Using maths to assess blocked arteries

In the near future, heart specialists will be using virtual devices based on mathematics and supercomputing to predict artery blockages before they happen.

Cardiologists already have an armoury of catheter-mounted tools they use to probe blockages in our arteries, from tiny cameras that read injected dyes, to lasers that produce high-resolution 3D images.

Professor Peter Barlis and Associate Professor Andrew MacIsaac use Optical Coherence Tomography (OCT) during a stent procedure. Video: Paul Burston/University of Melbourne

But researchers at the University of Melbourne have now used mathematical modelling to successfully calculate how badly a blockage is impeding the flow of blood, using the images already gathered from catheters regularly inserted into arteries. It replaces the need for inserting a physical pressure wire into an artery to measure blood pressure loss around a blockage.

Using maths as a “virtual pressure wire” like this isn’t new, but it is the first time it has been used in conjunction with high-resolution laser imaging taken from inside an artery, making it potentially much more accurate than previous modelling. The resulting highly detailed information also opens the way for using this modelling to prevent blockages in the first place, by assessing whether the shape of an artery makes it prone to fat and cholesterol build up. It could also be used to model the precise type of stent that is best suited to clearing a blockage.

Predicting problems

The modelled “virtual pressure wire” inside the artery showing the varied Fractional Flow Reserve (FFR) or blood pressure readings along the course of the artery. Picture: Supplied

“Arteries are very complicated geometrically, but if we can model how that affects fluid flow and turbulence within them we can then identify places where the fluid is slowing and is therefore at higher risk of developing blockages from deposited fats, cholesterol and calcium,” says Professor Peter Barlis, cardiologist and academic researcher based at St Vincent’s Hospital Melbourne, Northern Health, and the University of Melbourne.

“That could allow us to predict where patients may develop problems in the future and intervene early with perhaps medication or new therapies that can prevent future deterioration and complications.”

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