Parallel conductance (electric current flow through surrounding tissue) is an important determinant of accurate measurements of arterial lumen diameter, using the conductance method. The present study is focused on the role of non-uniform geometrical/electrical configurations of surrounding tissue, which are a primary source of electric current leakage. Computational models were constructed to simulate the conductance catheter measurement with two different excitation electrodes spacings (i.e. 12 and 20 mm for coronary and peripheral sizing, respectively) for different vessel -tissue configurations: (i) blood vessel fully embedded in muscle tissue, (ii) blood vessel superficially embedded in muscle tissue, and (iii) blood vessel superficially embedded in muscle tissue with fat covering half of the arterial vessel (anterior portion). The simulations suggest that the parallel conductance and accuracy of measurement is dependent on the inhomogeneous/anisotropic configuration of surrounding tissue, including the asymmetric dimension and anisotropy in electrical conductivity of surrounding tissue. Specifically, the measurement was shown to be accurate as long as the vessel was superficial, regardless of the considerable total surrounding tissue dimension for coronary or peripheral arteries. Moreover, it was shown that the unfavourable impact of parallel conductance on the accuracy of conductance catheter measurement is decreased by the combination of a lower transverse electrical conductivity of surrounding muscle tissue, a smaller electrode spacing and a larger lumen diameter. The present findings confirm that the conductance catheter technique provides an accurate platform for sizing of clinically relevant (i.e. superficial and diseased) arteries.
Transient displacement of blood in vessel lumen with saline injection is necessary in the conductance method for measurement of arterial cross-sectional area (CSA). The displacement of blood is dictated by the interactions between arterial flow hemodynamics and saline injection dynamics. The objective of the present study is to understand how the accuracy of conductance measurements is affected by the saline injection. Computational simulations were performed to assess the error in predictions of arterial CSA using conductance measurements over a range of peripheral artery diameters (i.e., 4, 7, and 10 mm) with an introducing catheter (6 Fr.) for various blood flow and saline injection rates. The simulation results were validated using the conductance measurements of the phantoms with known diameters (i.e., 7 and 10 mm). The results demonstrated that a minimum ratio of saline injection rate to blood flow rate of 3 is needed to fully displace the blood and result in accurate measurement of CSA for the peripheral artery sizes considered. Furthermore, the error was shown to be minimized as the detection electrodes are positioned between the distal to the mixing zone induced by saline injection and far downstream (4–8 cm from the injection catheter tip). The present study shows that even for the large peripheral arteries (7–10 mm) where mixing can occur, an appropriate injection rate and detection position can produce accurate measurement of lumen size.
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