Reversal of flow between serial bifurcation lesions: insights from computational fluid dynamic analysis in a population-based phantom model
EuroIntervention 2015;11:e1-e3 published online e-article September 2015. DOI: 10.4244/EIJV11I5A111
Peter Barlis1,2*, MBBS, PhD, FRACP, FACC, FESC; Eric K.W. Poon2, BEng, PhD; Vikas Thondapu1,2, MD; Maik J. Grundeken3, MD; Shengxian Tu4, PhD; Umair Hayat1, MBBS, FRACP; Andrew Ooi2, BEng, PhD; Stephen Moore5, BEng, PhD; Erhan Tenekecioglu6, MD; Joanna J. Wykrzykowska3, MD, PhD; Patrick W. Serruys7, MD, PhD, FACC, FESC
1. Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia; 2. Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, Vic
Bifurcation lesions remain a notoriously challenging proposition for the interventional cardiologist. Simple strategies have emerged as the general treatment of choice for several reasons but, to date, the interventional strategy often focuses only on the bifurcation in question. We demonstrate concepts arising from computational fluid dynamic (CFD) analysis that may question this approach.
Angiographic images were used to reconstruct a 3D phantom model of serial bifurcation lesions. Pulsatile CFD studies demonstrate several localised areas of flow recirculation in the healthy-appearing arterial segment between the bifurcations, causing broad exposure to physiologically significant low wall shear stress (WSS) (Figure 1A-1C, ...