Numerical simulation of pulsatile blood flow characteristics in a multi stenosed coronary artery

Abstract

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.