Quantitative rapid image-based method for coronary artery blood flow and wall shear stress extraction

This paper shows that it is possible to quickly determine the velocity field of coronary blood flow and wall shear stress using a very fast image-based approach on a routine coronary angiogram, which is an alternative approach to reconstructing a target arterial model and performing time-consuming computational fluid dynamics simulations. The method analyzes two frames from a short contrast washout sequence acquired 0.1 s apart and applies a convection-dominant transport model to estimate local projected velocity and instantaneous projected wall shear stress. In four patients with stenoses in the middle third of the left anterior descending coronary artery, the peak wall shear stress within the stenotic segment showed a mean relative difference of 10.3% compared with a same-geometry two-dimensional ANSYS computational fluid dynamics reference. These results suggest that rapid image-only wall shear stress estimation may be used as an adjunctive hemodynamic assessment tool to provide additional information to clinicians when time is critical. However, further studies are still needed for broader validation and for evaluation at multiple time points during the cardiac cycle.