Investigating the Impact of Arterial Irregularity On Clinical Parameters Using Reduced Order CFD Models In Stenosed Coronary Artery

Abstract: Coronary heart disease (CHD) remains a leading cause of mortality worldwide. This study introduces a novel approach that integrates patient-specific Multi-slice CT scans into CAD models, using a one-dimensional numerical framework to assess varying degrees of coronary artery stenosis. The computational analysis encompasses the entire arterial tree, with a particular focus on stenosed coronary arteries modeled analytically. Key parameters, such as area and velocity, are derived from one-dimensional characteristic equations based on forward and backward characteristic variables. A resistance model with zero reflection coefficient and realistic pressure waveform inputs is applied at the outflow and inflow, respectively. The global characteristics captured by the 1D model serve as boundary conditions for a 2D axisymmetric model that focuses on local characteristics. The numerical solvers are validated against existing literature, ensuring grid independence. Fractional Flow Reserve (FFR) and Instantaneous wave-free Ratio (iFR) are calculated using various non-Newtonian models across different stenosis severities. The study also investigates the impact of lesion irregularity in stenosed coronary arteries, finding that irregular arteries exhibit lower FFR and iFR values and higher pressure drops, indicating increased blood flow resistance. This method provides a reliable, non-invasive diagnostic tool for evaluating the functional severity of irregular coronary artery stenosis in clinical settings, effectively capturing both global and local hemodynamic characteristics.