Computational methods used to investigate atherosclerosis progression in coronary arteries: structural FEA, CFD or FSI

• Published in: Computer methods and programs in biomedicine Vol. 270; p. 108959
• Main Authors: Lissoni, Vittorio, Luraghi, Giulia, Stefanati, Marco, Rodriguez Matas, Jose Felix, Migliavacca, Francesco
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2025
• Subjects: Algorithms; Atherosclerosis; Atherosclerosis - diagnostic imaging; Atherosclerosis - pathology; Atherosclerosis - physiopathology; Computational fluid dynamics; Computer Simulation; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Coronary hemodynamics; Coronary simulation runtime; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Coronary Vessels - physiopathology; Disease Progression; Finite Element Analysis; Fluid-structure interaction; Humans; Hydrodynamics; Models, Cardiovascular; Pre-stress; Stress, Mechanical; Structural FEA; Computational fluid dynamics; Structural FEA; Atherosclerosis; Coronary simulation runtime; Fluid-structure interaction; Coronary hemodynamics; Pre-stress
• ISSN: 0169-2607; 1872-7565; 1872-7565
• DOI: 10.1016/j.cmpb.2025.108959

•Accounting for pre-stress led to significantly different structural results.•FSI provided similar atherosclerosis progression indices as CFD and FEA.•Assumptions made in CFD and FEA do not alter analysis of coronary atherosclerosis. In recent years, computational simulations have emerged as valuable tools for the evaluation of atherosclerosis progression in coronary anatomies, although only a few studies have utilized more realistic Fluid-Structure Interaction (FSI) simulations. This work aims to compare the results of Computational Fluid Dynamics (CFD), Structural Finite Element Analysis (structural FEA) and FSI simulations in order to assess differences in plaque progression indices estimation. We performed structural FEA, CFD and FSI on five patient-specific epicardial coronary anatomies using the commercial software LS-Dyna. To account for the vessel pre-stress, the zero-pressure configuration was calculated for each anatomy with an inverse elastostatic algorithm. CFD, structural FEA and FSI simulations were performed applying boundary conditions based on physiological values. The comparison between structural FEA and FSI showed similar stress distribution and vessel expansions, with differences found only in the distal parts of the coronaries, where pressure reduction due to pressure loss affects the vessel walls. The elastic walls of the coronaries impact blood flow, resulting in a more disturbed flow. However, time averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) distributions are similar across each coronary between CFD and FSI; TAWSS is slightly higher in CFD while OSI peaks are higher in FSI. In conclusion, given the significantly higher computational costs of FSI, we believe that CFD and structural FEA offer a more practical and cost-effective approach, providing results comparable to those of FSI, making them preferable options.