{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:47:51Z","timestamp":1777866471242,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001409","name":"DST-INTERNATIONAL BILATERAL COOPERATION DIVISION GRANT","doi-asserted-by":"publisher","award":["DST\/JSPS\/P-293\/2019"],"award-info":[{"award-number":["DST\/JSPS\/P-293\/2019"]}],"id":[{"id":"10.13039\/501100001409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computation"],"abstract":"<jats:p>Understanding the hemodynamics of the carotid artery is essential for assessing atherosclerotic disease progression and identifying regions vulnerable to plaque formation. Background: Disturbed flow patterns and abnormal shear stresses, particularly near the carotid bifurcation, are known to influence endothelial dysfunction; therefore, this study aims to quantify the impact of patient-specific carotid artery geometry on key hemodynamic parameters associated with atherosclerotic risk. Methods: Four patient-specific carotid artery geometries were reconstructed from medical imaging data, processed using MIMICS, and analyzed using computational fluid dynamics in ANSYS Fluent, with blood modeled as an incompressible non-Newtonian fluid using the Carreau\u2013Yasuda viscosity model under pulsatile flow conditions; velocity streamlines, pressure distribution, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) were evaluated at early systole, peak systole, and peak diastole. Results: The simulations revealed complex flow behaviour, including flow reversal, pressure build-up, and low-shear regions concentrated near the carotid bulb and bifurcation, with TAWSS consistently identifying low-shear zones (&lt;1 Pa) across all geometries and OSI exhibiting pronounced directional oscillations in models with increased curvature and wider bifurcation angles. Conclusions: These findings demonstrate that geometric characteristics such as bifurcation angle, vessel tortuosity, and asymmetry play a critical role in shaping local haemodynamics, underscoring the utility of patient-specific CFD analysis as a diagnostic and predictive tool for atherosclerotic risk assessment and supporting more informed, personalized clinical decision-making.<\/jats:p>","DOI":"10.3390\/computation14040077","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:10:24Z","timestamp":1774537824000},"page":"77","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient-Specific CFD Analysis of Carotid Artery Haemodynamics: Impact of Anatomical Variations on Atherosclerotic Risk"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6655-2551","authenticated-orcid":false,"given":"Abhilash Hebbandi","family":"Ningappa","sequence":"first","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"},{"name":"Department of Mechanical Engineering, Indian Institute of Technology, Kharagpur 721302, West Bengal, India"}]},{"given":"S. M. Abdul","family":"Khader","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"given":"Harishkumar","family":"Kamat","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5938-346X","authenticated-orcid":false,"given":"Masaaki","family":"Tamagawa","sequence":"additional","affiliation":[{"name":"Department of Biological Functions Engineering, Graduate School of Life Sciences and System Engineering, Kyushu Institute of Technology, Kitakyushu, Fukuoka 808-0196, Japan"}]},{"given":"Ganesh","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular & Thoracic Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-3006","authenticated-orcid":false,"given":"Raghuvir","family":"Pai B.","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"given":"Prakashini","family":"Koteswar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis & Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"given":"Irfan Anjum","family":"Badruddin","sequence":"additional","affiliation":[{"name":"Mechanical Engineering Department, College of Engineering, King Khalid University, Abha 61421, Saudi Arabia"}]},{"given":"Mohammad","family":"Zuber","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"given":"Kevin Amith","family":"Mathias","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5011-1487","authenticated-orcid":false,"given":"Gowrava Shenoy","family":"Baloor","sequence":"additional","affiliation":[{"name":"Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 576104, India"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3232","DOI":"10.1093\/eurheartj\/ehw334","article-title":"Cardiovascular Disease in Europe: Epidemiological Update 2016","volume":"37","author":"Townsend","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"1","article-title":"Cardiovascular Disease in India: A 360 Degree Overview","volume":"76","author":"Sinha","year":"2020","journal-title":"Med. J. Armed Forces India"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4896","DOI":"10.1038\/s41598-025-89100-2","article-title":"Hemodynamic Effects of Stenosis with Varying Severity in Different Segments of the Carotid Artery Using Computational Fluid Dynamics","volume":"15","author":"Yang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1146\/annurev.fluid.29.1.399","article-title":"Blood Flow in Arteries","volume":"29","author":"Ku","year":"1997","journal-title":"Annu. Rev. Fluid Mech."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jbiomech.2015.11.009","article-title":"Computational Study of the Fluid-Dynamics in Carotids before and after Endarterectomy","volume":"49","author":"Guerciotti","year":"2016","journal-title":"J. Biomech."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ngo, M.T., Lee, U.Y., Ha, H., Jin, N., Chung, G.H., Kwak, Y.G., Jung, J., and Kwak, H.S. (2021). Comparison of Hemodynamic Visualization in Cerebral Arteries: Can Magnetic Resonance Imaging Replace Computational Fluid Dynamics?. J. Pers. Med., 11.","DOI":"10.3390\/jpm11040253"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1177\/0271678X241251976","article-title":"Exploring the Relationship between Hemodynamics and the Immune Microenvironment in Carotid Atherosclerosis: Insights from CFD and CyTOF Technologies","volume":"44","author":"Ya","year":"2024","journal-title":"J. Cereb. Blood Flow Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1016\/j.cma.2011.03.001","article-title":"Growth Model for Cholesterol Accumulation in the Wall of a Simplified 3D Geometry of the Carotid Bifurcation","volume":"200","author":"Gessaghi","year":"2011","journal-title":"Comput. Methods Appl. Mech. Eng."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2935195","DOI":"10.1155\/2017\/2935195","article-title":"Assessment of Influences of Stenoses in Right Carotid Artery on Left Carotid Artery Using Wall Stress Marker","volume":"2017","author":"Bit","year":"2017","journal-title":"BioMed Res. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e443","DOI":"10.1016\/j.wneu.2021.07.049","article-title":"Turbulence Intensity as an Indicator for Ischemic Stroke in the Carotid Web","volume":"154","author":"Bae","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"112907","DOI":"10.1016\/j.jbiomech.2025.112907","article-title":"Hemodynamic Simulation Analysis of Tandem Carotid Artery Stenosis Based on a Patient-Specific Case","volume":"191","author":"Cao","year":"2025","journal-title":"J. Biomech."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1550008","DOI":"10.1142\/S0219519415500086","article-title":"The Influence of Hemodynamics on the Ulceration Plaques of Carotid Artery Stenosis","volume":"15","author":"Fu","year":"2015","journal-title":"J. Mech. Med. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.euromechflu.2012.03.011","article-title":"Shear-Induced Platelet Activation and Its Relationship with Blood Flow Topology in a Numerical Model of Stenosed Carotid Bifurcation","volume":"35","author":"Massai","year":"2012","journal-title":"Eur. J. Mech. B\/Fluids"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"011011","DOI":"10.1115\/1.4035122","article-title":"Modeling the Effect of Red Blood Cells Deformability on Blood Flow Conditions in Human Carotid Artery Bifurcation","volume":"139","author":"Urevc","year":"2017","journal-title":"J. Biomech. Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1016\/j.jbiomech.2011.06.028","article-title":"On the Importance of Blood Rheology for Bulk Flow in Hemodynamic Models of the Carotid Bifurcation","volume":"44","author":"Morbiducci","year":"2011","journal-title":"J. Biomech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.powtec.2018.07.091","article-title":"Multiphase Particle-in-Cell Simulation in Severe Internal Carotid Artery Stenosis","volume":"358","author":"Sia","year":"2019","journal-title":"Powder Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/978-3-319-59548-1_10","article-title":"Computational Comparison between Newtonian and Non-Newtonian Blood Rheologies in Stenotic Vessels","volume":"Volume 84","author":"Guerciotti","year":"2018","journal-title":"Biomedical Technology: Modeling, Experiments and Simulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1940054","DOI":"10.1142\/S0219519419400542","article-title":"The Effect of Patient-Specific Non-Newtonian Blood Viscosity on Arterial Hemodynamics Predictions","volume":"19","author":"Lee","year":"2019","journal-title":"J. Mech. Med. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"071006","DOI":"10.1115\/1.4001265","article-title":"Carotid Bifurcation Hemodynamics in Older Adults: Effect of Measured versus Assumed Flow Waveform","volume":"132","author":"Hoi","year":"2010","journal-title":"J. Biomech. Eng."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"121008","DOI":"10.1115\/1.4002800","article-title":"Effect of Common Carotid Artery Inlet Length on Normal Carotid Bifurcation Hemodynamics","volume":"132","author":"Hoi","year":"2010","journal-title":"J. Biomech. Eng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.37934\/araset.26.2.2940","article-title":"Pulsatile CFD Numerical Simulation to Investigate the Effect of Various Degree and Position of Stenosis on Carotid Artery Hemodynamics","volume":"26","author":"Subramaniam","year":"2022","journal-title":"J. Adv. Res. Appl. Sci. Eng. Technol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1108\/09615531111177741","article-title":"Influences of Domain Extensions to a Moderately Stenosed Patient-Specific Carotid Bifurcation: Investigation of Wall Quantities","volume":"21","author":"Nithiarasu","year":"2011","journal-title":"Int. J. Numer. Methods Heat Fluid Flow"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"091005","DOI":"10.1115\/1.4001886","article-title":"Outflow Conditions for Image-Based Hemodynamic Models of the Carotid Bifurcation: Implications for Indicators of Abnormal Flow","volume":"132","author":"Morbiducci","year":"2010","journal-title":"J. Biomech. Eng."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.1016\/j.cma.2006.10.014","article-title":"Transitional Flows in Arterial Fluid Dynamics","volume":"196","author":"Rayz","year":"2007","journal-title":"Comput. Methods Appl. Mech. Eng."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s13246-014-0246-0","article-title":"Effect of Postural Changes on Normal and Stenosed Common Carotid Artery Using FSI","volume":"37","author":"Ayachit","year":"2014","journal-title":"Australas. Phys. Eng. Sci. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1115\/1.2165691","article-title":"Numerical Simulation of Local Blood Flow in the Carotid and Cerebral Arteries Under Altered Gravity","volume":"128","author":"Kim","year":"2006","journal-title":"J. Biomech. Eng."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fung, Y.C. (1984). Biodynamics, Springer.","DOI":"10.1007\/978-1-4757-3884-1"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ferziger, J.H., and Peri\u0107, M. (2002). Computational Methods for Fluid Dynamics, Springer.","DOI":"10.1007\/978-3-642-56026-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/j.rinp.2018.01.021","article-title":"On Multiple Solutions of Non-Newtonian Carreau Fluid Flow over an Inclined Shrinking Sheet","volume":"8","author":"Khan","year":"2018","journal-title":"Results Phys."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Weddell, J.C., Kwack, J.H., Imoukhuede, P.I., and Masud, A. (2015). Hemodynamic Analysis in an Idealized Artery Tree: Differences in Wall Shear Stress between Newtonian and Non-Newtonian Blood Models. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0124575"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.jbiomech.2012.07.007","article-title":"Helical Flow in Carotid Bifurcation as Surrogate Marker of Exposure to Disturbed Shear","volume":"45","author":"Gallo","year":"2012","journal-title":"J. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e262","DOI":"10.1016\/j.wneu.2018.09.091","article-title":"Hemodynamic Factors Affecting Carotid Sinus Atherosclerotic Stenosis","volume":"121","author":"Li","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_33","unstructured":"Khader, S.M.A., Kumar, N., Pai, R., Khader, S.M.A., Kumar, N., and Pai, R. (2020). Fluid Structure Interaction Study of Stenosed Carotid Artery Considering the Effects of Blood Pressure and Altered Gravity. Finite Element Methods and Their Applications, IntechOpen."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"47","DOI":"10.37934\/arfmts.97.1.4761","article-title":"Influence of Altered Pressures on Flow Dynamics in Carotid Bifurcation System Using Numerical Methods","volume":"97","author":"Ningappa","year":"2022","journal-title":"J. Adv. Res. Fluid Mech. Therm. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/0021-9290(95)95273-8","article-title":"Computer Simulation of Local Blood Flow and Vessel Mechanics in a Compliant Carotid Artery Bifurcation Model","volume":"28","author":"Perktold","year":"1995","journal-title":"Biomechanics"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s12572-016-0161-6","article-title":"Computational Fluid Dynamic Simulation of Human Carotid Artery Bifurcation Based on Anatomy and Volumetric Blood Flow Rate Measured with Magnetic Resonance Imaging","volume":"8","author":"Gharahi","year":"2016","journal-title":"Int. J. Adv. Eng. Sci. Appl. Math."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.advms.2015.07.009","article-title":"Computational Simulation of Carotid Stenosis and Flow Dynamics Based on Patient Ultrasound Data\u2014A New Tool for Risk Assessment and Surgical Planning","volume":"61","author":"Sousa","year":"2016","journal-title":"Adv. Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jvs.2014.01.069","article-title":"Closure Technique after Carotid Endarterectomy Influences Local Hemodynamics","volume":"60","author":"Harrison","year":"2014","journal-title":"J. Vasc. Surg."},{"key":"ref_39","first-page":"293","article-title":"Pulsatile Flow and Atherosclerosis in the Human Carotid Bifurcation. Positive Correlation between Plaque Location and Low Oscillating Shear Stress","volume":"5","author":"Ku","year":"1985","journal-title":"Arterioscler. Off. J. Am. Heart Assoc. Inc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1115\/1.2795948","article-title":"Pulsatile Flow in the Human Left Coronary Artery Bifurcation: Average Conditions","volume":"118","author":"He","year":"1996","journal-title":"J. Biomech. Eng."}],"container-title":["Computation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-3197\/14\/4\/77\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:44:38Z","timestamp":1777538678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-3197\/14\/4\/77"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["computation14040077"],"URL":"https:\/\/doi.org\/10.3390\/computation14040077","relation":{},"ISSN":["2079-3197"],"issn-type":[{"value":"2079-3197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]}}}