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Numerical simulation of pulsatile blood flow characteristics in a multi stenosed coronary artery
1Research Centre for Advanced Materials Science (RCAMS), King Khalid University, Abha, Kingdom Saudi Arabia.
Insights
Multi-stenosis in coronary arteries significantly impacts blood flow dynamics. Decreasing inter-stenosis distance increases pressure drop and may promote plaque growth, affecting diagnosis.
Area of Science:
- Cardiovascular hemodynamics
- Biomedical engineering
- Computational fluid dynamics
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality.
- Stenosis, or plaque buildup, restricts blood flow, potentially causing myocardial infarction.
Purpose of the Study:
- To analyze the hemodynamic effects of multiple coronary artery stenoses.
- To investigate how varying stenosis severity and inter-stenosis distance influence blood flow parameters.
Main Methods:
- Utilized a finite volume-based software (Ansys CFX) for blood flow modeling.
- Simulated hemodynamic parameters including pressure, velocity, and wall shear stress.
Main Results:
- Maximum pressure drop occurred at 90% area stenosis (AS).
- Reduced inter-stenosis distance increased pressure drop and formed recirculation zones, potentially accelerating plaque progression.
- Wall shear stress increased with greater inter-stenosis distance, with maximums at 90% AS.
Conclusions:
- Clinical overestimation of distal stenosis severity is possible.
- Low wall shear stress between stenoses may promote atherosclerotic growth or merging of lesions.
Background:
Coronary artery disease is reported as one of the most common sources of death all over the world. The presence of stenosis (plaque) in the coronary arteries results in the restriction of blood supply, which leads to myocardial infarction.
Objective:
The aim of this study was to investigate the effect of multi stenosis on hemodynamics parameters in idealized coronary artery models with varying degrees of stenosis and interspace distance between the stenosis.
Methods:
A finite volume-based software package (Ansys CFX version 17.2) was employed to model the blood flow. The hemodynamic stenosis parameters of blood, such as the pressure, velocity, and wall shear stress were obtained.
Results:
The computed results showed that the pressure drop is maximum across the 90% area stenosis (AS). The pressure drop is increased as the distance between the proximal and distal stenosis is decreased across the proximal stenosis for the model P70_D70 during the systolic period of the cardiac cycle. A recirculation zone is formed behind the stenosis and is restricted by the occurrence of distal stenosis as the interspacing distance decreases, which could lead to further progression of stenosis in the flow-disturbed area. The wall shear stress was found to increase as the distance between the proximal and distal stenosis is increased across the distal stenosis. The maximum wall shear stress was found at 90% AS.
Conclusions:
In the clinical diagnosis, an overestimation of distal stenosis severity could be possible. Furthermore, the low wall shear stress zone in between the proximal and distal stenosis may help atherosclerotic growth or merge adjacent stenosis.
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