Computational study of the risk of restenosis in coronary bypasses


Computational Medicine for the Cardiocirculatory System
Computational study of the risk of restenosis in coronary bypasses
Wednesday 9th March 2016
Guerciotti, B; Vergara, C; Ippolito, S; Quarteroni, A; Antona, C; Scrofani, R.
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Coronary artery disease, caused by the build-up of atherosclerotic plaques in the coronary vessel wall, is one of the leading causes of death in the world. For high-risk patients, coronary artery bypass graft is the preferred treatment. Despite overall excellent patency rates, bypasses may fail due to restenosis. In this context, the purpose of this work is to perform a parametric computational study of the fuid-dynamics in patient-specific geometries with the aim of investigating a possible relationship between coronary stenosis degree and risk of graft failure. Firstly, we propose a strategy to prescribe realistic boundary conditions in absence of measured data, based on an extension of Murray's law to provide the flow division at bifurcations in case of stenotic vessels and non-Newtonian blood rheology. Then, we carry out numerical simulations in three patients affected by severe coronary stenosis and treated with a graft, in which the stenosis degree is virtually varied in order to compare the resulting fluid-dynamics in terms of hemodynamic indices potentially involved in restenosis development. Our findings suggest that low degrees of coronary stenosis produce a more disturbed fluid-dynamics in the graft, resulting in hemodynamic conditions that may promote a higher risk of graft failure.