Impact of Pressure Guidewire on Model-Based FFR Prediction

Area of Science:

• Cardiovascular imaging and hemodynamics
• Computational fluid dynamics (CFD)
• Medical device simulation

Background:

• Fractional Flow Reserve (FFR) invasively assesses coronary artery stenosis severity using pressure guidewires under hyperemia.
• Minimizing invasive risks and costs has driven interest in non-invasive, simulation-based FFR methods using CT angiography (CCTA).
• Existing CCTA-derived FFR models often overlook the guidewire's influence on flow dynamics.

Purpose of the Study:

• To quantify the impact of including a pressure guidewire in CCTA-derived FFR models.
• To evaluate how guidewire presence affects simulated pressure gradients and FFR predictions.

Main Methods:

• A CCTA-derived FFR model was utilized for patient-specific simulations.
• Simulations were performed with and without the pressure guidewire for 18 patients with suspected stable coronary artery disease (CAD).

Main Results:

• The inclusion of the pressure guidewire tended to predict lower FFR values across simulations.
• FFR reduction due to the guidewire was more significant in severe stenoses compared to moderate ones.

Conclusions:

• The pressure guidewire's influence on FFR prediction is most clinically relevant for intermediate coronary artery stenoses.
• Accounting for the guidewire in CFD models may refine FFR assessment for intermediate lesions.