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Session: Poster session II
Session starts: Thursday 24 January, 16:00

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Frank Gijsen ()
Hans Schuurbiers ()
Alina van der Giessen ()
Anton van der Steen ()
Jolanda Wentzel ()

Abstract:
Background: Heterogeneity in plaque composition in human coronary artery bifurcations is associated with blood flow induced shear stress. To compute shear stress distribution in human coronary arteries, we need 3D lumen data. We investigated two new procedures to generate 3D lumen data and combined the 3D reconstructions with computational fluid dynamics to study the relationship between shear stress and wall thickness in vivo. Methods: We imaged 10 patients with multislice computer tomography (MSCT) and intravascular ultrasound (IVUS). The 3D reconstruction of the main branch was based on the fusion of MSCT and IVUS [1]. The proximal part of side branch was reconstructed using IVUS data or MSCT data, resulting in two different reconstructions of the bifurcation region. The distal part of the side branch was based on MSCT data alone. The reconstructed lumen was combined with CFD to determine the shear stress [2]. Low and high shear stress regions were defined and shear stress patterns in the bifurcation regions were related to wall thickness values from derived IVUS. Results: The geometrical features of the bifurcation region for the two reconstruction procedures did not reveal appreciable differences. The shear stress maps however, showed differences between the reconstruction procedures: both the low and high shear stress regions in the bifurcation only showed an overlap of approximately 75%. The average wall thickness in the low and the high shear stress regions was not different for the two reconstruction procedures. The relationship between shear stress and wall thickness was not influenced by the reconstruction procedure. An inverse relationship between shear stress and wall thickness, which one might expect in these mildly diseased bifurcations, was observed in 3 out of 10 bifurcations. Conclusion: Reconstruction of the side branch with MSCT data alone is an adequate technique to study shear stress and wall thickness in the bifurcation region. The reconstruction procedure can be applied to further investigate the effect of shear stress on the progression atherosclerosis in coronary bifurcations. REFERENCES [1] Van der Giessen et al., Int.J. Cardiovasc Imaging, vol.26(7), pp. 78196, (2010). [2] Gijsen et al., Journal of Biomechannics, vol. 40(11), pp. 2349-57, (2007).