Unsteady blood flow and mass transfer of a human left coronary artery bifurcation: FSI vs. CFD

Malvè, Mauro; García, A.; Ohayon, Jacques; Martı́nez, Miguel Ángel

doi:10.1016/j.icheatmasstransfer.2012.04.009

Cited by 98 publications

(56 citation statements)

References 53 publications

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“…Because of the complexity of the problem, fluid-structure interaction (FSI) simulations of stented coronary bifurcations have not been proposed in the literature yet. FSI simulations were performed only on patient-specific coronary arteries without the presence of stents [53].…”

Section: Limitationsmentioning

confidence: 99%

Computational fluid dynamic simulations of image-based stented coronary bifurcation models

Chiastra

Morlacchi

Gallo

et al. 2013

J. R. Soc. Interface.

122

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One of the relevant phenomenon associated with in-stent restenosis in coronary arteries is an altered haemodynamics in the stented region. Computational fluid dynamics (CFD) offers the possibility to investigate the haemodynamics at a level of detail not always accessible within experimental techniques. CFD can quantify and correlate the local haemodynamics structures which might lead to in-stent restenosis. The aim of this work is to study the fluid dynamics of realistic stented coronary artery models which replicate the complete clinical procedure of stent implantation. Two cases of pathologic left anterior descending coronary arteries with their bifurcations are reconstructed from computed tomography angiography and conventional coronary angiography images. Results of wall shear stress and relative residence time show that the wall regions more prone to the risk of restenosis are located next to stent struts, to the bifurcations and to the stent overlapping zone for both investigated cases. Considering a bulk flow analysis, helical flow structures are generated by the curvature of the zone upstream from the stent and by the bifurcation regions. Helical recirculating microstructures are also visible downstream from the stent struts. This study demonstrates the feasibility to virtually investigate the haemodynamics of patient-specific coronary bifurcation geometries.

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Section: Limitationsmentioning

confidence: 99%

Computational fluid dynamic simulations of image-based stented coronary bifurcation models

Chiastra

Morlacchi

Gallo

et al. 2013

J. R. Soc. Interface.

122

View full text Add to dashboard Cite

show abstract

“…A wealth of literature has investigated this flow-structure interaction. 12,13,17,26,34,36,42,53,54,57,62,[66][67][68][69][70][71][72][73][74]80 Here, the impact of removing or displacing plaque is studied from a hemodynamic perspective. The plaque removal technique employed is orbital atherectomy plus balloon angioplasty or stenting; it is described in the literature, and interested readers are invited to references 10,25,55,62 for details on the procedure.…”

Section: Introductionmentioning

confidence: 99%

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

Plourde

Vallez

Sun

et al. 2016

Cardiovasc Eng Tech

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Simulations were made of the pressure and velocity fields throughout an artery before and after removal of plaque using orbital atherectomy plus adjunctive balloon angioplasty or stenting. The calculations were carried out with an unsteady computational fluid dynamic solver that allows the fluid to naturally transition to turbulence. The results of the atherectomy procedure leads to an increased flow through the stenotic zone with a coincident decrease in pressure drop across the stenosis. The measured effect of atherectomy and adjunctive treatment showed decrease the systolic pressure drop by a factor of 2.3. Waveforms obtained from a measurements were input into a numerical simulation of blood flow through geometry obtained from medical imaging. From the numerical simulations, a detailed investigation of the sources of pressure loss was obtained. It is found that the major sources of pressure drop are related to the acceleration of blood through heavily occluded cross sections and the imperfect flow recovery downstream. This finding suggests that targeting only the most occluded parts of a stenosis would benefit the hemodynamics. The calculated change in systolic pressure drop through the lesion was a factor of 2.4, in excellent agreement with the measured improvement. The systolic and cardiac-cycle-average pressure results were compared with measurements made in a multi-patient study treated with orbital atherectomy and adjunctive treatment. The agreements between the measured and calculated systolic pressure drop before and after the treatment were within 3%. This excellent agreement adds further confidence to the results. This research demonstrates the use of orbital atherectomy to facilitate balloon expansion to restore blood flow and how pressure measurements can be utilized to optimize revascularization of occluded peripheral vessels.

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“…This can underestimate the WSS values by as much as 10-25% when modeling the wall as compliant as found previously for smaller sized vessels 20,30,52 and 5% difference for time-averaged WSS values. 20 Malve et al 20 found similar trends in the temporal maximum and minimum WSS values along the bifurcation of the left coronary artery when comparing rigid wall CFD with compliant wall FSI.…”

Section: Discussionmentioning

confidence: 83%

The Effects That Cardiac Motion has on Coronary Hemodynamics and Catheter Trackability Forces for the Treatment of Coronary Artery Disease: An In Vitro Assessment

Morris

Fahy

Stefanov

et al. 2015

Cardiovasc Eng Tech

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The coronary arterial tree experiences large displacements due to the contraction and expansion of the cardiac muscle and may influence coronary haemodynamics and stent placement. The accurate measurement of catheter trackability forces within physiological relevant test systems is required for optimum catheter design. The effects of cardiac motion on coronary flowrates, pressure drops, and stent delivery has not been previously experimentally assessed. A cardiac simulator was designed and manufactured which replicates physiological coronary flowrates and cardiac motion within a patient-specific geometry. A motorized delivery system delivered a commercially available coronary stent system and monitored the trackability forces along three phantom patient-specific thin walled compliant coronary vessels supported by a dynamic cardiac phantom model. Pressure drop variation is more sensitive to cardiac motion than outlet flowrates. Maximum pressure drops varied from 7 to 49 mmHg for a stenosis % area reduction of 56 to 90%. There was a strong positive linear correlation of cumulative trackability force with the cumulative curvature. The maximum trackability forces and curvature ranged from 0.24 to 0.87 N and 0.06 to 0.22 mm(-1) respectively for all three vessels. There were maximum and average percentage differences in trackability forces of (23-49%) and (1.9-5.2%) respectively when comparing a static pressure case with the inclusion of pulsatile flow and cardiac motion. Cardiac motion with pulsatile flow significantly altered (p value <0.001) the trackability forces along the delivery pathways with high local percentage variations and pressure drop measurements.

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Unsteady blood flow and mass transfer of a human left coronary artery bifurcation: FSI vs. CFD

Cited by 98 publications

References 53 publications

Computational fluid dynamic simulations of image-based stented coronary bifurcation models

Computational fluid dynamic simulations of image-based stented coronary bifurcation models

Alterations of Blood Flow Through Arteries Following Atherectomy and the Impact on Pressure Variation and Velocity

The Effects That Cardiac Motion has on Coronary Hemodynamics and Catheter Trackability Forces for the Treatment of Coronary Artery Disease: An In Vitro Assessment

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