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Influence of Multiple Stenoses on Echo-Doppler Functional Diagnosis of Peripheral Arterial Disease: A Numerical and Experimental Study

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The objective of this paper was to evaluate the ability of the peak systolic velocity ratio (PSVR) and pressure drop (ΔP) to detect and grade multiple stenoses in lower limb mimicking arteries. Numerical simulations and experiments in vascular phantoms allowing ultrasound duplex scanning and pressure measurements were used to investigate simple and double stenotic arterial segments. Inter-stenotic distance, severity of the distal stenosis, flow rate and flow profile (steady or pulsatile) were the tested parameters. The three-dimensional simulations considered the turbulent two-equation Wilcox model. Agreements were observed between the experimental and numerical results for ΔP and PSVR. The maximum PSVR along the artery was shown to be mainly influenced by the severity of the most important stenosis. However, mutual interactions of both stenoses on hemodynamics were noted. By using the clinical PSVR threshold used to diagnose critical lesions (PSVR ≥ 2), its longitudinal evolution along the artery poorly reflected the length of the lesion or the impact of surrounding stenoses. This investigation confirms the interaction between adjacent stenoses on hemodynamics and its impact on the Doppler ultrasound index PSVR.

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ACKNOWLEDGMENTS

This work was supported by a merit fellowship for post-doctoral research of the Quebec Ministry of Education (to C.B.), a studentship from the Natural Sciences and Engineering Research Council of Canada (to. B.L.), and a grant from the Canadian Institutes of Health Research (#MOP-53244 to G.C., L.G.D., G.S.). Drs. Soulez and Cloutier are respectively recipient of a clinical research scholarship award and of a national scientist award from the Fonds de la Recherche en Santé du Québec. Dr. Bertolotti performed this work at the Institut de Recherches Cliniques of Montreal, and then with the Équipe Biomécanique Cardiovasculaire, EGIM, at the C.N.R.S. (I.R.P.H.E.) UMR 6594, Marseille, France. The authors acknowledge Philips Medical System (Dr. Helen Routh) for the loan of the ultrasound system used in this study.

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Authors and Affiliations

  1. Laboratory of Biomedical Engineering, Institut de Recherches Cliniques de Montréal, Montréal, Québec,, Canada

    Christine Bertolotti, Brigitte Lamontagne & Louis-Gilles Durand

  2. Laboratory of Biorheology and Medical Ultrasonics, Research Center, Centre hospitalier de l’Université de Montréal, Montréal, Québec,, Canada

    Zhao Qin, Brigitte Lamontagne & Guy Cloutier Eng., Ph.D. (Director)

  3. Department of Interventional Radiology, Centre hospitalier de l’Université de Montréal, Montréal, Québec,, Canada

    Gilles Soulez

  4. Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montréal, Québec,, Canada

    Gilles Soulez & Guy Cloutier Eng., Ph.D. (Director)

  5. Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital, Pavilion J.A. de Sève (room Y-1619), 2099 Alexandre de Sève, Montréal, Québec, H2L 2W5, Canada

    Guy Cloutier Eng., Ph.D. (Director)

  6. Institute of Biomedical Engineering, Université Montréal, Montél, Québec, Canada

    Guy Cloutier Eng., Ph.D. (Director)

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  1. Christine Bertolotti
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  2. Zhao Qin
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  3. Brigitte Lamontagne
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  4. Louis-Gilles Durand
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  5. Gilles Soulez
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  6. Guy Cloutier Eng., Ph.D.
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Correspondence to Guy Cloutier Eng., Ph.D..

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Bertolotti, C., Qin, Z., Lamontagne, B. et al. Influence of Multiple Stenoses on Echo-Doppler Functional Diagnosis of Peripheral Arterial Disease: A Numerical and Experimental Study. Ann Biomed Eng 34, 564–574 (2006). https://doi.org/10.1007/s10439-005-9071-7

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  • DOI: https://doi.org/10.1007/s10439-005-9071-7

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