Numerical study of stenotic side branch hemodynamics in true bifurcation lesions

Frattolin, Jennifer; Zarandi, Marjan Molavi; Pagiatakis, Catherine; Bertrand, Olivier; Mongrain, Rosaire

doi:10.1016/j.compbiomed.2014.11.014

Cited by 19 publications

(13 citation statements)

References 38 publications

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“…The bifurcation at the LM coronary to LAD and LCX served as a divider to the blood flow. Severe stenosis at the LAD had increased the resistance of the vascular bed, resulting in side branch steal [ 34 , 35 ]. Flow reversal was also not seen in the stenosis in other cases, as shown in Fig 9 (labeled in red arrows), but it appeared at the bifurcation of the LM to LAD and LCX.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery

et al. 2016

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The alterations of the hemodynamics in the coronary arteries, which result from patient-specific geometric significances are complex. The effect of the stenosis on the blood flow alteration had been wildly reported, but the combinational contribution from geometric factors required a comprehensive investigation to provide patient-specific information for diagnosis and assisting in the decision on the further treatment strategies. In the present study, we investigated the correlation between hemodynamic parameters and individual geometric factors in the patient-specific coronary arteries. Computational fluid dynamic simulations were performed on 22 patient-specific 3-dimensional coronary artery models that were reconstructed based on computed tomography angiography images. Our results showed that the increasing severity of the stenosis is associated with the increased maximum wall shear stress at the stenosis region (r = 0.752, P < 0.001). In contrast, the length of the recirculation zone has a moderate association with the curvature of the lesion segment (r = 0.505, P = 0.019) and the length of the lesions (r = 0.527, P = 0.064). Moreover, bifurcation in the coronary arteries is significantly correlated with the occurrence of recirculation, whereas the severity of distal stenosis demonstrated an effect on the alteration of the flow in the upstream bifurcation. These findings could serve as an indication for treatment planning and assist in prognosis evaluation.

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Section: Discussionmentioning

confidence: 99%

The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery

et al. 2016

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“…The coronary bifurcation configurations (Figure 1) from Frattolin et al [6], presented in this study, were made up of the left anterior descending artery, the left main coronary artery, and the left circumflex artery bifurcation. The idealized coronary arteries (Figure 2(a)) in all the models were 3 mm for the SB, 4.2 mm for the MBP, and 3.2 mm for the MBD [11].…”

Section: Methodsmentioning

confidence: 99%

“…To satisfy Finet's law of coronary bifurcations, idealized coronaries were set with a fractal ratio (the mother-vessel diameter to the sum of the two daughter-vessel diameters) of 0.67 [13]. The bifurcation angle, which is the deviation angle between the SB and the MBD, was 75°, in accordance with the dimensions of typical anatomical data [6]. Figures 1(b)-1(c) display the coronary bifurcation models that were utilized in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, it has been shown that disturbed blood flow in or near side branches is associated with the occurrence of vascular inflammation and atherosclerosis [4, 5]. Early studies have also demonstrated that disturbed or oscillatory flows near an arterial bifurcation play a critical role in stenotic SB occlusion [4, 5, 6]. Nevertheless, due to the accumulating atherogenic lipids on the arterial wall leading to the genesis of atherosclerosis, researchers typically focus on the mass transfer, such as low-density lipoproteins (LDL) [7].…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the difficulties in the analysis of blood flow in patients, numerical simulations on coronary bifurcation were performed to better understand its hemodynamic changes [6, 11]. The Medina classification and some studies indicated that the type (1,1,1) of bifurcation lesion would be the greatest risk type of branch.…”

Section: Introductionmentioning

confidence: 99%

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Transfer of Low-Density Lipoproteins in Coronary Artery Bifurcation Lesions with Stenosed Side Branch: Numerical Study

Fan

Liu

Zhang

et al. 2019

Computational and Mathematical Methods in Medicine

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Evidence from clinical data suggests that the stenotic side branch (SB) is one of the key predictors for SB occlusion-based adverse events. In this study, we hypothesized that coronary bifurcations with stenotic SB might lead to severe concentration polarization of atherogenic lipids, such as the low-density lipoproteins (LDL), motivating the adverse events in the clinic. To confirm this hypothesis, this work numerically investigated the transport of LDL in different bifurcation lesions based on the Medina classification with various location and stenosis severities. The results showed that the coronary bifurcations with stenotic SB might be suffering more serious concentration polarization of LDL on the luminal surface of the SB due to higher level of LDL concentrations. Moreover, compared to the other bifurcation lesion types, the type (1,0,1) had the highest luminal surface LDL concentration along the SB and the highest degree of risk to enhance the process of atherosclerosis. In addition, this study also showed that the luminal surface LDL concentration increased with elevated stenosis severity. The type (1,0,1) with the severe stenosis (75% diameter reduction) had the highest concentration at the SB. In conclusion, these results suggested that both location of lesions and stenosis severities had great influence on the distribution of LDL on the luminal surface of the SB. Therefore, the estimation of disease severity and the interventional therapy should be carried out not only according to the stenosis severities in clinic. Moreover, compared to the other bifurcation lesion types, the type (1,0,1), rather than the type (1,1,1) as usually considered, had the highest luminal surface LDL concentration along the SB and the highest degree of risk to enhance the process of atherosclerosis.

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Flow-Induced Dynamics of Bifurcated Coronary Arteries

Carpenter

Gholipour

Ghayesh

et al. 2021

Vibration Engineering for a Sustainable Future

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Numerical study of stenotic side branch hemodynamics in true bifurcation lesions

Cited by 19 publications

References 38 publications

The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery

The Impact of the Geometric Characteristics on the Hemodynamics in the Stenotic Coronary Artery

Transfer of Low-Density Lipoproteins in Coronary Artery Bifurcation Lesions with Stenosed Side Branch: Numerical Study

Flow-Induced Dynamics of Bifurcated Coronary Arteries

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