The effect of wall shear stress and oscillatory shear index on probability of atherosclerosis plaque formation in normal left coronary artery tree

It is accepted that wall shear stress (WSS) and Oscillatory Shear index (OSI) are strong hemodynamic factors to development of atherosclerotic (AS) plaque. Sometimes, OSI has an important effect on AS plaque formation, because WSS doesnt make it happen alone. Most computational fluid dynamic (CFD) simulations were performed on left main coronary bifurcation geometry, and whole left coronary artery tree has not been investigated by now. In this paper, a thorough three-dimensional model of left coronary artery tree was considered, including left main coronary, left anterior descending and its branches, left circumflex artery and its branches. Effects of cardiac motions on vessel wall of left coronary were considered. The governing Navier–Stokes equations for pulsatile flow and incompressible non-Newtonian blood was analyzed with finite element method. The study concentrates on shear stress distribution and OSI distribution on the vessel wall. Comparing the results of this study with previous clinical investigations shows that the regions with low wall shear stress (equal to and less than 1.5[Pa]) along with high OSI value (equal to and more than 0.3) have potential to development of AS plaque. So it can be predicted that the LAD region after D3 and the bifurcation of LCxA-OM have high potential to development of AS, in addition to the bifurcation of LCxA-LMCA which had been specified before.