Pulsatile spiral blood flow through arterial stenosis

Pulsatile spiral blood flow in a modelled three-dimensional arterial stenosis, with a 75% cross-sectional area reduction, is investigated by using numerical fluid dynamics. Two-equation k-ω model is used for the simulation of the transitional flow with Reynolds numbers 500 and 1000. It is found that the spiral component increases the static pressure in the vessel during the deceleration phase of the flow pulse. In addition, the spiral component reduces the turbulence intensity and wall shear stress found in the post-stenosis region of the vessel in the early stages of the flow pulse. Hence, the findings agree with the results of Stonebridge et al. (2004). In addition, the results of the effects of a spiral component on time-varying flow are presented and discussed along with the relevant pathological issues

The impact of the number of tears in patient-specific Stanford type B aortic dissecting aneurysm: CFD simulation

It is believed that the progression of Stanford type B aortic dissection is closely associated with vascular geometry and hemodynamic parameters. The hemodynamic differences owing to the presence of greater than two tears have not been explored. The focus of the present study is to investigate the impact of an additional re-entry tear on the flow, pressure and wall shear stress distribution in the dissected aorta. A 3D aorta model with one entry and one re-entry tear was generated from computed tomography (CT) angiographic images of a patient with Stanford Type B aortic dissection. To investigate the hemodynamic effect of more than two tear locations, an additional circular re-entry tear was added 24mm above the original re-entry tear. Our simulation results showed that the presence of an additional re-entry tear provided an extra return path for blood back to the true lumen during systole, and an extra outflow path into the false lumen during diastole. The presence of this additional path led to a decrease in the false lumen pressure, particularly at the distal region. Meanwhile, the presence of this additional tear causes no significant difference on the time average wall shear stress (TAWSS) distribution except at regions adjacent to re-entry tear 2. Moderate and concentrated TAWSS was observed at the bottom region of this additional tear which may lead to further extension of the tear distally

Effects of blood flow patent and cross-sectional area on hemodynamic into patient-specific cerebral aneurysm via fluid-structure interaction method : A review

Fluid-structure interaction (FSI) simulation is carried out to investigate the blood flow analysis in different patient-specific cerebral aneurysms. In this study, we reviewed the studies done on the numerical simulation of blood flow in patient-specific aneurysm by using FSI analysis methods. Based on these studies, the wall shear stress (WSS) plays an important role in the development, growth, and rupture of the cerebral aneurysm. Prediction of the hemodynamic forces near the aneurysmal site helps to understand the formation and rupture of the aneurysms better. Then most of the aneurysms studied are located in the middle cerebral artery (MCA). In the existing considered, many researchers are more familiar with the experimental method in studies of blood flow through cerebral aneurysm compared to the numerical method. Nevertheless, numerical simulation of patient-specific cerebral aneurysms can give a better understanding and clear visualization of WSS distribution and fluid flow pattern in the aneurysm region

Computational fluid dynamicaccuracy in mimicking changes in blood hemodynamics in patients with acute type IIIb aortic dissection treated with TEVAR

Background: We aimed to verify the accuracy of the Computational Fluid Dynamics (CFD) algorithm for blood flow reconstruction for type IIIb aortic dissection (TBAD) before and after thoracic endovascular aortic repair (TEVAR). Methods: We made 3D models of the aorta and its branches using pre- and post-operative CT data from five patients treated for TBAD. The CFD technique was used to quantify the displacement forces acting on the aortic wall in the areas of endograft, mass flow rate/velocity and wall shear stress (WSS). Calculated results were verified with ultrasonography (USG-Doppler) data. Results: CFD results indicated that the TEVAR procedure caused a 7-fold improvement in overall blood flow through the aorta (p = 0.0001), which is in line with USG-Doppler data. A comparison of CFD results and USG-Doppler data indicated no significant change in blood flow through the analysed arteries. CFD also showed a significant increase in flow rate for thoracic trunk and renal arteries, which was in accordance with USG-Doppler data (accuracy 90% and 99.9%). Moreover, we observed a significant decrease in WSS values within the whole aorta after TEVAR compared to pre-TEVAR (1.34 ± 0.20 Pa vs. 3.80 ± 0.59 Pa, respectively, p = 0.0001). This decrease was shown by a significant reduction in WSS and WSS contours in the thoracic aorta (from 3.10 ± 0.27 Pa to 1.34 ± 0.11Pa, p = 0.043) and renal arteries (from 4.40 ± 0.25 Pa to 1.50 ± 0.22 Pa p = 0.043). Conclusions: Post-operative remodelling of the aorta after TEVAR for TBAD improved hemodynamic patterns reflected by flow, velocity and WSS with an accuracy of 99%

Image‐based computational fluid dynamics for estimating pressure drop and fractional flow reserve across iliac artery stenosis: a comparison with in‐vivo measurements

Computational Fluid Dynamics (CFD) and time‐resolved phase‐contrast magnetic resonance imaging (PC‐MRI) are potential non‐invasive methods for the assessment of the severity of arterial stenoses. Fractional flow reserve (FFR) is the current “gold standard” for determining stenosis severity in the coronary arteries but is an invasive method requiring insertion of a pressure wire. CFD derived FFR (vFFR) is an alternative to traditional catheter derived FFR now available commercially for coronary artery assessment, however, it can potentially be applied to a wider range of vulnerable vessels such as the iliac arteries. In this study CFD simulations are used to assess the ability of vFFR in predicting the stenosis severity in a patient with a stenosis of 77% area reduction (>50% diameter reduction) in the right iliac artery. Variations of vFFR, overall pressure drop and flow split between the vessels were observed by using different boundary conditions. Correlations between boundary condition parameters and resulting flow variables are presented. The study concludes that vFFR has good potential to characterise iliac artery stenotic disease

A computational study on the biomechanical factors related to stent-graft models in the thoracic aorta

Endovascular aortic stent-graft is a new, minimally invasive procedure for treating thoracic aortic diseases, and has quickly evolved to be one of the standard treatments subject to anatomic constraints. This procedure involves the placement of a self-expanding stent-graft system in a high-flow thoracic aorta. Stent-graft deployment in the thoracic aorta, especially close to the aortic arch, normally experiences a significant drag force which might lead to the risk of stent-graft failure. A comprehensive investigation on the biomechanical factors affecting the drag force on a stent-graft in the thoracic aorta is thus in order, and the goal is to perform an in-depth study on the contributing biomechanical factors. Three factors affecting the deployed stent-graft are considered, namely, the internal diameter of the vessel, the starting position of the graft and the diameter of curvature of the aortic arch. Computational fluid dynamic techniques are applied to model the blood flow. The inlet velocity and outlet pressure are assumed to be pulsatile. The three-dimensional continuity equation and the time-dependent Navier-Stokes equations for an incompressible fluid were solved numerically. The drag force due to the change of momentum within the stent-graft and the shear stress were calculated and analyzed. The drag force on a stent-graft will depend critically on the internal diameter and the starting position of stent-graft deployment. Larger internal diameter leads to larger drag force and the stent-graft deployed at the more distal position may be associated with significantly diminished drag force. Smaller diameter of curvature of the aortic arch probably results in a decline of the drag force on the stent-graft, even though this factor merely causes only a modest difference. These findings may have important implications for the choice and design of stent-grafts in the future. © International Federation for Medical and Biological Engineering 2008.link_to_subscribed_fulltex

Computational analysis of blood flow and stress patterns in the aorta of patients with Marfan syndrome

Personalised external aortic root support (PEARS) was designed to prevent progressive aortic dilatation, and the associated risk of aortic dissection, in patients with Marfan syndrome by providing an additional support to the aorta. The objective of this thesis was to understand the biomechanical implications of PEARS surgery as well as to investigate the altered haemodynamics associated with the disease and its treatment. Finite element (FE) models were developed using patient-specific aortic geometries reconstructed from pre and post-PEARS magnetic resonance (MR) images of three Marfan patients. The wall and PEARS materials were assumed to be isotropic, incompressible and linearly elastic. A static load on the inner wall corresponding to the patients’ pulse pressure was applied with a zero-displacement constraint at all boundaries. Results showed that peak aortic stresses and displacements before PEARS were located at the sinuses of Valsalva but following PEARS surgery, they were shifted to the aortic arch, at the intersection between the supported and unsupported aorta. The zero-displacement constraint at the aortic root was subsequently removed and replaced with downward motion measured from in vivo images. This revealed significant increases in the longitudinal wall stress, especially in the pre-PEARS models. Computational fluid dynamics (CFD) models were developed to evaluate flow characteristics. The correlation-based transitional Shear Stress Transport (SST-Tran) model was adopted to simulate potential transitional and turbulence flow during part of the cardiac cycle and flow waveforms derived from phase-contrast MR images were imposed at the inlets. Qualitative patterns of the haemodynamics were similar pre- and post-PEARS with variations in mean helicity flow index (HFI) of -10%, 35% and 20% in the post-PEARS aortas of the three patients. A fluid-structure interaction (FSI) model was developed for one patient, pre- and post-PEARS in order to examine the effect of wall compliance on aortic flow as well as the effect of pulsatile flow on wall stress. This model excluded the sinuses and was based on the laminar flow assumption. The results were similar to those obtained using the rigid wall and static structural models, with minor quantitative differences. Considering the higher computational cost of FSI simulations and the relatively small differences observed in peak wall stress, it is reasonable to suggest that static structural models would be sufficient for wall stress prediction. Additionally, aortic root motion had a more profound effect on wall stress than wall compliance. Further studies are required to assess the statistical significance of the findings outlined in this thesis. Recommendations for future work were also highlighted, with emphasis on model assumptions including material properties, residual stress and boundary conditions.Open Acces

Numerical solving of relationship between true and false lumen in acute aortic dissection

Aorta, kao osnovni i najveći krvni sud u čoveku, neprekidno je izložena visokom pulzativnom pritisku i smičućim silama. Disekcija aorte predstavlja veoma ozbiljno i urgentno stanje, u kojem dolazi do cepanja i raslojavanja unutrašnjeg sloja aortnog zida, dok spoljnji sloj ostaje netaknut. Numeričke simulacije dinamičkog ponašanja fluida-krvi u aorti sa disekcijom mogu dosta pomoći lekarima, jer daju uvid u dalji razvoj bolesti. Osnovni metod koji je korišćen u ovom radu jeste metod konačnih elemenata (MKE). Brzine strujanja fluida, pritisaka i smičućih napona u čvorovima konačnih elemenata određuju se u karakterističnim tačkama pulzatornog strujanja krvi. U jednom delu rada, primenom komercijalnih softvera, izvršene su trodimenzionalne rekonstrukcije medicinskih snimaka, a potom, primenom softvera koji je razvijen u Istraživačko razvojnom centru za bioinženjering, sprovedeno je numeričko rešavanje odnosa pravog i lažnog lumena akutne aortne disekcije. Osnovni cilj teze je da se primenom numeričkih simulacija odrede pritisci, smičući naponi i brzine u pravom i lažnom lumenu čime se dobija jasna slika njihovog međusobnog odnosa. Virtuelnim simuliranjem efekta operacije (isecanjem uzlazne aorte i zamene tubus graftom) određuju se protoci kroz bočne opstruirane grane aorte zahvaćene disekcijom, što pokazuje kako hirurški zahvat zamene uzlazne aorte i prekidanje protoka lažnog lumena, ima uticaj na protok kroz grane aortnog luka i visceralne grane (grane abdominalne aorte). Određivanjem von Mizesovih napona u zidu lažnog lumena dobijaju se potencijalna mesta rupture aorte. Ovim putem se neinvazivnim pristupom određuje rizik od nastanka rupture aorte i daje prednost ovom metodu, umesto kriterijuma maksimalnog prečnika.Aorta, as the main and the largest blood vessel in the human body, is constantly exposed to high pulse pressure and shear forces. Aortic dissection is a very serious condition and medical emergency, which leads to tearing and delamination of the inner layer of the aortic wall, while the outer layer remains intact. Numerical simulations of the dynamic behavior of fluid-blood in the aorta dissection can be of great help to doctors, because they provide insight into further development of the disease. The main method used in this paper is the finite element method (FEM). Fluid velocity, pressure and wall shear stress in nodes of finite elements are determined by specific points of the pulsatile blood flow. One section of the paper focuses on a three-dimensional reconstruction of medical images using a commercial software and in the next section, by using the software developed in the Research and Development Centre for Bioengineering, the numerical solution of relations between true and false lumens of acute aortic dissection is performed. The main objective of the thesis is to determine pressures, wall shear stress and velocity in the true and false lumen by applying numerical simulations, which gives a clear picture of their relationship. Virtual simulation of the effects of the operation (by cutting the ascending aorta and replacing it with the stent graft) determines the flow through the obstructed side branches of aortic dissection, which shows how the surgical intervention of replacing the ascending aorta and interrupting the flow in the false lumen has an impact on the flow through the branches of the aortic arch and the visceral branches (branches of the abdominal aorta). By determining von Mises stresses in the wall of the false lumen, potential points of rupture of the aorta are obtained. In this manner, the risk of rupture of the aorta is determined by using a non-invasive approach, giving this method an advantage over the maximum diameter criterion

Conceptual framework of a novel hybrid methodology between computational fluid dynamics and data mining techniques for medical dataset application

This thesis proposes a novel hybrid methodology that couples computational fluid dynamic (CFD) and data mining (DM) techniques that is applied to a multi-dimensional medical dataset in order to study potential disease development statistically. This approach allows an alternate solution for the present tedious and rigorous CFD methodology being currently adopted to study the influence of geometric parameters on hemodynamics in the human abdominal aortic aneurysm. This approach is seen as a “marriage” between medicine and computer domains