslaar, Chrysafios C Girasis, Gregg W GW Stone, Johan H C JHC Reiber, Lampros K LK Michalis, Patrick W PW Serruys, Pim J PJ de Feyter, Hector M HM Garcia-Garcia, Dimitrios I DI Fotiadis

Indexed on: 14 Jun '17Published on: 14 Jun '17Published in: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology



Abstract

Examine the effect of the daughter branches to the haemodynamics and the potential prediction of atherosclerotic plaque development as well as the best flow division model for accurate blood flow modelling.In this study, we analysed computed tomographic coronary angiography retrospective data portraying 17 coronary artery bifurcations in 15 patients recruited in the PROSPECT MSCT study. The baseline and three year follow-up imaging data were used to reconstruct coronary artery anatomy and in the baseline models blood flow simulations was performed using three flow division approaches: stress-free, Murray's law and Doriot's law. Blood flow simulation was also performed neglecting the daughter branch. The association between ESS estimated in models that incorporated the daughter branches and lumen reduction is higher than the cases where the side branch is neglected. Murray's law provides the most accurate results when comparing the different division flow models. More specifically, low ESS is predictor of significant lumen reduction (P=0.007), plaque burden increase (P=0.0006) and necrotic core change (P=0.025).The ESS distribution in coronary models including the daughter branches and based on the calculations implementing the Murray's Law allows more accurate prediction of atherosclerotic evolution than the ESS estimated in models including only the main vessel.

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