Method and system for determining treatments by modifying patient-specific geometrical models

1. A system for evaluating cardiovascular treatment options for a patient, the system comprising: at least one computer system configured to:

create a three-dimensional model representing at least a portion of the patient's heart or vasculature based on patient-specific data regarding a geometry of the patient's heart or vasculature;

retrieve a stored plurality of treatment geometries, each treatment geometry including a geometry of a stent or a bypass graft;

for each of the plurality of treatment geometries, modify at least one of the three-dimensional model or a reduced order model of the patient's heart or vasculature based on a respective one of the retrieved treatment geometries;

determine, for each of the plurality of treatment geometries, a value of a blood flow characteristic calculated from at least one of the modified three-dimensional model and the modified reduced order model; and

identify one of the plurality of treatment geometries that solves a function of at least one of: the determined blood flow characteristics of the patient's heart or vasculature, and one or more costs stored in association with each of the plurality of retrieved treatment geometries.

2. The system of claim 1 , wherein the computer system is configured to modify, for each of the plurality of treatment geometries, the three-dimensional model using a geometric modification technique.

3. The system of claim 1 , wherein the computer system is configured to modify, for each of the plurality of treatment geometries, the three-dimensional model using a constructive solid geometry union.

4. The system of claim 1 , wherein the computer system is configured to modify, for each of the plurality of treatment geometries, the three-dimensional model using an elastic deformation modification technique.

5. The system of claim 1 , wherein the computer system is configured to modify, for each of the plurality of treatment geometries, the three-dimensional model based on a simulated location of an inserted stent or bypass graft.

6. The system of claim 1 , wherein the computer system is configured to modify the three-dimensional model for a subset of each of the plurality of treatment geometries in locations that exhibit a predetermined threshold level of a blood flow characteristic.

7. The system of claim 1 , wherein the computer system is configured to:

create the reduced order model relating to a blood flow characteristic of the patient's heart or vasculature, based on the three-dimensional model; and

modify the reduced order model for the respective one of the retrieved treatment geometries, using a resistance value estimated to be associated with a type and location of the respective possible treatment option geometry.

8. The system of claim 1 , wherein the computer system is configured to determine resistance values associated with possible treatment geometries from historical data of known resistance values associated with a known dimension or geometry of previously implemented treatment geometries.

9. The system of claim 1 , wherein the function is an objective function configured to maximize blood flow or minimize pressure changes in a patient's coronary vasculature.

10. The system of claim 1 , wherein the function is an objective function configured to penalize one or more of: increasing numbers of stents or bypass grafts; decreasing of FFR values in larger vessels, as opposed to smaller vessels; increasing proximity of inserted stents; treatment costs; and the existence or number of bifurcations.

11. The system of claim 1 , wherein the three-dimensional model representing at least the portion of the patient's heart or vasculature includes at least a portion of an aorta and at least a portion of a plurality of coronary arteries emanating from the portion of the aorta.

12. The system of claim 1 , wherein: the blood flow characteristic indicates a ratio between a pressure in the aorta and a pressure at a location in the plurality of coronary arteries; and the at least one computer system is configured to determine the blood flow characteristic at a plurality of locations in the plurality of coronary arteries.

13. The system of claim 1 , wherein the patient-specific data includes imaging data provided by computer tomography or magnetic resonance imaging techniques.

14. The system of claim 1 , wherein at least the reduced order model or the modified reduced order model includes at least one lumped parameter model representing a blood flow through boundaries of the three-dimensional model.

15. The system of claim 1 , wherein the at least one computer system is configured to determine the blood flow characteristic using a parameter associated with at least one of a level of hyperemia, a level of exercise, or a medication.

16. A method for evaluating cardiovascular treatment options for a patient, the method comprising:

creating a three-dimensional model representing at least a portion of the patient's heart or vasculature based on patient-specific data regarding a geometry of the patient's heart or vasculature;

retrieving a stored plurality of treatment geometries, each treatment geometry including a geometry of a stent or a bypass graft;

for each of the plurality of treatment geometries, modifying at least one of the three-dimensional model or a reduced order model of the patient's heart or vasculature based on a respective one of the retrieved treatment geometries;

determining, for each of the plurality of treatment geometries, a value of a blood flow characteristic calculated from at least one of the modified three-dimensional model and the modified reduced order model; and

identifying one of the plurality of treatment geometries that solves a function of at least one of: the determined blood flow characteristics of the patient's heart or vasculature, and one or more costs stored in association with each of the plurality of retrieved treatment geometries.

17. The method of claim 16 , further comprising modifying, for each of the plurality of treatment geometries, the three-dimensional model using at least one of: a geometric modification technique; a constructive solid geometry union; and an elastic deformation modification technique.

18. The method of claim 16 , further comprising modifying, for each of the plurality of treatment geometries, the three-dimensional model based on a simulated location of an inserted stent or bypass graft.

19. The method of claim 16 , further comprising modifying the three-dimensional model for a subset of each of the plurality of treatment geometries in locations that exhibit a predetermined threshold level of a blood flow characteristic.

20. The method of claim 16 , further comprising:

creating the reduced order model relating to a blood flow characteristic of the patient's heart or vasculature, based on the three-dimensional model; and

modifying the reduced order model for each possible treatment geometries, using a resistance value estimated to be associated with a type and location of the respective possible treatment option.

21. The method of claim 16 , further comprising determining resistance values associated with possible treatment geometries from historical data of known resistance values associated with a known dimension or geometry of previously implemented treatment geometries.

22. The method of claim 16 , wherein the function is an objective function configured to maximize blood flow or minimize pressure changes in a patient's coronary vasculature.

23. The method of claim 16 , wherein the function is an objective function configured to penalize one or more of: increasing numbers of stents or bypass grafts; decreasing of FFR values in larger vessels, as opposed to smaller vessels; increasing proximity of inserted stents; treatment costs; and the existence or number of bifurcations.

24. The method of claim 16 , wherein the three-dimensional model representing at least the portion of the patient's heart includes at least a portion of an aorta and at least a portion of a plurality of coronary arteries emanating from the portion of the aorta.

25. The method of claim 16 , wherein: the blood flow characteristic indicates a ratio between a pressure in the aorta and a pressure at a location in the plurality of coronary arteries; and the at least one computer system is configured to determine the blood flow characteristic at a plurality of locations in the plurality of coronary arteries.

26. The method of claim 16 , wherein the patient-specific data includes imaging data provided by computer tomography or magnetic resonance imaging techniques.

27. The method of claim 16 , wherein at least the reduced order model or the modified reduced order model includes at least one lumped parameter model representing a blood flow through boundaries of the three-dimensional model.

28. The method of claim 16 , further comprising determining the blood flow characteristic using a parameter associated with at least one of a level of hyperemia, a level of exercise, or a medication.