Background: Accurate prediction of hemodynamic outcomes after percutaneous coronary intervention (PCI) is crucial for optimal treatment planning. We previously validated a simplified computational fluid dynamics (CFD) method for estimating fractional flow reserve (FFR) using a vascular volume ratio-based boundary condition. This study aimed to evaluate the feasibility of this method to predict post-PCI FFR based solely on pre-procedural coronary computed tomography (CT) data.
Methods: This prospective study enrolled four patients undergoing PCI. Three-dimensional coronary models were reconstructed from pre-PCI CT scans. A virtual stenting procedure was performed by expanding the stenosis according to the distal reference vessel diameter, mimicking clinical practice while not referencing the actual stent dimensions. Subsequently, post-PCI FFR_CFD was calculated using our previously established CFD method.
Results: The predicted post-PCI FFR_CFD values showed good agreement with invasively measured FFR. The diameters of the virtual stents closely approximated those of the deployed stents, with a maximum difference of 0.25 mm. However, prediction errors for post-PCI FFR were larger than those observed for pre-PCI FFR in some cases.
Conclusion: This pilot study suggests that our simplified CFD method is feasible and promising for predicting post-PCI hemodynamic outcomes using only pre-procedural anatomical information.
Larger-scale validation studies are warranted to confirm its potential as a clinical tool for non-invasive PCI planning.