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Shepard L, Sommer K, Izzo R, Podgorsak A, Wilson M, Said Z, Rybicki FJ, Mitsouras D, Rudin S, Angel E, Ionita CN. Initial Simulated FFR Investigation Using Flow Measurements in Patient-specific 3D Printed Coronary Phantoms. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2017. [PMID: 28649159 DOI: 10.1117/12.2253889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Accurate patient-specific phantoms for device testing or endovascular treatment planning can be 3D printed. We expand the applicability of this approach for cardiovascular disease, in particular, for CT-geometry derived benchtop measurements of Fractional Flow Reserve, the reference standard for determination of significant individual coronary artery atherosclerotic lesions. MATERIALS AND METHODS Coronary CT Angiography (CTA) images during a single heartbeat were acquired with a 320×0.5mm detector row scanner (Toshiba Aquilion ONE). These coronary CTA images were used to create 4 patient-specific cardiovascular models with various grades of stenosis: severe, <75% (n=1); moderate, 50-70% (n=1); and mild, <50% (n=2). DICOM volumetric images were segmented using a 3D workstation (Vitrea, Vital Images); the output was used to generate STL files (using AutoDesk Meshmixer), and further processed to create 3D printable geometries for flow experiments. Multi-material printed models (Stratasys Connex3) were connected to a programmable pulsatile pump, and the pressure was measured proximal and distal to the stenosis using pressure transducers. Compliance chambers were used before and after the model to modulate the pressure wave. A flow sensor was used to ensure flow rates within physiological reported values. RESULTS 3D model based FFR measurements correlated well with stenosis severity. FFR measurements for each stenosis grade were: 0.8 severe, 0.7 moderate and 0.88 mild. CONCLUSIONS 3D printed models of patient-specific coronary arteries allows for accurate benchtop diagnosis of FFR. This approach can be used as a future diagnostic tool or for testing CT image-based FFR methods.
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Affiliation(s)
- Lauren Shepard
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY
| | - Kelsey Sommer
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY
| | - Richard Izzo
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY.,The Jacobs Institute, Buffalo, NY
| | - Alexander Podgorsak
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY
| | - Michael Wilson
- Interventional Cardiology, University at Buffalo Medicine, UBMD, Buffalo, NY
| | - Zaid Said
- Interventional Cardiology, University at Buffalo Medicine, UBMD, Buffalo, NY
| | - Frank J Rybicki
- The Ottawa Hospital Research Institute and the Department of Radiology, University of Ottawa, Ottawa, ON, CA
| | | | - Stephen Rudin
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY
| | - Erin Angel
- Toshiba American Medical Systems, Tustin, CA
| | - Ciprian N Ionita
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Toshiba Stroke and Vascular Research Center, Buffalo, NY
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