Secondary flow in bifurcations – Important effects of curvature, bifurcation angle and stents

Shen, Chaoqi; Gharleghi, Ramtin; Li, Darson Dezheng; Stevens, Michael C.; Dokos, Socrates; Beier, Susann

doi:10.1016/j.jbiomech.2021.110755

Cited by 16 publications

(9 citation statements)

References 36 publications

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“…The relationship between geometrical features of coronary artery and their impact on the hemodynamics of the subsequent branches have been thoroughly explored previously in different studies, both with idealized and patient-specific cases [18,19,50]. Although the studies have reported both similar and contradictory conclusions regarding the effects of geometry on hemodynamics, to our knowledge, no study has yet identified the order of dominance of the geometrical features of coronary arteries on the risk of atherosclerosis development through systematic CFD experimentation.…”

Section: Discussionmentioning

confidence: 99%

“…To investigate the impact of arterial geometric characteristics on hemodynamic behavior, Computational fluid dynamics (CFD) studies have long been performed across various arterial branches and subbranches and showed supporting results to clinical findings [14,[17][18][19]. Hemodynamic behavior can be characterized by evaluating intravascular and nearwall hemodynamic descriptors such as average helicity intensity (h 2 ), wall shear stress (WSS), time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT).…”

Section: Introductionmentioning

confidence: 92%

“…Left coronary arteries with a greater α LAD-LCx are more likely to be affected by atherosclerosis as the area under low WSS and flow disturbance rises [5,14,17]. Interestingly, other studies have found that a reduced bifurcation angle between two daughter branches elevates the area under low TAWSS, which increases the risk of atherosclerosis [18,21,22]. On the other hand, the curvature of LMS strongly influences the distribution of WSS in LAD but has minimal to no effect in LM and LCx [19].…”

Section: Introductionmentioning

confidence: 98%

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Design of experiment approach to identify the dominant geometrical feature of left coronary artery influencing atherosclerosis

Ashrafee,

Yashfe,

Khan

et al. 2024

Biomed. Phys. Eng. Express

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Objective: Coronary artery geometry heavily influences local hemodynamics, potentially leading to atherosclerosis. Consequently, the unique geometrical configuration of an individual by birth can be associated with future risk of atherosclerosis. Thus, this study aims to identify the order of influence of the geometrical features through systematic experiments, which can reveal the dominant geometrical feature for future risk assessmentMethods: According to Taguchi’s method of design of experiment (DoE), the left main stem (LMS) length (lLMS), curvature (kLMS), diameter (dLMS) and the bifurcation angle between left anterior descending (LAD) and left circumflex (LCx) artery (αLAD-LCx) of two reconstructed patient-specific left coronary arteries (LCA) were varied in three levels to create L9 orthogonal array. Computational fluid dynamic (CFD) simulations with physiological boundary conditions were performed on the resulting eighteen LCA models. Results:The proximal LAD was identified to be the most atheroprone region of the left coronary artery due to large relative atheroprone area (RAA) of helicity intensity (h2), time averaged wall shear stress (TAWSS < 0.4 Pa), oscillatory shear index (OSI ~ 0.5), relative residence time (RRT > 4.17 Pa-1). In both patient specific cases, based on h2 and TAWSS, dlms is the dominant geometric parameter while based on OSI and RRT, αLAD-LCx is the dominant one influencing hemodynamic condition in proximal LAD (p < 0.05). Based on RRT, the rank of the geometrical factors is: αLAD-LCx > dLMS > lLMS > kLMS, indicating that αLAD-LCx is the most dominant geometrical factor influencing hemodynamics at proximal LAD which may lead to atherosclerosis.Conclusion:The proposed identification of the rank of geometrical features of LCA and the dominant feature may assist clinicians in predicting the possibility of atherosclerosis, of an individual, long before it will occur. 

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 98%

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Design of experiment approach to identify the dominant geometrical feature of left coronary artery influencing atherosclerosis

Ashrafee,

Yashfe,

Khan

et al. 2024

Biomed. Phys. Eng. Express

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“…To overcome the problems with these traditional segmentation methods, we created high quality segmentations of the coronary arteries, to serve as both a benchmark dataset for newly developed segmentation methods and pre-existing segmentation for further processing, for example investigating differences in helicity between stented idealized and patient-specific vessels 10 . This was part of the ' Automated Segmentation of Coronary Arteries' (ASOCA) Challenge 11,12 we facilitated during the Medical Image Computing and Computer Assisted Intervention (MICCAI) 2020 conference to focus on the development of automated segmentation algorithms using this data, providing a convenient system for submission of results and automated evaluation and ranking.…”

Section: Background and Summarymentioning

confidence: 99%

Annotated computed tomography coronary angiogram images and associated data of normal and diseased arteries

et al. 2023

Self Cite

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Computed Tomography Coronary Angiography (CTCA) is a non-invasive method to evaluate coronary artery anatomy and disease. CTCA is ideal for geometry reconstruction to create virtual models of coronary arteries. To our knowledge there is no public dataset that includes centrelines and segmentation of the full coronary tree. We provide anonymized CTCA images, voxel-wise annotations and associated data in the form of centrelines, calcification scores and meshes of the coronary lumen in 20 normal and 20 diseased cases. Images were obtained along with patient information with informed, written consent as part of the Coronary Atlas. Cases were classified as normal (zero calcium score with no signs of stenosis) or diseased (confirmed coronary artery disease). Manual voxel-wise segmentations by three experts were combined using majority voting to generate the final annotations. Provided data can be used for a variety of research purposes, such as 3D printing patient-specific models, development and validation of segmentation algorithms, education and training of medical personnel and in-silico analyses such as testing of medical devices.

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“…There are many studies investigating the impact of the angle formed by two branches on blood flow [19], [18], [5]. The creation of the meshes in those studies mostly relies on manual design using 3D modeling or CAD softwares.…”

Section: E Branch Anglementioning

confidence: 99%

A Software to Visualize, Edit, Model and Mesh Vascular Networks

Decroocq

Lavoué

Ohta

et al. 2022

2022 44th Annual International Conference of the IEEE Engineering in Medicine &Amp; Biology Society (EMBC)

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Computational fluid dynamics (CFD) is a key tool for a wide range of research areas, beyond the computer science community. In particular, CFD is used in medicine to measure blood flow from patient specific models of arteries. In this field, the creation of accurate meshes remains the most challenging step, as it is based on the segmentation of medical images, a time-consuming task which often requires manual intervention by medical doctors. In this context, userfriendly, interactive softwares are valuable. They enable to spread the new advances in numerical treatment to the medical community and enrich them with the expert knowledge (e.g anatomical knowledge) of clinicians. In this work, we present a user interface dedicated to the meshing of vascular networks from centerlines. It allows for the 3D visualization and edition of input centerlines, which constitute a simplified, easy-tomanipulate representation of vascular networks. The surface of the artery can be reconstructed from the modified centerlines by an editable parametric model and then meshed with high quality hexahedral elements. At every step of the process, the network can be confronted with medical images with enhanced visualization. The software will be released publicly.Clinical relevance-This tool facilitates the manual extraction and editing of vascular networks by medical doctors. It opens the generation of hexahedral meshes for computational fluid dynamics studies to non-expert users.

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Secondary flow in bifurcations – Important effects of curvature, bifurcation angle and stents

Cited by 16 publications

References 36 publications

Design of experiment approach to identify the dominant geometrical feature of left coronary artery influencing atherosclerosis

Design of experiment approach to identify the dominant geometrical feature of left coronary artery influencing atherosclerosis

Annotated computed tomography coronary angiogram images and associated data of normal and diseased arteries

A Software to Visualize, Edit, Model and Mesh Vascular Networks

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