Computational Assessment of Hemodynamics in Asymmetric-Type Lesion of Idealized Coronary Stenoses

Abstract

Purpose: Coronary artery stenosis, characterized by the narrowing of the arterial lumen, significantly alters blood flow and contributes to the progression of cardiovascular diseases. This study investigates the hemodynamic effects of different stenosis morphologies, all maintaining an 80% lumen reduction, to determine how variations in shape influence flow behavior and mechanical stresses. Methods: We employed computational fluid dynamics (CFD) to analyze five idealized stenosis geometries with the following asymmetric and symmetric configurations: C1 (10% and 70%), C2 (20% and 60%), C3 (30% and 50%), C4 (40% and 40%), and C5 (0% and 80%). Using physiological pulsatile flow conditions, we evaluated key hemodynamic parameters, including velocity profiles, wall shear stress, and pressure distribution. Results: Despite having the same degree of lumen reduction, each stenosis configuration produced distinct hemodynamic profiles. Asymmetric stenoses, particularly the C1 and C2 cases, exhibited pronounced flow disturbances, higher wall shear stress at the stenosis throat, and increased post-stenotic turbulence. In contrast, symmetric stenoses, such as C4, demonstrated more uniform flow and reduced vortex formation. These findings suggest that stenosis morphology plays a crucial role in determining local flow dynamics. Conclusion: Our findings challenge the common practice of generalizing results across stenosis configurations without considering morphological variations, which is prevalent in many CFD studies using idealized models. This study emphasizes the need for stenosis-specific assessments in CFD analyses and clinical interpretations to improve the accuracy of diagnostic tools, optimize personalized treatment strategies, and guide the design of medical devices such as stents. © The Author(s), under exclusive licence to The Brazilian Society of Biomedical Engineering 2025.