Influence of Multi Stenosis on Hemodynamic Parameters in an Idealized Coronary Artery Model

Document Type : Regular Article


Department of Mechanical Engineering, College of Engineering, King Khalid University, PO Box 394, Abha 61421, Kingdom of Saudi Arabia


This study explores the influence of tandem stenosis on hemodynamic constraints in idealized coronary artery models with different interspace distance between the stenosis and its severity. The blood was assumed as non-Newtonian, incompressible, and pulsatile fluid. The hemodynamic parameters of blood, such as the oscillatory shear index (OSI), wall shear stress (WSS) and time average wall shear stress (TAWSS) are obtained and compared for various degrees of stenosis and interspacing distance in various blood models. The computed results showed that as the interspacing distance between the stenosis decreases, the low wall shear stress area increases for the model P70_D70, leading to further progression of stenosis in the distal region. No significant variation was observed for the model P70_D90, whereas the low WSS region increases as the interspace distance of proximal and distal stenosis increases for the model P90_D70. The highest TAWSS sites were created across the 90% AS (area stenosis) for all the cases studied. As the higher value of TAWSS is clinically significant since it could damage the endothelial layer. It is well known that the maximum value of OSI is strongly associated with the critical areas of stenosis rupture. The maximum value of OSI was found at the proximal and distal stenosis for all the models simulated.


Badruddin, I. A., S. Kamangar, A. Algahtani, M. A. Khan, S. A. NJ, C. A. Saleel and T. Y. Khan (2019). A Computational Study of Curvature Effect on the Coronary Diagnostic Parameters in Stenosed Coronary Artery. Chinese Journal of Mechanical Engineering 40(5), 539-546.##
Banerjee, R. K., L. H. Back, M. R. Back and Y. I. Cho (2003). Physiological flow analysis in significant human coronary artery stenoses. Biorheology 40(4), 451-476.##
Berger, S. and L. D. Jou (2000). Flows in stenotic vessels. Annual Review of Fluid Mechanics 32(1), 347-382.##
Buradi, A. and A. Mahalingam (2018) Effect of Stenosis Severity on Wall Shear Stress Based Hemodynamic Descriptors using Multiphase Mixture Theory, Journal of Applied Fluid Mechanics 11(6), 1497-1509.##
Caro, C., J. Fitz-Gerald and R. Schroter (1969) Arterial wall shear and distribution of early atheroma in man. Nature 223(5211), 1159-1161.##
Chatzizisis, Y. S., A. U. Coskun, M. Jonas, E. R. Edelman, C. L. Feldman and P. H. Stone (2007). Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior. Journal of the American College of Cardiology 49(25), 2379-2393.##
Dash, R. K., Jayaraman, G. and K. N. Mehta (1999). Flow in a catheterized curved artery with stenosis. Journal of Biomechanics 32(1), 49-61.##
Frauenfelder, T., E. Boutsianis, T. Schertler, L. Husmann, S. Leschka, D. Poulikakos and H. Alkadhi (2007). Flow and wall shear stress in end-to-side and side-to-side anastomosis of venous coronary artery bypass grafts. Biomedical Engineering Online 6(1), 35.##
Govindaraju, K., G. N. Viswanathan, I. A. Badruddin, S. Kamangar, N. S. Ahmed and A. A. Al-Rashed (2016). A parametric study of the effect of arterial wall curvature on non-invasive assessment of stenosis severity: computational fluid dynamics study. Current Science 483-491.##
He, X. and Ku, D. N. (1996). Pulsatile flow in the human left coronary artery bifurcation: average conditions. Journal of Biomechanical Engineering 118(1), 74-82.##
Jahangiri, M., M.  Saghafian and M. R. Sadeghi (2015). Numerical simulation of hemodynamic parameters of turbulent and pulsatile blood flow in flexible artery with single and double stenoses. Journal of Mechanical Science and Technology 29(8), 3549-3560.##
Kamangar, S., G. Kalimuthu, I. Anjum Badruddin, A. Badarudin, N. J. Salman Ahmed and T. M. Khan (2014). Numerical investigation of the effect of stenosis geometry on the coronary diagnostic parameters. The Scientific World Journal 2014, 1-7.##
Kamangar, S., I. A. Badruddin, N. A. Ahamad, K. Govindaraju, N. Nik-Ghazali, N. J. Ahmed and T. M. Khan (2017a). The Influence of Geometrical Shapes of Stenosis on the Blood Flow in Stenosed Artery. Sains Malaysiana 46(10), 1923-1933.##
Kamangar, S., I. A. Badruddin, K. Govindaraju, N. Nik-Ghazali, A. Badarudin, G. N. Viswanathan and T. Y. Khan (2017b). Patient-specific 3D hemodynamics modelling of left coronary artery under hyperemic conditions. Medical & Biological Engineering & Computing 55(8), 1451-1461.##
Kamangar, S., N. J. Salman Ahmed, I. A. Badruddin, N. Al-Rawahi, A. Husain, K. Govindaraju and Y. Khan (2019). Effect of stenosis on hemodynamics in left coronary artery based on patient-specific CT scan. Bio-Medical Materials and Engineering 30(4), 463-473.##
Karayannacos, P. E., N. Talukder, R. M. Nerem, S. Roshon and J. S. Vasko (1977). The role of multiple noncritical arterial stenoses in the pathogenesis of ischemia. The Journal of Thoracic and Cardiovascular Surgery 73(3), 458-469.##
Karimi, S., M. Dabagh, P. Vasava, M. Dadvar, B. Dabir and P. Jalali (2014). Effect of rheological models on the hemodynamics within human aorta: CFD study on CT image-based geometry. Journal of Non-Newtonian Fluid Mechanics 207, 42-52.##
Konala, B. C., A. Das and R. K. Banerjee (2011). Influence of arterial wall-stenosis compliance on the coronary diagnostic parameters. Journal of Biomechanics 44(5), 842-847.##
Li, M. X., J. J. Beech-Brandt, L. R. John, P. R Hoskins and W. J. Easson (2007). Numerical analysis of pulsatile blood flow and vessel wall mechanics in different degrees of stenoses. Journal of Biomechanics 40(16), 3715-3724.##
Malek, A.M., S.L. Alper and S. J. J. Izumo (1999). Hemodynamic shear stress and its role in atherosclerosis 282(21), 2035-2042.##
Moreno, C. and K. Bhaganagar (2013). Modeling of Stenotic coronary artery and implications of plaque morphology on blood flow. Modelling and Simulation in Engineering 2013.##
Nosovitsky, V. A., O. J. Ilegbusi, J. Jiang, P. H. Stone and C. L. Feldman (1997). Effects of curvature and stenosis-like narrowing on wall shear stress in a coronary artery model with phasic flow. Computers and Biomedical Research 30(1), 61-82.##
Rathish Kumar, B. V., T. Yamaguchi, H. Liu and R. Himeno (2002). A numerical study of an unsteady laminar flow in a doubly constricted 3D vessel. International Journal for Numerical Methods in Fluids 38(12), 1159-1176.##
Stone, P. H., A. U. Coskun, Y. Yeghiazarians, S. Kinlay, J. J. Popma, R. E. Kuntz and C. L. Feldman (2003). Prediction of sites of coronary atherosclerosis progression: in vivo profiling of endothelial shear stress, lumen, and outer vessel wall characteristics to predict vascular behavior. Current Opinion in Cardiology 18(6), 458-470.##
Suess, T., J. Anderson, L. Danielson, K. Pohlson, T. Remund, E. Blears and P. Kelly (2016). Examination of near-wall hemodynamic parameters in the renal bridging stent of various stent graft configurations for repairing visceral branched aortic aneurysms. Journal of Vascular Surgery 64(3), 788-796.##
Wu, J., G. Liu, W. Huang, D. N. Ghista and K. K. Wong (2015). Transient blood flow in elastic coronary arteries with varying degrees of stenosis and dilatations: CFD modelling and parametric study. Computer Methods in Biomechanics and Biomedical Engineering 18(16), 1835-1845.##