Document Detail


Which diameter and angle rule provides optimal flow patterns in a coronary bifurcation?
MedLine Citation:
PMID:  22365499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The branching angle and diameter ratio in epicardial coronary artery bifurcations are two important determinants of atherogenesis. Murray's cubed diameter law and bifurcation angle have been assumed to yield optimal flows through a bifurcation. In contrast, we have recently shown a 7/3 diameter law (HK diameter model), based on minimum energy hypothesis in an entire tree structure. Here, we derive a bifurcation angle rule corresponding to the HK diameter model and critically evaluate the streamline flow through HK and Murray-type bifurcations. The bifurcations from coronary casts were found to obey the HK diameter model and angle rule much more than Murray's model. A finite element model was used to investigate flow patterns for coronary artery bifurcations of various types. The inlet velocity and pressure boundary conditions were measured by ComboWire. Y-bifurcation of Murray type decreased wall shear stress-WSS (10%-40%) and created an increased oscillatory shear index-OSI in atherosclerosis-prone regions as compared with HK-type bifurcations. The HK-type bifurcations were found to have more optimal flow patterns (i.e., higher WSS and lower OSI) than Murray-type bifurcations which have been traditionally believed to be optimized. This study has implications for changes in bifurcation angles and diameters in percutaneous coronary intervention.
Authors:
Yunlong Huo; Gérard Finet; Thierry Lefevre; Yves Louvard; Issam Moussa; Ghassan S Kassab
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-02-25
Journal Detail:
Title:  Journal of biomechanics     Volume:  45     ISSN:  1873-2380     ISO Abbreviation:  J Biomech     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-16     Completed Date:  2012-08-09     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / adverse effects,  methods
Animals
Atherosclerosis / etiology,  pathology,  physiopathology
Biomechanical Phenomena
Blood Flow Velocity / physiology
Computer Simulation
Coronary Vessels / anatomy & histology*,  physiology*
Female
Finite Element Analysis
Hemodynamics / physiology
Hemorheology / physiology
Humans
Male
Models, Cardiovascular*
Stents
Sus scrofa
Grant Support
ID/Acronym/Agency:
R01 HL092048/HL/NHLBI NIH HHS; R01 HL092048-02/HL/NHLBI NIH HHS; R01-HL092048/HL/NHLBI NIH HHS

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