Challenges of the 21st Century: Part 3 - The anatomical risk factors which predict future disaster

A novel approach using dynamic angiography to study cavitation in coronary arteries as related to anatomical structure and fluid dynamics was applied to patient cases. Cases were evaluated to determine if vessel anatomy/variations (i.e., length, diameter, curves, side branches, ostia, branching patterns, etc.) that affected blood flow could be used as predictive factors of future lesion formation or events. Laminar flow through arterial segments and smooth curves was predictive of absence of lesion. Anatomical variations, arterial size that affected boundary layers, turbulent flow, stop line; location of ostium and height of aortic sinus, were found to be predictive factors of lesion formation. This demonstration of how anatomy (1) changes blood flow, (2) influences lesion formation via cavitation and bubble explosion; and (3) can be used as a predictive factor in the formation of coronary lesions is new and critical knowledge for anatomists, cardiologists and interventional cardiologists (i.e., interventional anatomists). Still further, this new perspective and knowledge applies to all vessels in the body, and may translate into new and effective management of patients with vessel disorder or disease.