TCT-174 Comparison of Thrombotic Risk Between Coronary Artery Aneurysm and Coronary Ectasia Based on Hemodynamic Parameters

Document Type

Article

Publication Date

9-20-2022

Department

Department of Biomedical Engineering

Abstract

Background

The aneurysmal form of the coronary arteries is mainly classified into 2 Categories: coronary artery aneurysm (CAA) and coronary artery ectasia (CAE). The corresponding thrombotic risk of these vascular phenotypes is assessed by the maximum luminal diameter and z-scores in the clinical routines. However, their morphology and local hemodynamic status can be much different. In this study, we compared the thrombotic risk of fusiform CAA with CAE on the basis of hemodynamic indexes, while having the same diameters and z-scores.

Methods

Idealized axisymmetric 3-dimensional models of CAA and CAE were designed with the same maximum diameter and z-scores. Computational fluid dynamics were used to simulate the blood flow in these 2 cases. The hemodynamic indexes time-averaged wall shear stress (TAWSS) and relative residence time (RRT) were calculated for each case. Generally, regions with low TAWSS and high RRT are correlated with an elevated risk for atherosclerosis and thrombosis.

Results

The streamlines at peak flow in these 2 cases are illustrated in Figure 1. The results indicate that although the mean TAWSS (0.999 [Pa] vs 1.065 [Pa]) and the mean RRT (2.84 [1/Pa] vs 2.58 [1/Pa]) for CAA and CAE are in the same range. However, it is observed that the area exposed to vortices and circulatory flow in CAE is much larger than in CAA, which are candidate sites for thrombus formation.

Publication Title

Journal of the American College of Cardiology

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