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Updated: May 1, 2026
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Thrombotic risk stratification using computational modeling in patients with coronary artery aneurysms following
Dibyendu Sengupta1, Andrew M Kahn, Ethan Kung
1Department of Mechanical and Aerospace Engineering, University of California San Diego, 9500 Gilman Dr., La Jolla, CA , 92037, USA.
Insights
Kawasaki disease patients with coronary aneurysms face thrombosis risks. Hemodynamic data from simulations may better predict clot risk than aneurysm size alone, guiding treatment decisions.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Cardiovascular Research
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children.
- Coronary artery aneurysms in KD patients increase risks of thrombus formation, myocardial infarction, and sudden death.
- Current anticoagulant therapy decisions rely on aneurysm diameter, potentially overlooking other risk factors.
Purpose of the Study:
- To investigate if patient-specific hemodynamic data can more accurately predict thrombotic risk in Kawasaki disease patients than aneurysm diameter alone.
- To compare hemodynamic parameters with clinical outcomes in KD patients with coronary artery aneurysms.
Main Methods:
- Patient-specific blood flow simulations were conducted on six KD patients (five with aneurysms, one with normal coronary arteries).
- Key hemodynamic parameters (wall shear stress, particle residence time) and geometric indices were extracted.
- Fluid structure interaction simulations were performed to assess the impact of radial expansion on wall shear stress.
Main Results:
- Hemodynamic parameters showed potential as more accurate predictors of thrombotic risk compared to aneurysm diameter.
- Preliminary fluid structure interaction simulations indicated modest differences in wall shear stress with radial expansion.
Conclusions:
- Hemodynamic data derived from patient-specific simulations may offer a superior method for assessing thrombotic risk in Kawasaki disease.
- Incorporating hemodynamic information into a clinical index could improve patient selection for anticoagulant therapy.
Abstract:
Kawasaki disease (KD) is the leading cause of acquired heart disease in children and can result in life-threatening coronary artery aneurysms in up to 25 % of patients. These aneurysms put patients at risk of thrombus formation, myocardial infarction, and sudden death. Clinicians must therefore decide which patients should be treated with anticoagulant medication, and/or surgical or percutaneous intervention. Current recommendations regarding initiation of anticoagulant therapy are based on anatomy alone with historical data suggesting that patients with aneurysms [Formula: see text]8 mm are at greatest risk of thrombosis. Given the multitude of variables that influence thrombus formation, we postulated that hemodynamic data derived from patient-specific simulations would more accurately predict risk of thrombosis than maximum diameter alone. Patient-specific blood flow simulations were performed on five KD patients with aneurysms and one KD patient with normal coronary arteries. Key hemodynamic and geometric parameters, including wall shear stress, particle residence time, and shape indices, were extracted from the models and simulations and compared with clinical outcomes. Preliminary fluid structure interaction simulations with radial expansion were performed, revealing modest differences in wall shear stress compared to the rigid wall case. Simulations provide compelling evidence that hemodynamic parameters may be a more accurate predictor of thrombotic risk than aneurysm diameter alone and motivate the need for follow-up studies with a larger cohort. These results suggest that a clinical index incorporating hemodynamic information be used in the future to select patients for anticoagulant therapy.
