Experimental Reproduction of Hemodynamic Index to Assess Severity of Arterial Stenoses: Implications for Revascularization Recommendations

Arterial stenosis, a prevalent medical condition characterized by the narrowing of an arterial lumen, hinders blood flow and can lead to life-threatening consequences like myocardial ischemia and ischemic stroke. The trans-stenotic pressure gradient (TSPG) is considered a key indicator of the hemodynamic significance of noncoronary arterial stenoses. However, its clinical application is limited due to challenges in noninvasively measuring distal and proximal pressure and the absence of standardized guidelines for assessing stenosis severity. To overcome these limitations, we recently introduced a new, noninvasive, and patient-specific hemodynamic index using image-based computational hemodynamics techniques. This index effectively evaluates the severity of noncoronary stenoses and has been successfully applied to four renal stenosis cases, producing computational results consistent with medical practice. The hemodynamic index is based on the correlation between TSPG and arterial lumen volume reduction, utilizing standard imaging data and parametric analysis to determine the degree of hemodynamic severity and offer revascularization recommendations. In this study, we utilize a newly developed mock circulation loop to experimentally derive the hemodynamic index for both renal and iliac stenosis cases. This unique experimental approach validates and reinforces our computational research, significantly enhancing the reliability and clinical applicability of our findings in real-world medical settings. By synergistically combining computational and experimental techniques, our work aims to provide valuable insights to improve the assessment and management of arterial stenosis, ultimately benefiting patient care and enhancing their overall well-being.