A Reduced-Order CFD Approach for Intermediate grade Coronary Arterial Clinical Parameter Assessment

TL;DR

This paper presents a novel reduced-order computational approach integrating patient-specific imaging and 1D/2D modeling to assess coronary artery stenosis severity, offering a reliable, non-invasive diagnostic tool.

Contribution

The study introduces a combined 1D-2D modeling framework using patient-specific CT data for detailed coronary hemodynamics analysis, enhancing non-invasive assessment of stenosis severity.

Findings

FFR and iFR decrease with stenosis severity

The method accurately captures global and local hemodynamics

Numerical results validated against literature data

Abstract

Coronary heart disease (CHD) remains a top reason of mortality worldwide. This study introduces a novel approach by integrating patient-specific Multi-slice CT scans into CAD models and employing a one-dimensional numerical framework to assess varying degrees of stenosis. The computational analysis encompasses the entire arterial tree, with a particular focus on stenosed coronary arteries modelled using an analytical equation. One-dimensional characteristic equations, utilizing forward and backward characteristic variables, are used to derive essential parameters such as area and velocity. A model based on resistance with reflection coefficient set to zero and realistic pressure waveform input is applied at the outflow and inflow respectively. Boundary conditions generated from the 1D model, capturing global characteristics, are subsequently used to simulate a 2D axisymmetric model, which captures local characteristics. The numerical solvers are validated against literature results, ensuring grid independence. Fractional Flow Reserve (FFR) and instantaneous wave-free ratio (iFR) are calculated using various non-Newtonian models across different severities for higher order model. Additionally, the role of lesion length in stenosed coronary arteries is investigated. Numerical simulations are performed over one cardiac cycle, covering both systole and diastole phases. The results demonstrate that FFR and iFR decrease with increasing stenosis severity. This method provides a reliable and non-invasive diagnostic tool for evaluating the functional severity of coronary artery stenosis in clinical settings, effectively capturing both global and local hemodynamic characteristics.