34 - "In silico models of coronary artery pathophysiology for clinical decision support"
Host:
Professor Frans N. van de Vosse
Eindhoven University of Technology
Abstract:
Obstructed coronary artery disease is one of the main causes of myocardial ischemia and can be treated by medication or by clinical interventions such as PCI (percutaneous coronary intervention) or CABG (coronary artery bypass grafting). In cases where the right decision how to intervene is not clear from X-ray or CT imaging of the obstruction, invasive (measured) fractional flow reserve (FFR), using a sensor equipped guidewire, is the “gold standard” for assessing the physiological significance of coronary artery disease during invasive coronary angiography. The FFR then is defined as the ratio between the time averaged pressure distal and proximal to the obstruction. Despite the fact that FFR-guided percutaneous coronary intervention improves patient outcomes and reduces stent insertion and cost, due to several practical and operator related factors, it is used in less than 10% of percutaneous coronary intervention procedures. Virtual fractional flow reserve (vFFR) using an in-silico model of the coronary artery blood flow in pathophysiological conditions has emerged as an attractive alternative to invasive FFR. In this webinar an overview of the development of the in-silico models and use for clinical decision making will be given. In addition the possible use for future in-silico clinical trials to optimize procedures and medical devices will be discussed in the context of the generated synthetic data collections using hybrid (mechanistic-data driven) models.
