Significance of plaque morphology in modifying flow characteristics in a diseased coronary artery: Numerical simulation using plaque measurements from intravascular ultrasound imaging

The paper deals with numerical investigation of the effect of plaque morphology on the flow characteristics in a diseased coronary artery using realistic plaque morphology. The morphological information of the lumen and the plaque is obtained from intravascular ultrasound imaging measurements of 42 patients performed at Cleveland Clinic Foundation, Ohio. For this data, study of Bhaganagar et al. (2010) [1] has revealed the stenosis for 42 patients can be categorized into four types – type I (peak-valley), type II (ascending), type III (descending), and type IV (diffuse). The aim of the present study is to isolate the effect of shape of the stenosis on the flow characteristics for a given degree of the stenosis. In this study, we conduct fluid dynamic simulations for the four stenosis types (type I–IV) and analyze the differences in the flow characteristics between these types. Finely refined tetrahedral mesh for the 3-D solid model of the artery with plaques has been generated. The 3-D steady flow simulations were performed using the turbulence (k–ε) model in a finite volume based computational fluid dynamics solver. The axial velocity, the radial velocity, turbulence kinetic energy and wall shear stress profiles of the plaque have been analyzed. From the axial and radial velocity profiles results the differences in the velocity patterns are significantly visible at proximal as well as distal to the throat, region of maximum stenosis. Turbulent kinetic energy and wall shear stress profiles have revealed significant differences in the vicinity of the plaque. Additional unsteady flow simulations have been performed to validate the hypothesis of the significance of plaque morphology in flow alterations in diseased coronary artery. The results revealed the importance of accounting for plaque morphology in addition to plaque height to accurately characterize the turbulent flow in a diseased coronary artery.