The impact of stenting on hemodynamic environment of tortuous coronary artery: results derived from a numerical simulation model

Figures

• 

  FIGURE 1. Construction of idealized tortuous coronary artery models. (a) Three levels of tortuosity (low, medium, and high) generated by varying arc curvature; (b) four stenosis severities (40%, 50%, 60%, and 70%) introduced at the third arc, resulting in 12 models; (c) representation of post-stenting geometry by straightening the third arc segment to simulate vessel straightening after stent implantation.

• 

  FIGURE 2. Mesh generation and mesh independence analysis. (a) Representative tetrahedral mesh with boundary layer refinement (5 layers). (b,c) Mesh convergence study showing variation of average velocity with mesh density. A mesh size of 0.25 mm was selected when the variation was less than 5%.

• 

  FIGURE 3. Boundary conditions used in computational fluid dynamics (CFD) simulations. The inlet and outlet were extended to ensure a fully developed flow. A pulsatile velocity waveform was prescribed at the inlet, and a time-dependent pressure condition was applied at the outlet.

• 

  FIGURE 4. Definition of hemodynamic metrics. (a) Velocity magnitude evaluated at three representative time points within the cardiac cycle (selected to capture low, peak, and intermediate flow phases), together with the cycle-averaged value; (b) wall shear stress (WSS) evaluated at the same time points.

• 

  FIGURE 5. Velocity reduction after stent implantation. (a) Intra-group comparison of velocity reduction under different stenosis severities within each tortuosity group. (a1–a3) Representative velocity contour distributions (or cross-sectional velocity fields) corresponding to high, medium, and low tortuosity, respectively, illustrating the spatial differences in velocity patterns among different tortuosity conditions. (b) Inter-group comparison of velocity reduction among low, medium, and high tortuosity groups at the same stenosis level.

• 

  FIGURE 6. WSS reduction after stent implantation. (a) Intra-group comparison of WSS reduction under different stenosis severities within each tortuosity group. (a1–a3) Representative WSS distributions corresponding to high, medium, and low tortuosity, respectively, illustrating the spatial differences in wall shear stress patterns among different tortuosity conditions; (b) Inter-group comparison of WSS reduction among low, medium, and high tortuosity groups at the same stenosis level.