Experimental and numerical study of pulsatile flows through stenosis: wall shear stress analysis.

Different shapes of pulsatile flows through a model of stenosis are experimentally and numerically modeled to validate both methods and to determine the wall shear stress temporal evolution downstream from the stenosis. Two-dimensional velocity measurements are performed in a 75% severity stenosis using a pulsed Doppler ultrasonic velocimeter. Finite element package is employed for the transient numerical simulations. Polynomial method, based on the experimental velocity values, is proposed to determine the wall shear stress temporal evolution. There is a good agreement between the numerical and experimental results. The wall shear stress temporal analysis shows oscillating wall shear stress values during the cycle with high wall shear stress values at the throat of about 120 dyn/cm2, and low values downstream from the stenosis of about - 2.5 dyn/cm2. The key result of the study is that the presence of the stenosis leads the artery to work in a direction which is opposite to the direction of a healthy artery.     

Laminar-to-turbulent transition in pulsatile flow through a stenosis

Laminar-to-turbulent transition in pulsatile flow through a stenosis is studied by means of three-dimensional numerical simulations. The flow transition is associated with the occurrence of a flow instability initiating in the stenosis region. The instability is manifested by a three-dimensional symmetry-breaking and leads to asymmetric separation and intense swirling motion downstream of the stenosis. The above have profound effects on the wall shear stress (WSS). The simulations reveal that the asymmetric separation is extended several radii downstream of the stenosis with substantial WSS fluctuations, in both space and time, occurring in the poststenotic region.     

Comparison of pressure losses in steady non-Newtonian flow through experimental tapered and cylindrical arterial prostheses

The use of an arterial prosthesis with a tapered lumen has several important advantages; for example, improved stability of flow, increased wall shear and better matching of its size with that of the host vessel. Tapering may, however, lead to increased energy losses, particularly if the angle of taper is large and the flow is high. This study is concerned with the determination of pressure drop for steady and laminar converging flow through rigid wall models of tapered arterial grafts. The angles of taper examined ranged from 0.5° to 1.0°. Aqueous solutions of polyacrylamide, with non-Newtonian viscous properties similar to those of blood, were used. The pressure drops across the tapered tubes were measured and the data were measured and the data were related to the pressure loss in cylindrical tubes of equivalent dimensions. Expressions for the ratio of the pressure drop in a tapered tube to that in a cylindrical tube for steady flow of a power law fluid were derived; there was good agreement between the predicted and the measured pressure drop ratios over a wide range of flows. The results of this study may be applied to the design of tapered arterial grafts. The pressure losses to be expected in tapered bypass grafts having various dimensions can easily be computed.     

Comparison of physiological and simple pulsatile flows through stenosed arteries.

Most experimental and numerical studies of pulsatile flow through stenosed arteries have been performed for a first harmonic oscillatory flow. In this paper, numerical solutions are presented for a physiological pulsatile flow as well as for an equivalent simple pulsatile flow, having the same stroke volume as the physiological flow, and the differences in their flow behavior are discussed. The analysis is restricted to laminar flow, Newtonian fluid and axisymmetric rigid stenosis. Comparison of results shows that the behaviors of the two flows are similar at some instances of time, however, important observed differences indicate that for thorough understanding of pulsatile flow behavior in stenosed arteries, the actual physiological flow should be simulated.     

Pressure losses in non-Newtonian flow through rigid wall tapered tubes

Pressure drop and pressure gradient were measured in steady Newtonian and non-Newtonian flow through tapered tubes having angles of taper, alpha, between 0.5 degree and 1.25 degrees. Aqueous solutions of polyacrylamide, characterized as power law fluids, were used for the non-Newtonian flow measurements. These solutions had power law parameters similar in magnitude to those of blood. The pressure drop-flow rate data compared well with the predictions of a semi-empirical flow model over a large range of flow rates (Re alpha up to 10 for Newtonian flow and 5.7 for non-Newtonian flow). The pressure gradient increased with distance, z, into the taper as the radius decreased. The linear relationship between pressure gradient and z, derived by Oka (Biorheology, 10, 207-212, 1973) was found to be valid only when alpha z was small. For the tapered tubes examined here, agreement was confined to the region near the inlet. If higher order terms in alpha z were taken into account the agreement was extended further into the taper. However, under higher flow conditions, when the inertial losses are not negligible, the semi-empirical model provides much better estimates of pressure gradient.     

Characteristics of secondary flow in steady and pulsatile flows through a symmetrical bifurcation

Steady and pulsatile flow in a glass model simulating an arterial bifurcation was investigated by flow visualization techniques. Secondary flow generated at the bifurcation has a similar pattern to a vortex, called the horseshoe vortex, produced around a wall-based protuberance in a circular tube. The same flow disturbance was clearly observed during the decelerating phase of pulsatile flow. The vortex produces a stagnation point on the top and bottom wall just upstream from the bifurcation apex. When aluminium dust was suspended in the test fluid perfusing the blood vessel model, particles deposited over an area spreading from the stagnation point to the lateral corners of the bifurcation. Comparison between the present results and topographical patterns of atherosclerosis reported in the literature suggests that it is in such low shear regions that lipid deposition tends to occur most.     

Numerical investigation of physiologically realistic pulsatile flow through arterial stenosis

Numerical simulations of pulsatile blood flow in straight tube stenosis models were performed to investigate the poststenotic flow phenomena. In this study, three axisymmetrical and three asymmetrical stenosis models with area reduction of 25%, 50% and 75% were constructed. A measured human common carotid artery blood flow waveform was used as the upstream flow condition which has a mean Reynold's number of 300. All calculations were performed with high spatial and temporal resolutions. Flow features such as velocity profiles, flow separation zone (FSZ), and wall shear stress (WSS) distributions in the poststenotic region for all models are presented. The results have demonstrated that the formation and development of FSZs in the poststenotic region are very complex, especially in the flow deceleration phase. In axisymmetric stenoses the poststenotic flow is more sensitive to changes in the degree of stenosis than in asymmetric models. For severe stenoses, the stenosis influence length is shorter in asymmetrical models than in axisymmetrical cases. WSS oscillations (between positive and negative values) have been observed at various downstream locations in some models. The amplitude of the oscillation depends strongly on the axial location and the degree of stenosis.     

Finite element simulation of pulsatile flow through arterial stenosis.

The problem of blood flow through a stenosis is solved using the incompressible Navier-Stokes equations in a rigid circular tube presenting a partial occlusion. Calculations are based on a Galerkin finite element method. The time marching scheme employs a predictor-corrector technique using a variable time step. Results are obtained for steady and physiological pulsatile flows. Computational experiments analyse the effect of varying the degree of stenosis, the stricture length, the Reynolds number and Womersley number. The method gives results which agree well with previous computations for steady flows and experimental findings for steady and pulsatile flows.     

Onset of pulsatile pressure causes transiently increased filtration through artery wall

Convective fluid motion through artery walls aids in the transvascular transport of macromolecules. Although many measurements of convective filtration have been reported, they were all obtained under constant transmural pressure. However, arterial pressure in vivo is pulsatile. Therefore, experiments were designed to compare filtration under steady and pulsatile pressure conditions. Rabbit carotid arteries were cannulated and excised from male New Zealand White rabbits anesthetized with pentobarbitol sodium (30 mg/kg i.v. administered). Hydraulic conductance was measured in cannulated excised rabbit carotid arteries at steady pressure. Next, pulsatile pressure trains were applied within the same vessels, and, simultaneously, arterial distension was monitored using Optical coherence tomography (OCT). For each pulse train, the volume of fluid lost through filtration was measured (subtracting volume change due to residual distension) and compared with that predicted from steady pressure measurements. At 60- and 80-mmHg baseline pressures, the experimental filtration volumes were significantly increased compared with those predicted for steady pressure (P < 0.05). OCT demonstrated that the excess fluid volume loss was significantly greater than the volume that would be lost through residual distension (P < 0.05). After 30 s, the magnitude of the excess of fluid loss was reduced. These results suggest that sudden onset of pulsatile pressure may cause changes in arterial interstitial hydration.     

Experimental study of finite amplitude pulsatile pressure waves in elastic tubes

An experimental study of the propagation of pulsatile pressure waves in an elastic tube was made and results were compared to a theoretical analysis by Lou. The pressure waves were sinusoidally varying acting in a horizontal, longitudinally constrained tube containing water. The independent experimental parameters varied were the pressure wave frequency, pressure wave volume per cycle, static tube pressure and steady flow rate. The wave propagation speeds, measured by non-intrusive techniques, were found to be functions of the wave frequency and the phase angles of the wave elements as theoretically predicted by Lou.     

An experimental study on the effect of rigid fixation on the developing craniofacial skeleton

Rigid fixation of the craniofacial skeleton has proven of great value in adult orthognathic and traumatic reconstructive surgical procedures. This technique has gained increased acceptance in the surgical treatment of infants and young children with congenital malformations, despite the fact that its effects on subsequent craniofacial growth are unknown. To examine this question, an experimental model using 25 young kittens was developed to compare rigid fixation with conventional wire fixation, with and without osteotomy. Our findings demonstrate a regional restriction of growth in the developing craniofacial skeleton when both wire and plate and screw fixation are utilized in concert with osteotomy. Further, a compensatory growth was observed in individual animals when plate fixation was utilized that was not seen in the wire-treated group. This suggests that there is a dynamic growth interaction between restriction and compensation in this setting.     

Two-phase pulsatile flows through porous conical tubes of small diameters. Modelisation of the blood microcirculation

A theoretical study concerning two-component fluid pulsating flow through porous conical ducts is presented. The model corresponds to blood flows through small diameter porous conical vessels. This approach is based on a finite difference method. The physical hypothesis used were based on findings from simultaneous visualization methods. The influence of geometrical, hydrodynamical and structural parameters is systematically examined and related to velocity profiles, hydrostatic pressure.     

Dominance competition through affiliation and support in Japanese macaques: An experimental study

It has been proposed that monkeys direct grooming to high-ranking individuals in an attempt to obtain agonistic support in return. But whether these two categories of interactions are causally related has proven difficult to establish. Part of the problem stems from the fact that in stable groups social relationships reflect an equilibrium state and that behaviors need only be performed at low rates and long intervals to maintain the current social structure. In theory, however, if affiliative and supportive interactions are indeed causally related, it should be possible to accentuate their temporal relation, hence their causal dynamics. For example, destabilizing dominance relations can be expected to induce competition for status and force individuals to deploy behavioral tactics for settling new rank relations. We experimentally induced rank reversals in a captive group of Japanese macaques (Macaca fuscata) composed of three matrilines (A-B-C rank order). A reversed C-A-B order composed of three individuals per matriline was maintained for 2 weeks. The results show the close temporal relation among (i) asserting one’s rank, (ii) competing for access to dominants through affiliation and interferences in affiliation, (iii) receiving support from dominants against lower-ranking individuals, and (iv) supporting dominants against subordinates. These findings are compatible with one version of the affiliation-for-support hypothesis, namely that monkeys affiliate with dominants as a way to assert their position in the hierarchy. In a functional perspective, mutual selfishness provides a better explanation than reciprocal altruism because the possibility that both groomers and supporters derive immediate net benefits cannot be excluded.     

Reflection coefficients in pulsatile flow through converging junctions and the pressure distribution in a simple loop

Analytical expressions for the reflection coefficients in pulsatile flow through converging junctions are derived by two independent methods and are used to study the effects of wave reflections on the pressure distribution in a simple vascular loop. A simulated physiological situation is used as an example in which the loop is formed by the combination of a bypass and a bypassed vessel, the relative diameter of the latter being varied in order to simulate a narrowing. The results demonstrate how, in the case of a converging junction, the effects of wave reflections on the pressure distribution in one vessel depend on conditions within the vessel itself as well as in the other. The new reflection coefficients take into account this interdependence of flow in the two vessels forming a converging junction, and are shown to be consistent with reflection coefficients commonly used in diverging junctions.     

Application of large-eddy simulation to the study of pulsatile flow in a modeled arterial stenosis

The technique of large-eddy simulation (LES) has been applied to the study of pulsatile flow through a modeled arterial stenosis. A simple stenosis model has been used that consists of a one-sided 50 percent semicircular constriction in a planar channel. The inlet volume flux is varied sinusoidally in time in a manner similar to the laminar flow simulations of Tutty (1992). LES is used to compute flow at a peak Reynolds number of 2000 and a Strouhal number of 0.024. At this Reynolds number, the flow downstream of the stenosis transitions to turbulence and exhibits all the classic features of post-stenotic flow as described by Khalifa and Giddens (1981) and Lieber and Giddens (1990). These include the periodic shedding of shear layer vortices and transition to turbulence downstream of the stenosis. Computed frequency spectra indicate that the vortex shedding occurs at a distinct high frequency, and the potential implication of this for noninvasive diagnosis of arterial stenoses is discussed. A variety of statistics have been also extracted and a number of other physical features of the flow are described in order to demonstrate the usefulness of LES for the study of post-stenotic flows.     

Numerical and experimental investigations of pulsatile blood flow pattern through a dysfunctional mechanical heart valve

Around 250,000 heart valve replacements are performed every year around the world. Due their higher durability, approximately 2/3 of these replacements use mechanical prosthetic heart valves (mainly bileaflet valves). Although very efficient, these valves can be subject to valve leaflet malfunctions. These malfunctions are usually the consequence of pannus ingrowth and/or thrombus formation and represent serious and potentially fatal complications. Hence, it is important to investigate the flow field downstream of a dysfunctional mechanical heart valve to better understand its impact on blood components (red blood cells, platelets and coagulation factors) and to improve the current diagnosis techniques. Therefore, the objective of this study will be to numerically and experimentally investigate the pulsatile turbulent flow downstream of a dysfunctional bileaflet mechanical heart valve in terms of velocity field, vortex formation and potential negative effect on blood components. The results show that the flow downstream of a dysfunctional valve was characterized by abnormally elevated velocities and shear stresses as well as large scale vortices. These characteristics can predispose to blood components damage. Furthermore, valve malfunction led to an underestimation of maximal transvalvular pressure gradient, using Doppler echocardiography, when compared to numerical results. This could be explained by the shifting of the maximal velocity towards the normally functioning leaflet. As a consequence, clinicians should try, when possible, to check the maximal velocity position not only at the central orifice but also through the lateral orifices. Finding the maximal velocity in the lateral orifice could be an indication of valve dysfunction.     

An in vitro experimental study on the relationship between pulsatile tinnitus and the dehiscence/thinness of sigmoid sinus cortical plate

Pulsatile tinnitus (PT), characterized as pulse-synchronous, is generally objective. Sigmoid sinus (SS) venous sound is widely suggested to be a possible sound source of PT. The dehiscence and thinness of SS cortical plate (CP) was commonly reported as PT pathology in previous studies, but lack quantitative or biomechanical analysis. In this study, it was aimed to quantify the relationship between venous sound and CP dehiscence/thinness using in vitro experiment. The in vitro models of SS and CP were established based on 3D-printing, with the developed pulsatile venous flow in the SS model. The generated sound signal and the vibration response at the dehiscent/thinned area were analyzed. The sound signal generated in the normal-sized dehiscence model was pulse-synchronous within 100-–400 Hz, which had similar acoustic characteristics as the clinical PT sounds. It was concluded that the pulsatile venous sound is produced at TS-SS junction in case of CP dehiscence. The CP, even a thinned one can effectively diminish the venous sound and sound-generating pulsatile vibration at TS-SS junction. The CP dehiscence would induce pulse-synchronous and high pressure venous sound, as well as pulse-synchronous vibration above 20 Hz, regardless of the dehiscence size. On the contrary, the CP thinness would not induce obvious venous sound or pulsatile vibration above 20 Hz.