Outflow boundary conditions for 3D simulations of non-periodic blood flow and pressure fields in deformable arteries

The simulation of blood flow and pressure in arteries requires outflow boundary conditions that incorporate models of downstream domains. We previously described a coupled multidomain method to couple analytical models of the downstream domains with 3D numerical models of the upstream vasculature. This prior work either included pure resistance boundary conditions or impedance boundary conditions based on assumed periodicity of the solution. However, flow and pressure in arteries are not necessarily periodic in time due to heart rate variability, respiration, complex transitional flow or acute physiological changes. We present herein an approach for prescribing lumped parameter outflow boundary conditions that accommodate transient phenomena. We have applied this method to compute haemodynamic quantities in different physiologically relevant cardiovascular models, including patient-specific examples, to study non-periodic flow phenomena often observed in normal subjects and in patients with acquired or congenital cardiovascular disease. The relevance of using boundary conditions that accommodate transient phenomena compared with boundary conditions that assume periodicity of the solution is discussed

Immediate Effect of Physical Exercise on Blood Flow Velocity in Radial Artery in Young Adults

Purpose: Quantify changes in blood flow velocity in radial artery after local dynamic exercise and compare these results between a group of women and men. Acquire data of normal resting blood flow in radial artery.   Methods: We examined 42 healthy young volunteers (21 men and 21 women) of the age about 20. A pocket Doppler ultrasound device was used for measurements. Physical exercise was defined as one-minute-long, one-handed weightlifting. Hemodynamic parameters were registered during resting before exercise and immediately after exercise.Results: Resting baseline values: overall maximum blood flow velocity 26.49 cm/s (SD: 9.99 cm/s), mean blood flow velocity 8.46 cm/s (SD: 6.17 cm/s), and pulsatility index (PI) 5.46 (SD: 5.7) for the whole group. Mean percentage increase of maximum blood flow velocity is 36.5 %, mean blood flow velocity 243 %. PI was reduced by 52.8 %.  There was a presumed significant difference in the percentage change of PI between the group of women and men (p<0.05). . There is also a typical change in velocity waveform after exercise. Conclusion: The most altered parameter is mean blood flow velocity, which corresponds to observed change of velocity waveform probably caused by local vasodilatation lasting only for several seconds

Integration of anatomical and hemodynamical information in magnetic resonance angiography

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Multiscale Modeling of Hemodynamics in Human Vessel Network and Its Applications in Cerebral Aneurysms

Three-dimensional (3D) simulation of patient-specific morphological models has been widely used to provide the hemodynamic information of individual patients, such as wall shear stress (WSS), oscillatory shear index (OSI), and flow patterns, etc. Since patient-specific morphological segment was only restricted locally, boundary conditions (BCs) are required to implement the CFD simulation. Direct measurements of the flow and pressure waveforms were often required as input BCs for 3D CFD simulations of patient-specific models. However, as the morphology develops, the feedback from this topological deformation may lead to BCs being altered, and hence without this feedback, the flow characteristics of the morphology are only computed locally. A one-dimensional (1D) numerical model containing the entire human vessel network has been proposed to compute the global hemodynamics. In the meantime, experimental studies of blood flow in the patient-specific modeling of the circle of Willies (CoW) was conducted. The flow and pressure waveforms were quantified to validate the accuracy of the pure 1D model. This 1D model will be coupled with a 3D morphological model to account for the effects of the altered BCs. The proposed 1D-3D multi-scale modeling approach investigates how the global hemodynamic changes can be induced by the local morphological effects, and in consequence, may further result in altering of BCs to interfere with the solution of the 3D simulation. Validation of the proposed multi-scale model has also been made by comparing the solution of the flow rate and pressure waveforms with the experimental data and 3D numerical simulations reported in the literature. Moreover, the multi-scale model is extended to study a patient-specific cerebral aneurysm and a stenosis model. The proposed multi-scale model can be used as an alternative to current approaches to study intracranial vascular diseases such as an aneurysm, stenosis, and combined cases

Computational analysis of the hemodynamic performance of novel endovascular and surgical procedures for complex aortic diseases

Novel branched stent-grafts (BSG) have been developed for endovascular repair of complex thoracic aortic aneurysms (TAA) involving the aortic arch or thoracoabdominal aorta, but their haemodynamic performance has not been adequately studied. In addition, surgical replacement of the ascending aorta with a Dacron graft remains the gold standard for type A aortic dissection (TAAD), although 12% of patients are at risk of aortic rupture due to further dilatation of the residual dissected aorta. The underlying mechanisms for progressive aortic dilatation following TAAD repair are poorly understood, but haemodynamic and biomechanical factors are believed to play an important role. Therefore, the present study aims to provide more insights into the haemodynamics in novel BSGs developed for treating complex aortic diseases, and a comprehensive evaluation of flow and biomechanical conditions in post-surgery TAADs by means of state-of-the-art computational methods. The first part of this thesis focuses on evaluating the haemodynamic performance of novel BSG designs, including thoracoabdominal branch endoprosthesis (TAMBE) and dual-branched thoracic endograft. Haemodynamics in idealised and patient-specific BSG models has been analysed by examining side branch outflow waveforms, wall shear stress related indices, and displacement forces, in order to assess their long-term durability. The numerical results show that all the stent-graft models examined in this study are capable of providing normal blood perfusion to side vessels, and are at low risk of in-stent thrombosis and device migration. Furthermore, it has been shown that geometric variations in TAMBE do not affect the key haemodynamic results, indicating its potential suitability for a variety of visceral artery anatomies. Comparisons of dual-branched thoracic endograft models with different inner tunnel diameters suggest that BSGs with larger inner tunnel diameters than the respective vessels would be preferred. Comparisons between the pre- and post-intervention models show that insertion of a dual-branched stent-graft significantly alters the flow pattern in the aortic arch, some of which may have a detrimental effect in the long term, thus requiring follow-up studies. The second part of the thesis provides a comprehensive analysis of the haemodynamic and biomechanical conditions in surgically repaired TAAD. Geometric and haemodynamic parameters have been analyzed and compared between the group of patients with stable aortic diameter and another group with progressive aortic dilatation. The number of re-entry tears (6±5 vs 2±1;P= 0.02) and luminal pressure difference (1.3 ±1 vs 11.7 ±14.6 mmHg;P= 0.001) have been identified as potential predictors of progressive aortic dilatation in TAAD patients following surgical repair. This is an important finding and can potentially assist clinicians to make the most appropriate choice or surgical plan for individual patients. Based on the finite element analysis of four patient-specific cases, there are no clear differences in biomechanical parameters between the stable and unstable groups. Furthermore, a preliminary fluid-solid interaction (FSI) simulation performed on a single TAAD model has demonstrated the important influence of wall compliance on pressures in the true and false lumen. Compared to a rigid wall model, the FSI simulation results show a reduction in systolic pressure by up to 10 mmHg and a slight increase in diastolic pressure. However, pressures in the true and false lumen are affected in the same way, so that the luminal pressure difference remains the same between the rigid and FSI models.Open Acces

Transient Cardiovascular Hemodynamics In A Patient-Specific Arterial System

The ultimate goal of the present study is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present study a full cardiovascular experimental phantom and digital phantom (CFD model) was fabricated to study: (1) the effects of local hemodynamics on global hemodynamics, (2) the effects of transition from bed-rest to upright position, and (3) transport of dye (drug delivery) in the arterial system. Computational three dimensional (3-D) models (designs A, B, and C) stents were also developed to study the effects of stent design on hemodynamic flow and the effects of drug deposition into the arterial wall. The experimental phantom used in the present study is the first system reported in literature to be used for hemodynamic assessment in static and orthostatic posture changes. Both the digital and experimental phantom proved to provide different magnitudes of wall shear and normal stresses in sections where previous studies have only analyzed single arteries. The dye mass concentration study for the digital and experimental cardiovascular phantom proved to be useful as a surrogate for medical drug dispersion. The dye mass concentration provided information such as transition time and drug trajectory paths. For the stent design CFD studies, hemodynamic results (wall shear stress (WSS), normal stress, and vorticity) were assessed to determine if simplified stented geometries can be used as a surrogate for patient-specific geometries and the role of stent design on flow. Substantial differences in hemodynamic parameters were found to exist which confirms the need for patient-specific modeling. For drug eluting stent studies, the total deposition time for the drug into the arterial wall was approximately 3.5 months

An inverse transmission line model of the lower limb arterial system

Includes bibliography. Includes disk in pocket at back of book

Computer simulation of arterial blood flow

Computer models have been widely used to simulate pressure and flow propagation in the arterial system. While experimentation involving the human arterial system is difficult and impractical, computer models offer an attractive alternative for the study of arterial hemodynamics. The purpose of the present study was to develop a computer model of the whole systemic circulation and to use this model to study pressure and flow propagation under normal flow conditions, as well as under conditions of arterial disease;The mathematical model used to describe flow in an arterial segment was based on the one-dimensional continuity and momentum equations. The model includes nonlinearities arising from the convective acceleration term and the pressure-area relationship. The mathematical model also includes a seepage term for the modeling of small branches, as well as a body force term for the modeling of gravitational and external acceleration forces. Arterial segments that do not branch are terminated using modified windkessel lumped impedances. Arterial stenoses are modeled using an empirical pressure drop-flow relationship. The problem was solved numerically by employing either an explicit finite difference scheme, or a finite element scheme based on the Galerkin method;The physiological model consisted of 55 arterial segments and included most major arteries. The majority of the parameter data were obtained from the literature. Under normal flow conditions, the model predicted satisfactorily the major characteristics of pressure and flow throughout the arterial system. Tests were also run to assess the influence of model parameters, such as those related to boundary conditions, nonlinearities, and the wall shear stress model, on the model predictions;Finally, the model was used to study cases of medical interest, such as the effect of various forms of cardiovascular disease on pressure and flow waveforms. The cases studied include the effect of arterial stenoses on the mean flow and the pulsatility of the flow, the effect of heart valvular disease on central and peripheral pressure waveforms, as well as the effect of arteriosclerosis and hypertension on peripheral pressure pulse formation. The results were in reasonably good agreement with published experimental findings, suggesting that the computer model can be used to gain valuable information on the hemodynamics of the human arterial system