Computational system for three-dimensional reconstruction of coronary vessels from intravascular ultrasound (IVUS) and orthogonal angiography (AX/Ort).

Employing IVUS images and AX/Ort images to add lacking spatial information in the intrinsic coordinates of the IVUS study in order to complete the description of the vessel under study system, the computational modeling developed in 5.1.1, 5.1.2 and 5.1.5 allows the three-dimensional high-quality computational reconstruction of the patients arterial vessels, providing additional information on mechanical behavior and consequent stability of atheroma to perform custom computational hemodynamic studies with patient-specific anatomical features.

Impact

The information that physicians obtain from IVUS and AX/Ort images regarding the severity of a given stenosis and the atheroma plaques behavior are not functional, leading to false positives. Those are responsible for high operating costs related to angioplasty and implementation of stents. The same images integrated with scientific computing would allow to reduce false positives, contributing thus to a higher life quality of patients and a significant cost reduction.

Methodologies for testing the computational system

Routine IVUS exams in both clinics of Incor (HC, FM-USP, SP) and ICES (HUCFF, FM-UFRJ, RJ) will be used together with synchronized ECG readings. Contrast-enhanced angiographic images will be acquired in two orthogonal positions in the presence of the IVUS catheter and the transducer at the distal site.

Specifications and results to be provided by the computational system

• Computational characterization of the patients heart rate and its comparison with the ECG results.
• Elimination of artifacts in the image caused by axial, longitudinal and rotation movements induced in the transducer (IVUS) by the deformation of the heart during the cardiac cycle.
• Reconstruction in the IVUS’ intrinsic coordinates of the lumen and the arterial wall with characterization of atheromatous plaques. Consequent possibility to identify fibrous, fibro-lipidm and necrotic tissues, as well as calcifications.
• Three-dimensional reconstruction (real coordinates) of the arteries under study and its validation against reconstructions via CT scans to be considered as the gold standard.
• In vivo characterization of mechanical properties and stability of atheroma.