Research and Clinical Applications of Biomechanical Analysis in Optimization of Coronary Interventions

Abstract

Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. It is the disease of the blood vessels supplying the heart muscle. The fatty plaques built within the walls of the coronary arteries might rupture, creating a thrombus, thereby blocking the entire flow through the vessel, which is followed by a heart attack. Patients who suffer from CAD with documented ischemia are predominately sent to the catheterization laboratory for an invasive procedure (PCI, or percutaneous coronary intervention) to open the vessel by the placement of a “stent” as a scaffolding device to release from ischemia. Identifying the culplit lesions that cause the actual ischemia is crucial for PCI optimization. It has been shown in many clinical trials that the integration of coronary imaging and physiology is better in guiding PCI compared to imaging alone. Over the past years, we have developed approaches to derive coronary physiological data using image reconstruction and biomechanical analysis, thus realizing seamless co-registration between imaging and physiology without using extra invasive devices to measure coronary physiology. Some of these approaches are being transferred into clinical applications that have potential to increase the utility of physiological assessment in patients with CAD. In this talk, I will present these activities and our efforts in developing practical solutions for tailored treatment strategies.