Abstract
Computational fluid dynamic-based modeling is commonly used in stenosed and stented coronary artery to characterize blood flow and identify hemodynamics factors that could lead to coronary stenosis. One such factor is the residence time (RT), which is important for investigating stenosis and restenosis progression. The current method to calculate RT, known as the relative residence time (RRT) method, does not provide the original scale of RT and only provides a relative value. We recently introduced a novel method, designated as RT method, based on developing the advection-diffusion equation with a scalar to calculate the absolute residence time. The goal of this study was to compare both methods. Our results show that both could detect regions with a high risk of stenosis and restenosis, but the RT method is also able to show the recirculation zone using pathlines in the lumen and quantify actual RT. Moreover, RT method also provided blood flow pathlines, and is correlated to wall shear stress (WSS), oscillatory shear index (OSI), RRT, and Localized Normalized Helicity (LNH) which are other critical factors to gauge stenosis severity and assess stenting in bifurcations coronary.
Highlights
Coronary artery disease (CAD) is the leading cause of death in US with over 840,768 deaths annually (Benjamin et al, 2019)
The pathlines for patient C showed some small vortex after bifurcation near wall during diastole; some circulation appeared after passing flow through the stent strut in the daughter branch during diastole while patient C without stent’s pathlines do not show the circulations (Figure 2)
The wall shear stress (WSS) contours showed that patient A did not have significant change of WSS in long direction specially in systolic phase but for Patient B, WSS increased in throat of stenosis and decreases in downstream of stenosis (Figure 3)
Summary
Coronary artery disease (CAD) is the leading cause of death in US with over 840,768 deaths annually (Benjamin et al, 2019). Interventional cardiologists encounter coronary stenosis in 40–90% of such patients and have to make a decision about performing percutaneous coronary intervention (PCI, placement of a stent) (Mozaffarian et al, 2016). About 15–20% of stented bifurcation coronaries fail between 6 months and 1 year post-intervention (Genuardi et al, 2020). The clinical gold standard for quantification of coronary lesions is invasive measurement of Fractional Flow Reserve (FFR) (Gould et al, 1990; De Bruyne et al, 2000). FFR is measured by inserting a pressure measurement wire across a stenotic coronary lesion (Gould et al, 1990). Diagnosis of coronary artery stenosis is a popular application of image-based
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