Catheter obstruction effect on pulsatile flow rate-pressure drop during coronary angioplasty

The coupling of computational hemodynamics to measured translesional mean pressure gradients with an angioplasty catheter in human coronary stenoses was evaluated. A narrowed flow cross section with the catheter present effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angioplasty; thus elevating the pressure gradient and reducing blood pow during the measurements. For resting conditions with the catheter present, flow was believed to be about 40 percent of normal basal flow in the absence of the catheter, and for hyperemia, about 20 percent of elevated flow in the patient group. The computations indicated that the velocity field was viscous dominated and quasi-steady with negligible phase lag in the Delta p(t) - (u) over bar(t) relation during the cardiac cycle at the lower hydraulic Reynolds numbers and frequency parameter. Hemodynamic interactions with smaller catheter-based pressure sensors evolving in clinical use require subsequent study since artifactually elevated translesional pressure gradients can occur during measurements with current angioplasty catheters.