A new noninvasive and patient-specific hemodynamic index for the severity of renal stenosis and outcome of interventional treatment

dc.contributor.authorYu, Huidan
dc.contributor.authorKhan, Monsurul
dc.contributor.authorWu, Hao
dc.contributor.authorDu, Xiaoping
dc.contributor.authorChen, Rou
dc.contributor.authorRollins, Dave M.
dc.contributor.authorFang, Xin
dc.contributor.authorLong, Jianyun
dc.contributor.authorXu, Chenke
dc.contributor.authorSawchuk, Alan P.
dc.contributor.departmentSurgery, School of Medicine
dc.date.accessioned2023-08-30T16:21:10Z
dc.date.available2023-08-30T16:21:10Z
dc.date.issued2022-07
dc.description.abstractRenal arterial stenosis (RAS) often causes renovascular hypertension, which may result in kidney failure and life-threatening consequences. Direct assessment of the hemodynamic severity of RAS has yet to be addressed. In this work, we present a computational concept to derive a new, noninvasive, and patient-specific index to assess the hemodynamic severity of RAS and predict the potential benefit to the patient from a stenting therapy. The hemodynamic index is derived from a functional relation between the translesional pressure indicator (TPI) and lumen volume reduction (S) through a parametric deterioration of the RAS. Our in-house computational platform, InVascular, for image-based computational hemodynamics is used to compute the TPI at given S. InVascular integrates unified computational modeling for both image processing and computational hemodynamics with graphic processing unit parallel computing technology. The TPI-S curve reveals a pair of thresholds of S indicating mild or severe RAS. The TPI at S = 0 represents the pressure improvement following a successful stenting therapy. Six patient cases with a total of 6 aortic and 12 renal arteries are studied. The computed blood pressure waveforms have good agreements with the in vivo measured ones and the systolic pressure is statistical equivalence to the in-vivo measurements with p < .001. Uncertainty quantification provides the reliability of the computed pressure through the corresponding 95% confidence interval. The severity assessments of RAS in four cases are consistent with the medical practice. The preliminary results inspire a more sophisticated investigation for real medical insights of the new index. This computational concept can be applied to other arterial stenoses such as iliac stenosis. Such a noninvasive and patient-specific hemodynamic index has the potential to aid in the clinical decision-making of interventional treatment with reduced medical cost and patient risks.
dc.eprint.versionFinal published version
dc.identifier.citationYu, H., Khan, M., Wu, H., Du, X., Chen, R., Rollins, D. M., Fang, X., Long, J., Xu, C., & Sawchuk, A. P. (2022). A new noninvasive and patient-specific hemodynamic index for the severity of renal stenosis and outcome of interventional treatment. International Journal for Numerical Methods in Biomedical Engineering, 38(7), e3611. https://doi.org/10.1002/cnm.3611
dc.identifier.other35509229
dc.identifier.urihttps://hdl.handle.net/1805/35246
dc.language.isoen
dc.publisherWiley
dc.relation.isversionof10.1002/cnm.3611
dc.relation.journalInternational Journal for Numerical Methods in Biomedical Engineering
dc.rightsAttribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.sourcePublisher
dc.subjectimage-based computational hemodynamics
dc.subjectnoninvasive and patient-specific assessment
dc.subjectrenal arterial stenosis
dc.subjectuncertainty quantification
dc.subjectvolumetric lattice Boltzmann method
dc.titleA new noninvasive and patient-specific hemodynamic index for the severity of renal stenosis and outcome of interventional treatment
dc.typeArticle
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