Features of local hemodynamics and the formation of atherosclerotic lesions in coronary artery bifurcation

Formation of atherosclerotic plaque in the coronary arteries is complex and multifactorial process, depending not only on conventional risk factors for cardiovascular diseases, but also on the features of local hemodynamics. Atherosclerotic plaques often form in the bifurcation area, where blood flow is uneven. In these settings, parietal shear stress becomes a key factor in the development, spread and progression of atherosclerotic plaque. In addition, a number of factors, such as the individual geometry of bifurcation, coronary stenting, and implantation technique can significantly affect the shear stress values, thus, affect the pathophysiology of coronary atherosclerosis.