A new virtual tool to detect heart patients needing stents

Virtual coronary intervention (VCI); instant one-stop in silico treatment planning (Dr Rebecca Gosling)

Supervised by Professor Julian Gunn, this Clinical Research Training Fellow is developing a new computer based tool for doctors to decide which patients with coronary heart disease need stents. In people with coronary heart disease, doctors use a technique called coronary angiography to examine the heart arteries and find out if narrowing of these vessels reduces blood flow enough to cause symptoms. If so, they insert a stent to open up the artery. But the decision to implant a stent is subjective and depends on a doctor’s assessment and experience. To be more objective, doctors can measure the pressure differences on either side of the blockage in the artery using a technique called fractional flow reserve, or FFR. Using this technique to select patients for stenting improves outcomes, but it requires inserting a pressure-sensitive wire into the artery and giving the patient a drug. To avoid this, Professor Gunn’s team has created a virtual stenting decision tool that uses a computer model of blood flow to calculate FFR from the angiography images. In this project, the fellow will test out ‘virtual coronary intervention'. They will use the virtual tool to test what effect treatments have on FFR. They will compare FFR results from patients who have already had stenting and FFR measurements with results obtained using the virtual coronary intervention. The fellow will present case studies of angiography findings to cardiologists to see what stent the heart team would have used before showing them the virtual coronary intervention results and asking if it alters their recommendations. A new virtual tool could help doctors decide the best treatments for their patients in a more objective way, improving outcomes for patients.