A numerical analysis of steady flow in a three-dimensional model of the carotid artery bifurcation

A finite element approximation of steady flow in a rigid three-dimensional model of the carotid artery bifurcation is presented. A Reynolds number of 640 and a flow division ratio of about 50/50, simulating systolic flow, was used. To limit the CPU- and I/O-times needed for solving the systems of equations, a mesh-generator was developed, which gives full control over the number of elements into which the bifurcation is divided. A mini-supercomputer, based on parallel and vector processing techniques, was used to solve the system of equations. The numerical results of axial and secondary flow compare favorably with those obtained from previously performed laser-Doppler velocity measurements. Also, the influence of the Reynolds number, the flow division ratio, and the bifurcation angle on axial and secondary flow in the carotid sinus were studied in the three-dimensional model. The influence of the interventions is limited to a relatively small variation in the region with reversed axial flow, more or less pronounced C-shaped axial velocity contours, and increasing or decreasing axial velocity maxima.     

Blood flow downstream of a two-dimensional bifurcation

Many cardiovascular lesions such as aneurysms, intimal cushions, and atherosclerotic plaques tend to occur near bifurcations. This suggests that hemodynamic factors may be involved. Since measuring devices (such as anemometers) are still too large to allow local measurements of flow disturbances, we have attempted to predict the nature of these factors mathematically. Biological variables include pulsatile flow of a nonNewtonian fluid in distensible branching vessels with different angles and flow rates. Our initial analysis considers the flow in a two-dimensional bifurcation with a symmetrical flow divider perfused with steady flow at variable Reynolds numbers. At all flows, high shear forces develop on either side of the flow divider (i.e. at the apex of the bifurcation). With high flows, regions of sluggish or reverse flow develop near the outer walls of the bifurcation. The analysis confirms that the flow at the apex is quite different from that at the outer angles and that the latter varies more with flow rate than the former.     

Use of factor analysis to characterize arterial geometry and predict hemodynamic risk: application to the human carotid bifurcation

The detailed geometry of atherosclerosis-prone vascular segments may influence their susceptibility by mediating local hemodynamics. An appreciation of the role of specific geometric variables is complicated by the considerable correlation among the many parameters that can be used to describe arterial shape and size. Factor analysis is a useful tool for identifying the essential features of such an inter-related data set, as well as for predicting hemodynamic risk in terms of these features and for interpreting the role of specific geometric variables. Here, factor analysis is applied to a set of 14 geometric variables obtained from magnetic resonance images of 50 human carotid bifurcations. Two factors alone were capable of predicting 12 hemodynamic metrics related to shear and near-wall residence time with adjusted squared Pearson's correlation coefficient as high as 0.54 and P-values less than 0.0001. One factor measures cross-sectional expansion at the bifurcation; the other measures the colinearity of the common and internal carotid artery axes at the bifurcation. The factors explain the apparent lack of an effect of branch angle on hemodynamic risk. The relative risk among the 50 bifurcations, based on time-average wall shear stress, could be predicted with a sensitivity and specificity as high as 0.84. The predictability of the hemodynamic metrics and relative risk is only modestly sensitive to assumptions about flow rates and flow partitions in the bifurcation.     

Construction of a physical model of the human carotid artery based upon in vivo magnetic resonance images

A method is described for construction of an in vitro flow model based on in vivo measurements of the lumen geometry of the human carotid bifurcation. A large-scale physical model of the vessel lumen was constructed using fused deposition modeling (a rapid prototyping technique) based on magnetic resonance (MR) images of the carotid bifurcation acquired in a healthy volunteer. The lumen negative was then used to construct a flow model for experimental studies that examined the hemodynamic environment of subject-specific geometry and flow conditions. The physical model also supplements physician insight into the three-dimensional geometry of the arterial segment, complementing the two-dimensional images obtained by MR. Study of the specific geometry and flow conditions in patients with vascular disease may contribute to our understanding of the relationship between their hemodvnamic environment and conditions that lead to the development and progression of arterial disease.     

Some features of oscillatory flow in a model bifurcation

Oscillatory flow in the lung is studied using an order-of-magnitude analysis and flow visualization experiments in a single bifurcation with lung-like geometry. The results are used to obtain a classification scheme that identifies three major flow regimes, distinguished on the basis of whether the flow is dominated by unsteadiness, viscous effects, or the effects of convective acceleration. The unsteady regime is found to exist for values of a dimensionless stroke length (L/a, i.e., stroke volume/local cross-sectional area) less than or equal to 3 and for values of a dimensionless frequency (alpha 2 = alpha 2 omega/nu, where alpha is airway radius, omega the oscillatory frequency, and nu the kinematic viscosity) less than or equal to 10 in basic agreement with previous studies. The viscous regime is found when alpha 2(L/a)(a/R)1/2 less than 10 and alpha 2 less than 10 where R is the local radius of curvature in the bifurcation; the convective regime is found when alpha 2(L/a)(a/R)1/2 greater than 10 and L/a greater than 3. This same approach yields scaling laws for the magnitude of secondary flow velocities and shows that the ratio of secondary-to-axial velocity is small everywhere outside of the convective regime where it scales with (a/R)1/2. Comparison of these results to related simple flows shows that many of the features observed can be attributed to the effects of curvature, suggesting that the influence of the flow divider and of area change may be of lesser importance than previously thought.     

Measurement and calculations of laminar flow in a ninety degree bifurcation

Measurements and numericaL calculations of laminar flow in a plane 90 degrees bifurcation are presented. The corresponding two-dimensional steady flow Navier-Stokes equations solved by a finite-difference procedure employing pressure and velocity as dependent variables. The influence of Reynolds number and mass flow ratio on the velocity field, streamlines, local shear stress and pressure drop are quantified and shown to be substantial. The circulation patterns and shear stresses are examined in view of available data regarding the formation of atherotic plaques in the human circulatory system. The calculated velocity profiles are compared with measurements obtained with laser Doppler anemometry and the agreement is shown to be satisfactory. Calculations outside the range of measurements which are of value to biomechanics are also presented.     

Pulsatile flow visualization in the abdominal aorta under differing physiologic conditions: implications for increased susceptibility to atherosclerosis.

The infrarenal abdominal aorta is a common site for clinically significant atherosclerosis. As has been shown in other susceptible locations, vessel geometry, flow division rates, and pulsatility may result in hemodynamic conditions which influence the preferential localization of disease in the abdominal aorta segment. Pulsatile flow visualization was performed in a glass model of the aorta constructed from measurements of angiograms and cadaver aortas. Flow rates and pulsatile waveforms were varied to reflect typical physiological conditions. Under normal resting conditions, the flow patterns in the infrarenal aorta were more complex than those in the suprarenal location. Time varying vortex patterns appeared at the level of the renal arteries and propagated through the infrarenal aorta into the common iliac arteries. A region of oscillating velocity direction extended from the renal arteries to the aortic bifurcation along the posterior wall. Dye became trapped along the posterior wall, requiring several cardiac cycles for clearance. In contrast, there was rapid clearance of the dye in the anterior aorta. Under postprandial conditions, the flow patterns in the aorta were basically unchanged. Simulated exercise conditions created laminar hemodynamic features very different from the resting conditions, including a decrease in dye residence time. This study reveals significant time-dependent variations in the hemodynamics of the abdominal aorta under differing physiologic conditions. Hemodynamic factors such as low wall shear stress, oscillating shear direction, and high particle residence time may be related to the clinically seen preferential plaque localization in the infrarenal aorta.     

Sex differences in intracranial arterial bifurcations

Background: Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor—a local sex difference in the intracranial arteries.Objective: The aim of this study was to explore sex variation in the bifurcation anatomy of the middle cerebral artery (MCA) and internal carotid artery (ICA), and the subsequent hemodynamic impact.Methods: Vessel radii and bifurcation angles were measured in patients with MCA and ICA bifurcations. Data from a previously published study of 55 patients undergoing diagnostic cerebral digital subtraction angiography at Dalcross Private Hospital in Sydney, Australia, between 2002 and 2003, were available for analysis. The measurements were used to create idealized, averaged bifurcations of the MCA and ICA for females and males. Computational fluid dynamics simulations were performed to calculate hemodynamic forces in the models.Results: The vessel radii and bifurcation angles of 47 MCA and 52 ICA bifurcations in 49 patients (32 females, 17 males; mean age, 53 years; age range, 14–86 years) were measured. Statistically significant sex differences were found in vessel diameter (males larger than females; P < 0.05), but not in bifurcation angle. Computational fluid dynamics simulations revealed higher wall shear stress in the female MCA (19%) and ICA (50%) bifurcations compared with the male bifurcations.Conclusions: This study of MCA and ICA bifurcations in female and male patients suggests that sex differences in vessel size and blood flow velocity result in higher hemodynamic forces acting on the vessel wall in females. This new hypothesis may partly explain why intracranial aneurysms and SAH are more likely to occur in females than in males.     

A numerical study on hemodynamics in the left coronary bifurcation with normal and hypertension conditions

In this study, a three-dimensional analysis of the non-Newtonian blood flow was carried out in the left coronary bifurcation. The Casson model and hyperelastic and rigid models were used as the constitutive equation for blood flow and vessel wall model, respectively. Physiological conditions were considered first normal and then compliant with hypertension disease with the aim of evaluating hemodynamic parameters and a better understanding of the onset and progression of atherosclerosis plaques in the coronary artery bifurcation. Two-way fluid–structure interaction method applying a fully implicit second-order backward Euler differencing scheme has been used which is performed in the commercial code ANSYS and ANSYS CFX (version 15.0). When artery deformations and blood pressure are associated, arbitrary Lagrangian–Eulerian formulation is employed to calculate the artery domain response using the temporal blood response. As a result of bifurcation, noticeable velocity reduction and backflow formation decrease shear stress and made it oscillatory at the starting point of the LCx branch which caused the shear stress to be less than 1 and 2 Pa in the LCx and the LAD branches, respectively. Oscillatory shear index (OSI) as a hemodynamic parameter represents the increase in residence time and oscillatory wall shear stress. Because of using the ideal 3D geometry and realistic physiological conditions, the values obtained for shear stress are more accurate than the previous studies. Comparing the results of this study with previous clinical investigations shows that the regions with low wall shear stress less than 1.20 Pa and with high OSI value more than 0.3 are in more potential risk to the atherosclerosis plaque development, especially in the posterior after the bifurcation.     

Diameter asymmetry of porcine coronary arterial trees: structural and functional implications

The coronary vasculature is characterized by highly asymmetric diameters at bifurcations, which may be an important determinant of flow distribution. To facilitate accurate reconstruction of the coronary network for hemodynamic analysis, we introduce a statistical data set of the diameter asymmetry at bifurcations based on morphometric data of the porcine coronary arterial and venous trees. The bifurcation asymmetry data were represented by the diameter ratio of the daughters relative to mother vessel and by an area expansion ratio (AER) at each bifurcation. A novel asymmetry ratio matrix was introduced to describe the diameter asymmetry of daughters to mother vessels. The relations between AER and flow velocity, and asymmetry ratio matrix and flow distribution, were considered. The results indicate that the ratio of large daughter to mother vessel has a minimum value at order 5 (mean diameter of approximately 70 microm), whereas the ratio of small daughter to mother vessel decreases monotonically with increase in order number. The AER was found to be fairly uniform for larger vessels and to increase from order 5 toward the capillaries. At order 5, we observe a transition in asymmetric bifurcation pattern that may mark a hemodynamic transition from transmural to perfusion subnetworks. The functional implications of these structural transitions are considered.     

Numerical investigation of the non-Newtonian pulsatile blood flow in a bifurcation model with a non-planar branch

The pulsatile flow of non-Newtonian fluid in a bifurcation model with a non-planar daughter branch is investigated numerically by using the Carreau-Yasuda model to take into account the shear thinning behavior of the analog blood fluid. The objective of this study is to deal with the influence of the non-Newtonian property of fluid and of out-of-plane curvature in the non-planar daughter vessel on wall shear stress (WSS), oscillatory shear index (OSI), and flow phenomena during the pulse cycle. The non-Newtonian property in the daughter vessels induces a flattened axial velocity profile due to its shear thinning behavior. The non-planarity deflects flow from the inner wall of the vessel to the outer wall and changes the distribution of WSS along the vessel, in particular in systole phase. Downstream of the bifurcation, the velocity profiles are shifted toward the flow divider, and low WSS and high shear stress temporal oscillations characterized by OSI occur on the outer wall region of the daughter vessels close to the bifurcation. Secondary motions become stronger with the addition of the out-of-plane curvature induced by the bending of the vessel, and the secondary flow patterns swirl along the non-planar daughter vessel. A significant difference between the non-Newtonian and the Newtonian pulsatile flow is revealed during the pulse cycle; however, reasonable agreement between the non-Newtonian and the rescaled Newtonian flow is found. Calculated results for the pulsatile flow support the view that the non-planarity of blood vessels and the non-Newtonian properties of blood are an important factor in hemodynamics and may play a significant role in vascular biology and pathophysiology.     

Shear stress paradigm for perinatal fractal arterial network remodeling in lambs with pulmonary hypertension and increased pulmonary blood flow

Congenital heart disease with increased blood flow commonly leads to the development of increased pulmonary vascular reactivity and pulmonary arterial hypertension by mechanisms that remain unclear. We hypothesized a shear stress paradigm of hemodynamic reactivity and network remodeling via the persistence and/or exacerbation of a fetal diameter bifurcation phenotype [parent diameter d(0) and daughters d(1) >or= d(2) with alpha < 2 in (d(1)/d(0))(alpha) + (d(2)/d(0))(alpha) and area ratio beta < 1 in beta = (d(1)(2)+ d(2)(2))/ d(0)(2)] that mechanically acts as a high resistance magnifier/shear stress amplifier to blood flow. Evidence of a hemodynamic influence on network remodeling was assessed with a lamb model of high-flow-induced secondary pulmonary hypertension in which an aortopulmonary graft was surgically placed in one twin in utero (Shunt twin) but not in the other (Control twin). Eight weeks after birth arterial casts were made of the left pulmonary arterial circulation. Bifurcation diameter measurements down to 0.010 mm in the Shunt and Control twins were then compared with those of an unoperated fetal cast. Network organization, cumulative resistance, and pressure/shear stress distributions were evaluated via a fractal model whose dimension D(0) approximately alpha delineates hemodynamic reactivity. Fetus and Control twin D(0) differed: fetus D(0)=1.72, a high-resistance/shear stress amplifying condition; control twin D(0) = 2.02, an area-preserving transport configuration. The Shunt twin (D(0)=1.72) maintained a fetal design but paradoxically remodeled diameter geometry to decrease cumulative resistance relative to the Control twin. Our results indicate that fetal/neonatal pulmonary hemodynamic reactivity remodels in response to shear stress, but the response to elevated blood flow and pulmonary hypertension involves the persistence and exacerbation of a fetal diameter bifurcation phenotype that facilitates endothelial dysfunction/injury.     

Atherosclerosis and flow in carotid arteries with authentic geometries

The influence of blood flow on the depositions and development of atherosclerotic lesions have been observed and described since the 19th century. Observations have shown that depositions correlate with regions of low wall shear stress. However, the exact correlations between depositions, vessel geometry and flow parameters are not yet known. The purpose of this study was the quantification of atherosclerosis risk factors in carotid bifurcation. This artery has attracted particular interest because lesions are often found in this bifurcation. Post mortem, the arteries are excised and vessel casts are produced. Afterwards, the arteries are analyzed morphometrically. The vessel casts are used for the assessment of some geometrical parameters. 31 carotid bifurcations were analyzed in this study. Eight vessel casts were digitized and rendered three-dimensional mathematical models of the arteries. These data were imported by the computational fluid dynamics program FLUENT. Further, the blood flow was reconstructed in a computer model based on the individual vessel geometry. The flow parameters, such as velocity, pressure and wall shear stress were computed. At the same time the geometrical parameters and wall alterations are known. This permits the comparison of the anatomical shape and its flow with the distribution and level of the wall alterations.     

Analysis of non-Newtonian effects within an aorta-iliac bifurcation region

The geometry of the arteries at or near arterial bifurcation influences the blood flow field, which is an important factor affecting arteriogenesis. The blood can act sometimes as a non-Newtonian fluid. However, many studies have argued that for large and medium arteries, the blood flow can be considered to be Newtonian. In this work a comprehensive investigation of non-Newtonian effects on the blood fluid dynamic behavior in an aorta-iliac bifurcation is presented. The aorta-iliac geometry is reconstructed with references to the values reported in Shah et al. (1978); the 3D geometrical model consists of three filleted cylinders of different diameters. Governing equations with the appropriate boundary conditions are solved with a finite-element code. Different rheological models are used for the blood flow through the lumen and detailed comparisons are presented for the aorta-iliac bifurcation. Results are presented in terms of the velocity profiles in the bifurcation zone and Wall Shear Stress (WSS) for different sides of the bifurcation both for male and female geometries, showing that the Newtonian fluid assumption can be made without any particular loss in terms of accuracy with respect to the other more complex rheological models.     

Unsteady flow field around a human hand and propulsive force in swimming

Much effort has been undertaken for the estimation of propulsive force of swimmers in the front crawl. Estimation is typically based on steady flow theory: the so-called quasi-steady analysis. Flow fields around a swimmer, however, are extremely unsteady because the change direction of hand produces unsteady vortex motions. To evaluate the force correctly, it is necessary to know the unsteady properties determined from the vortex dynamics because that unsteadiness is known to make the force greater. Unsteady flow measurements were made for this study using a sophisticated technique called particle image velocimetry (PIV) in several horizontal planes for subjects swimming in a flume. Using that method, a 100 time-sequential flow fields are obtainable simultaneously. Each flow field was calculated from two particle images using the cross-correlation method. The intensity of vortices and their locations were identified. A strong vortex was generated near the hand and then shed by directional change of the hand in the transition phase from in-sweep to out-sweep. When the vortex was shed, a new vortex rotating in the opposite direction around the hand was created. The pair of vortices induced the velocity component in the direction opposite to the swimming. Results of this study show that the momentum change attributable to the increase in this velocity component is the origin of thrust force by the hand.     

On the choice of outlet boundary conditions for patient-specific analysis of aortic flow using computational fluid dynamics

Boundary conditions (BCs) are an essential part in computational fluid dynamics (CFD) simulations of blood flow in large arteries. Although several studies have investigated the influence of BCs on predicted flow patterns and hemodynamic wall parameters in various arterial models, there is a lack of comprehensive assessment of outlet BCs for patient-specific analysis of aortic flow. In this study, five different sets of outlet BCs were tested and compared using a subject-specific model of a normal aorta. Phase-contrast magnetic resonance imaging (PC-MRI) was performed on the same subject and velocity profiles extracted from the in vivo measurements were used as the inlet boundary condition. Computational results obtained with different outlet BCs were assessed in terms of their agreement with the PC-MRI velocity data and key hemodynamic parameters, such as pressure and flow waveforms and wall shear stress related indices. Our results showed that the best overall performance was achieved by using a well-tuned three-element Windkessel model at all model outlets, which not only gave a good agreement with in vivo flow data, but also produced physiological pressure waveforms and values. On the other hand, opening outlet BCs with zero pressure at multiple outlets failed to reproduce any physiologically relevant flow and pressure features.     

The effects of non-Newtonian viscoelasticity and wall elasticity on flow at a 90 degrees bifurcation

To study the fundamentals of hemodynamics in arteries, the flow parameters: pulsatility, elasticity and non-Newtonian viscoelasticity were considered in detail in a 90 degrees-T-bifurcation of a rigid and elastic model. The velocity distribution 2.5 mm behind the bifurcation in the straight tube was measured with a laser-Doppler-anemometer. The fluid used was an aqueous glycerine solution and a viscoelastic Separan mixture. Flow visualization studies were done with a sheet of laser light in the plane of the bifurcation. The velocity distribution was measured for both steady and pulsatile flows with a laser-Doppler-anemometer in a backward scattered way. From the velocity measurements the shear gradients were calculated. Substantial differences were found in the flow behavior of Newtonian and non-Newtonian fluids, especially behind the bifurcation in the main tube, where secondary flows and flow separation started. Also, differences due to the elastic and rigid wall could be seen. Very high shear gradients were found in the flow between main flow and the separation zone which can lead to a damage of the blood cells.     

A two-dimensional numerical analysis of unsteady flow in the carotid artery bifurcation. A comparison with three-dimensional in-vitro measurements and the influence of minor stenoses

In the present study a two-dimensional finite element model for incompressible Newtonian flow is applicated to the modelling of carotid artery flow. In earlier studies, the numerical model was validated experimentally for several flow configurations. In general the pulsatile flow is characterized by reversed flow regions at the non-divider side walls of both the internal and external carotid arteries. The unsteadiness of the flow is associated with rather complex spatial and temporal velocity distributions and leads to temporal variations of the location and length of the reversed flow regions. As a consequence, pronounced spatial and temporal variations in the wall shear stresses are found. At the non-divider side walls, wall shear stresses are relatively low and exhibits an oscillatory behaviour in space and time. At the divider side walls, wall shear stresses are relatively high and approximately follow the flow rate distribution in time. The aim of this study is not only to present two-dimensional calculations but also to compare the calculated two-dimensional velocity profiles with those from three-dimensional experiments. It is observed that in the common carotid artery and in the proximal parts of the internal and external carotid arteries, the two-dimensional numerical model provides valuable information with respect to the three-dimensional configuration. In the more distal parts of especially the internal carotid artery, deviations are found between the two-dimensional numerical and three-dimensional experimental model. These deviations can mainly be attributed to the neglect of the secondary velocity distribution in the two-dimensional model. In the two-dimensional numerical model the influence of a minor stenosis in the internal carotid artery is hardly distinguishable from a minor geometrical variation without stenosis. Full three-dimensional analyses of the influence of minor stenoses are needed to prove numerically whether in-vivo measurements of the axial velocity distribution are useful in the detection of minor stenoses.