Key result
In computer simulations of coronary serial stenoses, a distal stenosis located further downstream caused a larger pressure drop and stronger reverse flow compared to the proximal stenosis.
Computational modeling demonstrates that in serial coronary stenoses, the distal lesion significantly dictates post-stenotic hemodynamics and pressure drops.
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Hypothesis-generating for serial stenosis assessment; human validation required before any clinical consideration.
Computer simulations of the blood flow through right coronary arteries with two stenoses in the same arterial segment are carried out to investigate the interactions of serial stenoses, especially the effect of the distal stenosis. Various mathematical models are developed by varying the location of the distal stenosis. The numerical results show that the variation of the distal stenosis has significant impact on coronary hemodynamics, such as the pressure drop, flow shifting, wall shear stress and flow separation. Our simulations demonstrate that the distal stenosis has insignificant effect on the disturbed flow pattern in the regions of upstream and across the proximal stenosis. In a curved artery segment with two moderate stenoses of the same size, the distal stenosis causes a larger pressure drop and a more disturbed flow field in the poststenotic region than the proximal stenosis does. A distal stenosis located at a further downstream position causes a larger pressure drop and a stronger reverse flow.
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Liu et al. (2018) studied Coronary serial stenoses. Variation of distal stenosis location vs. Proximal stenosis was evaluated on Coronary hemodynamics (pressure drop, flow shifting, wall shear stress, flow separation). In computer simulations of coronary serial stenoses, a distal stenosis located further downstream caused a larger pressure drop and stronger reverse flow compared to the proximal stenosis.
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