A Study of Coronary Artery Disease in the Left Circumflex Artery via Artificial Vessel Restoration

Abstract

In recent years, computational fluid dynamics techniques have been employed to advance the understanding of cardiovascular flows and have been largely focused on wall shear stress (WSS) and the effect of disturbed flows on atherosclerosis, and in turn, coronary artery disease (CAD). To gain further insight into the hemodynamics associated with CAD, numerical simulations were conducted on a diseased left circumflex artery (LCX). The vessel geometry was derived from computed tomography angiography (CTA) data of a diseased LCX vessel. The diseased vessel was then artificially restored to represent its initially healthy geometry, and simulations were re-run for comparison. It was determined that alongside the expected low WSS, a region of high vorticity was present at the location where CAD developed, resulting in disturbed blood flow. The vorticity may also be associated with the curvature of the vessel. The relevance of the observed characteristics was further supported by perturbing the geometry of the restored LCX via dilation to account for inaccuracies in the restoration process. This research suggests that vorticity is an important factor in assessing the risk for CAD, potentially improving the accuracy of non-invasive, computational diagnosis. In turn, as computational analysis of the coronary arteries improves, it is likely that unnecessary invasive diagnosis methods, such as an angiogram, can be avoided.