Hemodynamics simulation and analysis of left coronary artery aneurysms with concomitant stenosis_Journal of Biomedical Engineering

Authors：

SHI Zhengjia ¹ ,  SANG Jianbing ¹ ,  SUN Lifang ² , LI Fengtao ¹ , TAO Yaping ¹ , YANG Peng ¹

1. School of Mechanical Engineering, Hebei University of Technology, Tianjin 300401, P. R. China;
2. Hospital of Hebei University of Technology, Hebei University of Technology, Tianjin 300401, P. R. China;

Corresponding author：

SANG Jianbing, Email: sangjianbing@hebut.edu.cn; SUN Lifang, Email: sunlfang@hebut.edu.cn

Keywords：

Left anterior descending branch; Stenosis; Aneurysm; Rupture; Computational fluid dynamics

DOI：

10.7507/1001-5515.202310038

Video：

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The hemodynamic parameters in arteries are difficult to measure non-invasively, and the analysis and prediction of hemodynamic parameters based on computational fluid dynamics (CFD) has become one of the important research hotspots in biomechanics. This article establishes 15 idealized left coronary artery bifurcation models with concomitant stenosis and aneurysm lesions, and uses CFD method to numerically simulate them, exploring the effects of left anterior descending branch (LAD) stenosis rate and curvature radius on the hemodynamics inside the aneurysm. This study compared models with different stenosis rates and curvature radii and found that as the stenosis rate increased, the oscillatory shear index (OSI) and relative residence time (RRT) showed a trend of increase; In addition, the decrease in curvature radius led to an increase in the degree of vascular curvature and an increased risk of vascular aneurysm rupture. Among them, when the stenosis rate was less than 60%, the impact of stenosis rate on aneurysm rupture was greater, and when the stenosis rate was greater than 60%, the impact of curvature radius was more significant. Based on the research results of this article, it can be concluded that by comprehensively considering the effects of stenosis rate and curvature radius on hemodynamic parameters, the risk of aneurysm rupture can be analyzed and predicted. This article uses CFD methods to deeply explore the effects of stenosis rate and curvature radius on the hemodynamics of aneurysms, providing new theoretical basis and prediction methods for the assessment of aneurysm rupture risk, which has important academic value and practical guidance significance.

Citation： SHI Zhengjia, SANG Jianbing, SUN Lifang, LI Fengtao, TAO Yaping, YANG Peng. Hemodynamics simulation and analysis of left coronary artery aneurysms with concomitant stenosis. Journal of Biomedical Engineering, 2024, 41(5): 1026-1034. doi: 10.7507/1001-5515.202310038 Copy

1.	Matta A G, Yaacoub N, Nader V, et al. Coronary artery aneurysm: a review. World J Cardiol, 2021, 13(9): 446-455.
2.	Kim J H, Han H, Moon Y J, et al. Hemodynamic features of microsurgically identified, thin-walled regions of unruptured middle cerebral artery aneurysms characterized using computational fluid dynamics. Neurosurgery, 2020, 86(6): 851-859.
3.	Oliveira I L, Santos G B, Militzer J, et al. A longitudinal study of a lateral intracranial aneurysm: identifying the hemodynamic parameters behind its inception and growth using computational fluid dynamics. Journal of the Brazilian Society of Mechanical Sciences and Engineering, 2021, 43: 138.
4.	刘梦辰, 潘霁超, 蔡彦, 等. 动脉粥样硬化斑块的生物力学模型和数值模拟研究. 生物医学工程学杂志, 2020, 37(6): 948-955.
5.	何家胜, 钟伟健. 动脉粥样硬化斑块的断裂力学数值模拟研究. 生物医学工程学杂志, 2021, 38(6): 1097-1102, 1110.
6.	Teng B, Zhou Z, Zhao Y, et al. Combined curvature and wall shear stress analysis of abdominal aortic aneurysm: an analysis of rupture risk factors. Cardiovasc Intervent Radiol, 2022, 45(6): 752-760.
7.	Zhao J, Xiang X, Zhang H, et al. A study of the association between carotid artery curvature and intracranial aneurysms. Neurologist, 2023, 28(2): 99-103.
8.	Rashad S, Sugiyama S I, Niizuma K, et al. Impact of bifurcation angle and inflow coefficient on the rupture risk of bifurcation type basilar artery tip aneurysms. J Neurosurg, 2018, 128(3): 723-730.
9.	Murayama Y, Fujimura S, Suzuki T, et al. Computational fluid dynamics as a risk assessment tool for aneurysm rupture. Neurosurg Focus, 2019, 47(1): E12.
10.	Xiang J, Tutino V M, Snyder K V, et al. CFD: computational fluid dynamics or confounding factor dissemination? The role of hemodynamics in intracranial aneurysm rupture risk assessment. AJNR Am J Neuroradiol, 2014, 35(10): 1849-1857.
11.	Liang L, Steinman D A, Brina O, et al. Towards the clinical utility of CFD for assessment of intracranial aneurysm rupture-a systematic review and novel parameter-ranking tool. J Neurointerv Surg, 2019, 11(2): 153-158.
12.	Cebral J R, Vazquez M, Sforza D M, et al. Analysis of hemodynamics and wall mechanics at sites of cerebral aneurysm rupture. J Neurointerv Surg, 2015, 7(7): 530-536.
13.	Mu L, Liu X, Liu M, et al. In vitro study of endothelial cell morphology and gene expression in response to wall shear stress induced by arterial stenosis. Front Bioeng Biotechnol, 2022, 10: 854109.
14.	Mu L, Li X, Chi Q, et al. Experimental and numerical study of the effect of pulsatile flow on wall displacement oscillation in a flexible lateral aneurysm model. Acta Mechanica Sinica, 2019, 35: 1120-1129.
15.	王浩然, 张慧霞, 王文馨, 等. 左前降支冠状动脉瘤搭桥手术血流动力学研究. 北京生物医学工程, 2018, 37(5): 448-454, 466.
16.	Indolfi C, Achille F, Tagliamonte G, et al. Polytetrafluoroethylene stent deployment for a left anterior descending coronary aneurysm complicated by late acute anterior myocardial infarction. Circulation, 2005, 112(5): e70-e71.
17.	Negro F, Gentile F, Rizza A, et al. Etiology, clinical presentation, and management of left main coronary artery aneurysms. J Card Surg, 2022, 37(11): 3675-3686.
18.	Fan T, Zhou Z, Fang W, et al. Morphometry and hemodynamics of coronary artery aneurysms caused by atherosclerosis. Atherosclerosis, 2019, 284: 187-193.
19.	Abdollahi R, Vahidi B, Shojaee P, et al. A comparative study between CFD and FSI hemodynamic parameters in a patientspecific giant saccular cerebral aneurysm. AUT Journal of Modeling and Simulation, 2021, 53(1): 23-38.
20.	Wang H, Anzai H, Liu Y, et al. Hemodynamic-based evaluation on thrombosis risk of fusiform coronary artery aneurysms using computational fluid dynamic simulation method. Complexity, 2020, 2020: 8507273.
21.	Philip N T, Bolem S, Sudhir B J, et al. Hemodynamics and bio-mechanics of morphologically distinct saccular intracranial aneurysms at bifurcations: idealised vs patient-specific geometries. Comput Methods Programs Biomed, 2022, 227: 107237.
22.	Pivkin I V, Richardson P D, Laidlaw D H, et al. Combined effects of pulsatile flow and dynamic curvature on wall shear stress in a coronary artery bifurcation model. J Biomech, 2005, 38(6): 1283-1290.
23.	Medrano-Gracia P, Ormiston J, Webster M, et al. A study of coronary bifurcation shape in a normal population. J Cardiovasc Transl Res, 2017, 10(1): 82-90.
24.	Chiastra C, Gallo D, Tasso P, et al. Healthy and diseased coronary bifurcation geometries influence near-wall and intravascular flow: A computational exploration of the hemodynamic risk. J Biomech, 2017, 58: 79-88.
25.	Oviedo C, Maehara A, Mintz G S, et al. Intravascular ultrasound classification of plaque distribution in left main coronary artery bifurcations: where is the plaque really located?. Circulation: Cardiovascular Interventions, 2010, 3(2): 105-112.
26.	Rabby M G, Shupti S P, Molla M M. Pulsatile non-newtonian laminar blood flows through arterial double stenoses. Journal of Fluid, 2014, 2014: 757902.
27.	Abbasian M, Shams M, Valizadeh Z, et al. Effects of different non-Newtonian models on unsteady blood flow hemodynamics in patient-specific arterial models with in-vivo validation. Comput Methods Programs Biomed, 2020, 186: 105185.
28.	Evju Ø, Mardal K A. On the assumption of laminar flow in physiological flows: cerebral aneurysms as an illustrative example. Modeling The Heart and The Circulatory System, 2015: 177-195.
29.	Trenti C, Ziegler M, Bjarnegård N, et al. Wall shear stress and relative residence time as potential risk factors for abdominal aortic aneurysms in males: a 4D flow cardiovascular magnetic resonance case–control study. J Cardiovasc Magn Reson, 2022, 24(1): 18.
30.	Castro M A, Putman C M, Sheridan M J, et al. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture. Am J Neuroradiol, 2009, 30(2): 297-302.
31.	Cebral J R, Mut F, Weir J, et al. Quantitative characterization of the hemodynamic environment in ruptured and unruptured brain aneurysms. Am J Neuroradiol, 2011, 32(1): 145-151.
32.	Hassan T, Timofeev E V, Saito T, et al. A proposed parent vessel geometry-based categorization of saccular intracranial aneurysms: computational flow dynamics analysis of the risk factors for lesion rupture. J Neurosurg, 2005, 103(4): 662-680.
33.	Nixon A M, Gunel M, Sumpio B E. The critical role of hemodynamics in the development of cerebral vascular disease. J Neurosurg, 2010, 112(6): 1240-1253.
34.	Xiang J, Natarajan S K, Tremmel M, et al. Hemodynamic-morphologic discriminants for intracranial aneurysm rupture. Stroke, 2011, 42: 144-152.

1. Matta A G, Yaacoub N, Nader V, et al. Coronary artery aneurysm: a review. World J Cardiol, 2021, 13(9): 446-455.
2. Kim J H, Han H, Moon Y J, et al. Hemodynamic features of microsurgically identified, thin-walled regions of unruptured middle cerebral artery aneurysms characterized using computational fluid dynamics. Neurosurgery, 2020, 86(6): 851-859.
3. Oliveira I L, Santos G B, Militzer J, et al. A longitudinal study of a lateral intracranial aneurysm: identifying the hemodynamic parameters behind its inception and growth using computational fluid dynamics. Journal of the Brazilian Society of Mechanical Sciences and Engineering, 2021, 43: 138.
4. 刘梦辰, 潘霁超, 蔡彦, 等. 动脉粥样硬化斑块的生物力学模型和数值模拟研究. 生物医学工程学杂志, 2020, 37(6): 948-955.
5. 何家胜, 钟伟健. 动脉粥样硬化斑块的断裂力学数值模拟研究. 生物医学工程学杂志, 2021, 38(6): 1097-1102, 1110.
6. Teng B, Zhou Z, Zhao Y, et al. Combined curvature and wall shear stress analysis of abdominal aortic aneurysm: an analysis of rupture risk factors. Cardiovasc Intervent Radiol, 2022, 45(6): 752-760.
7. Zhao J, Xiang X, Zhang H, et al. A study of the association between carotid artery curvature and intracranial aneurysms. Neurologist, 2023, 28(2): 99-103.
8. Rashad S, Sugiyama S I, Niizuma K, et al. Impact of bifurcation angle and inflow coefficient on the rupture risk of bifurcation type basilar artery tip aneurysms. J Neurosurg, 2018, 128(3): 723-730.
9. Murayama Y, Fujimura S, Suzuki T, et al. Computational fluid dynamics as a risk assessment tool for aneurysm rupture. Neurosurg Focus, 2019, 47(1): E12.
10. Xiang J, Tutino V M, Snyder K V, et al. CFD: computational fluid dynamics or confounding factor dissemination? The role of hemodynamics in intracranial aneurysm rupture risk assessment. AJNR Am J Neuroradiol, 2014, 35(10): 1849-1857.
11. Liang L, Steinman D A, Brina O, et al. Towards the clinical utility of CFD for assessment of intracranial aneurysm rupture-a systematic review and novel parameter-ranking tool. J Neurointerv Surg, 2019, 11(2): 153-158.
12. Cebral J R, Vazquez M, Sforza D M, et al. Analysis of hemodynamics and wall mechanics at sites of cerebral aneurysm rupture. J Neurointerv Surg, 2015, 7(7): 530-536.
13. Mu L, Liu X, Liu M, et al. In vitro study of endothelial cell morphology and gene expression in response to wall shear stress induced by arterial stenosis. Front Bioeng Biotechnol, 2022, 10: 854109.
14. Mu L, Li X, Chi Q, et al. Experimental and numerical study of the effect of pulsatile flow on wall displacement oscillation in a flexible lateral aneurysm model. Acta Mechanica Sinica, 2019, 35: 1120-1129.
15. 王浩然, 张慧霞, 王文馨, 等. 左前降支冠状动脉瘤搭桥手术血流动力学研究. 北京生物医学工程, 2018, 37(5): 448-454, 466.
16. Indolfi C, Achille F, Tagliamonte G, et al. Polytetrafluoroethylene stent deployment for a left anterior descending coronary aneurysm complicated by late acute anterior myocardial infarction. Circulation, 2005, 112(5): e70-e71.
17. Negro F, Gentile F, Rizza A, et al. Etiology, clinical presentation, and management of left main coronary artery aneurysms. J Card Surg, 2022, 37(11): 3675-3686.
18. Fan T, Zhou Z, Fang W, et al. Morphometry and hemodynamics of coronary artery aneurysms caused by atherosclerosis. Atherosclerosis, 2019, 284: 187-193.
19. Abdollahi R, Vahidi B, Shojaee P, et al. A comparative study between CFD and FSI hemodynamic parameters in a patientspecific giant saccular cerebral aneurysm. AUT Journal of Modeling and Simulation, 2021, 53(1): 23-38.
20. Wang H, Anzai H, Liu Y, et al. Hemodynamic-based evaluation on thrombosis risk of fusiform coronary artery aneurysms using computational fluid dynamic simulation method. Complexity, 2020, 2020: 8507273.
21. Philip N T, Bolem S, Sudhir B J, et al. Hemodynamics and bio-mechanics of morphologically distinct saccular intracranial aneurysms at bifurcations: idealised vs patient-specific geometries. Comput Methods Programs Biomed, 2022, 227: 107237.
22. Pivkin I V, Richardson P D, Laidlaw D H, et al. Combined effects of pulsatile flow and dynamic curvature on wall shear stress in a coronary artery bifurcation model. J Biomech, 2005, 38(6): 1283-1290.
23. Medrano-Gracia P, Ormiston J, Webster M, et al. A study of coronary bifurcation shape in a normal population. J Cardiovasc Transl Res, 2017, 10(1): 82-90.
24. Chiastra C, Gallo D, Tasso P, et al. Healthy and diseased coronary bifurcation geometries influence near-wall and intravascular flow: A computational exploration of the hemodynamic risk. J Biomech, 2017, 58: 79-88.
25. Oviedo C, Maehara A, Mintz G S, et al. Intravascular ultrasound classification of plaque distribution in left main coronary artery bifurcations: where is the plaque really located?. Circulation: Cardiovascular Interventions, 2010, 3(2): 105-112.
26. Rabby M G, Shupti S P, Molla M M. Pulsatile non-newtonian laminar blood flows through arterial double stenoses. Journal of Fluid, 2014, 2014: 757902.
27. Abbasian M, Shams M, Valizadeh Z, et al. Effects of different non-Newtonian models on unsteady blood flow hemodynamics in patient-specific arterial models with in-vivo validation. Comput Methods Programs Biomed, 2020, 186: 105185.
28. Evju Ø, Mardal K A. On the assumption of laminar flow in physiological flows: cerebral aneurysms as an illustrative example. Modeling The Heart and The Circulatory System, 2015: 177-195.
29. Trenti C, Ziegler M, Bjarnegård N, et al. Wall shear stress and relative residence time as potential risk factors for abdominal aortic aneurysms in males: a 4D flow cardiovascular magnetic resonance case–control study. J Cardiovasc Magn Reson, 2022, 24(1): 18.
30. Castro M A, Putman C M, Sheridan M J, et al. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture. Am J Neuroradiol, 2009, 30(2): 297-302.
31. Cebral J R, Mut F, Weir J, et al. Quantitative characterization of the hemodynamic environment in ruptured and unruptured brain aneurysms. Am J Neuroradiol, 2011, 32(1): 145-151.
32. Hassan T, Timofeev E V, Saito T, et al. A proposed parent vessel geometry-based categorization of saccular intracranial aneurysms: computational flow dynamics analysis of the risk factors for lesion rupture. J Neurosurg, 2005, 103(4): 662-680.
33. Nixon A M, Gunel M, Sumpio B E. The critical role of hemodynamics in the development of cerebral vascular disease. J Neurosurg, 2010, 112(6): 1240-1253.
34. Xiang J, Natarajan S K, Tremmel M, et al. Hemodynamic-morphologic discriminants for intracranial aneurysm rupture. Stroke, 2011, 42: 144-152.

Journal of Biomedical Engineering

Hemodynamics simulation and analysis of left coronary artery aneurysms with concomitant stenosis

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