Wall shear rate measurements in an elastic curved artery model

Since atherosclerotic lesions tend to be localized at bends and branching points, knowledge of wall shear rate patterns in models of these geometries may help elucidate the mechanism of atherogenesis. This study uses the photochromic method of flow visualization to determine both the mean and amplitude of the wall shear rate waveform in straight and curved elastic arterial models to demonstrate the effects of curvature, elasticity, and the phase angle between the flow and pressure waveforms (impedance phase angle). Under sinusoidal flow conditions characteristic of large arteries, the mean shear rate at the inner wall of the curved tube is reduced 40–56% from its steady flow value, depending on the phase angle. Wall shear rate amplitudes in the curved tube are significantly reduced by wall motion (36–55% of the Womersley amplitude for a straight rigid tube). The shear rate amplitude at the outer wall decreases 30% as the phase angle is reduced from −20° to −66°, while the shear rate amplitude at the inner wall increases 45%. As a result, the oscillatory nature of flow at the outer wall decreases with decreasing negative phase angle, but flow at the inner wall becomes much more oscillatory. At large negative phase angles, characteristic of hypertension or vasoactive agents, the shear rate at the inner wall has a small mean and cycles through positive and negative values; the shear rate at the outer wall remains positive throughout the flow cycle. Thus, the impedance phase angle could affect atherogenesis along the inner wall if temporal and directional changes in wall shear rate play a role.     

犬不同血管搭桥方法及搭桥血管内流场的计算机数值模拟

目的血管搭桥术后的内膜增生往往导致手术失败,而内膜增生与搭桥血管内的流场密切相关,为改善搭桥血管中的流场结构,作者设计了偏心搭桥手术方法,利用计算机数值模拟技术,探索偏心搭桥和传统搭桥血管中流场的变化,为血管搭桥方法提供优化设计方案。方法16只犬随机分为偏心搭桥组和传统搭桥组进行血管搭桥,测定搭桥前后血管几何数据,搭桥后近心端及远心端吻合口血流量和血压。按测定的血管几何数据,FLUENT 6.2模拟搭桥血管内的流场。结果偏心搭桥近心端和远心端吻合口不在同一平面。传统搭桥中,主体动脉远心端吻合口对应面处存在一个较低壁面剪切应力（WSS）区域及流体停滞点,离脚跟较近的一部分流体会形成涡漩,血流进入主体动脉后,还会表现出迪恩涡二次流;偏心搭桥中,主体动脉吻合口对应面上的低WSS区域和流体停滞点消失,血流接触到吻合口底面后,以切向旋转的方式改变其流动方向,不会形成涡漩,且当血流进入主体动脉后,立即发生螺旋流态且能持续很长一段。结论偏心搭桥能够产生血液旋动流,显著增加远心端血流量、提高WSS。     

MRI and CFD studies of pulsatile flow in healthy and stenosed carotid bifurcation models

Pulsatile flow was studied in physiologically realistic models of a normal and a moderately stenosed (30% diameter reduction) human carotid bifurcation. Time-resolved velocity measurements were made using magnetic resonance imaging, from which wall shear stress (WSS) vectors were calculated. Velocity measurements in the inflow and outflow regions were also used as boundary conditions for a computational fluid dynamics (CFD) model. Experimental flow patterns and derived WSS vectors were compared qualitatively with the corresponding CFD predictions. In the stenosed phantom, flow in the bulb region of the "internal carotid artery" was concentrated along the outer wall, with a region of low and recirculating flow near the inner wall. In the normal phantom, the converse was found, with a low flow region near the outer wall of the bulb. Time-averaged WSS and oscillatory shear index were also markedly different for the two phantoms.     

Three-dimensional steady flow through a bifurcation

Steady flow of an incompressible, Newtonian fluid through a symmetric bifurcated rigid channel was numerically analyzed by solving the three-dimensional Navier-Stokes equations. The upstream Reynolds number ranged from 100 to 1500. The bifurcation was symmetrical with a branch angle of 60 deg and the area ratio of the daughter to the mother vessel was 2.0. The numerical procedure utilized a coordinate transformation and a control volume approach to discretize the equations to finite difference form and incorporated the SIMPLE algorithm in performing the calculation. The predicted velocity pattern was in qualitative agreement with experimental measurements available in the literature. The results also showed the effect of secondary flow which can not be predicted using previous two-dimensional simulations. A region of reversed flow was observed near the outer wall of the branch except for the case of the lowest Reynolds number. Particle trajectory was examined and it was found that no fluid particles remained within the recirculation zone. The shear stress was calculated on both the inner and the outer wall of the branch. The largest wall shear stress, located in the vicinity of the apex of the branch, was of the same order of magnitude as the level that can cause damage to the vessel wall as reported in a recent study.     

The effect of graft caliber upon wall shear within in vivo distal vascular anastomoses

Wall shear has been widely implicated as a contributing factor in the development of intimal hyperplasia in the anastomoses of chronic arterial bypass grafts. Earlier studies have been restricted to either: (1) in vitro or computer simulation models detailing the complex hemodynamics within an anastomosis without corresponding biological responses, or (2) in vivo models that document biological effects with only approximate wall shear information. Recently, a specially designed pulse ultrasonic Doppler wall shear rate (PUDWSR) measuring device has made it possible to obtain three near-wall velocity measurements nonintrusively within 1.05 mm of the vessel luminal surface from which wall shear rates (WSRs) were derived. It was the purpose of this study to evaluate the effect of graft caliber, a surgically controllable variable, upon local hemodynamics, which, in turn, play an important role in the eventual development of anastomotic hyperplasia. Tapered (4-7 mm I.D.) 6-cm-long grafts were implanted bilaterally in an end-to-side fashion with 30 deg proximal and distal anastomoses to bypass occluded common carotid arteries of 16 canines. The bypass grafts were randomly paired in contralateral vessels and placed such that the graft-to-artery diameter ratio, DR, at the distal anastomosis was either 1.0 or 1.5. For all grafts, the average Re was 432 +/- 112 and the average Womersley parameter, alpha, was 3.59 +/- 0.39 based on artery diameter. There was a sharp skewing of flow toward the artery floor with the development of a stagnation point whose position varied with time (up to two artery diameters) and DR (generally more downstream for DR = 1.0). Mean WSRs along the artery floor for DR = 1.0 and 1.5 were found to range sharply from moderate to high retrograde values (589 s-1 and 1558 s-1, respectively) upstream to high antegrade values (2704 s-1 and 2302 s-1, respectively) immediately downstream of the stagnation point. Although there were no overall differences in mean and peak WSRs between groups, there were significant differences (p < 0.05) in oscillatory WSRs as well as in the absolute normalized mean and peak WSRs between groups. There were also significant differences (p < 0.05) in mean and peak WSRs with respect to axial position along the artery floor for both DR cases. In conclusion, WSR varies widely (1558 s-1 retrograde to 2704 s-1 antegrade) within end-to-side distal graft anastomoses, particularly along the artery floor, and may play a role in the development of intimal hyperplasia through local alteration of mass transport and mechano-signal transduction within the endothelium.     

Unsteady and three-dimensional simulation of blood flow in the human aortic arch

A three-dimensional and pulsatile blood flow in a human aortic arch and its three major branches has been studied numerically for a peak Reynolds number of 2500 and a frequency (or Womersley) parameter of 10. The simulation geometry was derived from the three-dimensional reconstruction of a series of two-dimensional slices obtained in vivo using CAT scan imaging on a human aorta. The numerical simulations were obtained using a projection method, and a finite-volume formulation of the Navier-Stokes equations was used on a system of overset grids. Our results demonstrate that the primary flow velocity is skewed towards the inner aortic wall in the ascending aorta, but this skewness shifts to the outer wall in the descending thoracic aorta. Within the arch branches, the flow velocities were skewed to the distal walls with flow reversal along the proximal walls. Extensive secondary flow motion was observed in the aorta, and the structure of these secondary flows was influenced considerably by the presence of the branches. Within the aorta, wall shear stresses were highly dynamic, but were generally high along the outer wall in the vicinity of the branches and low along the inner wall, particularly in the descending thoracic aorta. Within the branches, the shear stresses were considerably higher along the distal walls than along the proximal walls. Wall pressure was low along the inner aortic wall and high around the branches and along the outer wall in the ascending thoracic aorta. Comparison of our numerical results with the localization of early atherosclerotic lesions broadly suggests preferential development of these lesions in regions of extrema (either maxima or minima) in wall shear stress and pressure.     

An S-type bypass can improve the hemodynamics in the bypassed arteries and suppress intimal hyperplasia along the host artery floor

The development of distal end-to-side anastomotic intimal hyperplasia (IH) has been attributed to the flow disturbance and abnormal wall shear stress (WSS) distribution there. The geometry of the bypass has a strong influence on the flow pattern and WSS distribution. Using a canine model of end-to-side anastomosis, a 45 degrees S-type bypass was compared with 60 degrees , 45 degrees and 30 degrees conventional bypasses in the term of IH along the host artery floor. Numerical blood flow simulations were also carried out to characterize the flow patterns at the distal parts of the bypassed arteries for the 4 models. The results showed that the averaged intima thicknesses of the host artery floors for the 4 bypass models were 119.50+/-10.30 microm (60 degrees ), 65.56+/-6.53 microm (45 degrees ), 45.26+/-5.99 microm (30 degrees ) and 47.64+/-4.85 microm (S-type), respectively, vs. 9.81+/-1.88 microm in the control group (without bypass surgery). Compared with the control group, neointima thickness in all 4 bypass models was significantly increased, but the neointima thickness of the 45 degrees S-type bypass was apparently much better than its 45 degrees conventional counterpart, and was as good as the 30 degrees conventional bypass. The numerical simulation revealed an apparent swirling flow pattern in the S-type bypass, which was very different than the flow patterns in the 3 conventional bypass models. This swirling flow altered the overall flow pattern in the distal part of the bypassed artery and eliminated the low WSS zone along the host artery floor. The improvement in the term of IH for the S-type bypass is most likely due to the alteration of the overall flow pattern and WSS distribution by the geometrical configuration of the S-type bypass.     

A numerical simulation of steady flow fields in a bypass tube.

Steady flow in a complete by-pass tube was simulated numerically. The study was to consider a complete flow field, which included both the by-pass and the host tubes. The changes of the hemodynamics were investigated with three parameters: the inlet flow Reynolds number (Re), anastomotic angle (alpha) and the position of the occlusion in the host tube. The baseline flow field was set up with Re=200, alpha=45 degrees and the centered position of occlusion. The parametric study was then conducted on combination of Re=100, 200, 400, alpha=35 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees and three occlusion positions: left, center and right. It was found that in the baseline case, large slow/recirculation flows could be seen in the host tube both upstream and downstream of the occlusion. The separation points were on the opposite walls to the junctions. Recirculation zones were also found near the toe and in the proximal outer wall of the by-pass tube. Their sizes were about one diameter of the tube or smaller. In some cases, pairing vortices could be seen in the host tube upstream of the occlusion. The shear rate distribution associated with the flow fields was presented. The flow pattern obtained was agreeable to those observed experimentally by other investigators. The difference of the flow fields between a complete bypass and simple anastomosis was discussed. The present numerical code provides a preliminary simulation/design tool for bypass graft flows.     

Velocity and wall shear stress patterns in the human right coronary artery.

Blood flow dynamics in the human right coronary artery have not been adequately quantified despite the clinical significance of coronary atherosclerosis. In this study, a technique was developed to construct a rigid flow model from a cast of a human right coronary artery. A laser photochromic method was used to characterize the velocity and wall shear stress patterns. The flow conditions include steady flow at Reynolds numbers of 500 and 1000 as well as unsteady flow with Womersley parameter and peak Reynolds number of 1.82 and 750, respectively. Characterization of the three-dimensional geometry of the artery revealed that the largest spatial variation in curvature occurred within the almost branch-free proximal region, with the greatest curvature existing along the acute margin of the heart. In the proximal segment, high shear stresses were observed on the outer wall and lower, but not negative, stresses along the inner wall. Low shear stress on the inner wall may be related to the preferential localization of atherosclerosis in the proximal segment of the right coronary artery. However, it is possible that the large difference between the outer and inner wall shear stresses may also be involved.     

Dynamic curvature strongly affects wall shear rates in a coronary artery bifurcation model

This study was motivated by the need for a better understanding of coronary artery blood flow patterns and their possible role in atherosclerosis formation. Of particular interest in this study was the effects of the dynamic deformation due to myocardial contraction on wall shear rate patterns in the coronary arteries. A better understanding of these effects on wall shear rate in a bifurcation geometry and an evaluation of the importance of these effects was desired. A three-dimensional computer model of a bifurcation lying on the surface of a sphere with time-varying radius of curvature was employed to simulate the motion and deformation of the arteries. The results indicated low mean shear rates along the myocardial wall and very high shear rate variations (over 100% of the static mean shear rate) along the outer wall. The results obtained using a quasi-static analysis were found to underestimate the dynamic wall shear rate variation along the myocardial and outer walls. It was concluded that dynamic geometry effects are important in determining sites of low mean and oscillating wall shear that have been associated with atherogenesis in curved, bifurcating arteries.     

The influence of out-of-plane geometry on pulsatile flow within a distal end-to-side anastomosis

We present an experimental and computational investigation of time-varying flow in an idealized fully occluded 45 degrees distal end-to-side anastomosis. Two geometric configurations are assessed, one where the centerlines of host and bypass vessels lie within a plane, and one where the bypass vessel is deformed out of the plane of symmetry, respectively, termed planar and non-planar. Flow experiments were conducted by magnetic resonance imaging in rigid wall models and computations were performed using a high order spectral/hp algorithm. Results indicate a significant change in the spatial distribution of wall shear stress and a reduction of the time-averaged peak wall shear stress magnitude by 10% in the non-planar model as compared to the planar configuration. In the planar geometry the stagnation point follows a straight-line path along the host artery bed with a path length of 0.8 diameters. By contrast in the non-planar case the stagnation point oscillates about a center that is located off the symmetry plane intersection with the host artery bed wall, and follows a parabolic path with a 0.7 diameter longitudinal and 0.5 diameter transverse excursion. A definition of the oscillatory shear index (OSI) is introduced that varies between 0 and 0.5 and that accounts for a continuous range of wall shear stress vector angles. In both models, regions of elevated oscillatory shear were spatially associated with regions of separated or oscillating stagnation point flow. The mean oscillatory shear magnitude (considering sites where OSI>0.1) in the non-planar geometry was reduced by 22% as compared to the planar configuration. These changes in the dynamic behavior of the stagnation point and the oscillatory shear distribution introduced by out-of-plane graft curvature may influence the localization of vessel wall sites exposed to physiologically unfavorable flow conditions.     

Geometric design improvements for femoral graft-artery junctions mitigating restenosis

The present study is based on the hypothesis that nonuniform hemodynamics, represented by large time-averaged wall shear stress gradients, trigger abnormal biological processes leading to rapid restenosis, i.e. excessive tissue overgrowth and renewed plaque formation, and hence early graft failure. It implies that this problem may be significantly mitigated by finding graft-artery bypass configurations for which the wall shear stress gradient is approximately zero and hence nearly uniform hemodynamics is achieved. These fluid flow and geometric design considerations are applied to four different end-to-side anastomoses for the distal end of a femoral artery bypass with an appropriate test input pulse and a typical 20–80 flow division. A validated finite-volume code has been used to compute the transient three-dimensional velocity vector fields, wall shear stress distributions and surface contours of the wall shear stress gradients. It is shown that large anastomotic flow areas, small continuously changing bifurcation angles, and smooth junction wall curvatures reduce local time-averaged wall shear stress gradients significantly and hence should mitigate restenosis.     

Blood flow dynamics in saccular aneurysm models of the basilar artery

Blood flow dynamics under physiologically realistic pulsatile conditions plays an important role in the growth, rupture, and surgical treatment of intracranial aneurysms. The temporal and spatial variations of wall pressure and wall shear stress in the aneurysm are hypothesized to be correlated with its continuous expansion and eventual rupture. In addition, the assessment of the velocity field in the aneurysm dome and neck is important for the correct placement of endovascular coils. This paper describes the flow dynamics in two representative models of a terminal aneurysm of the basilar artery under Newtonian and non-Newtonian fluid assumptions, and compares their hemodynamics with that of a healthy basilar artery. Virtual aneurysm models are investigated numerically, with geometric features defined by beta = 0 deg and beta = 23.2 deg, where beta is the tilt angle of the aneurysm dome with respect to the basilar artery. The intra-aneurysmal pulsatile flow shows complex ring vortex structures for beta = 0 deg and single recirculation regions for beta = 23.2 deg during both systole and diastole. The pressure and shear stress on the aneurysm wall exhibit large temporal and spatial variations for both models. When compared to a non-Newtonian fluid, the symmetric aneurysm model (beta = 0 deg) exhibits a more unstable Newtonian flow dynamics, although with a lower peak wall shear stress than the asymmetric model (beta = 23.2 deg). The non-Newtonian fluid assumption yields more stable flows than a Newtonian fluid, for the same inlet flow rate. Both fluid modeling assumptions, however, lead to asymmetric oscillatory flows inside the aneurysm dome.     

Numerical simulation of sinusoidal flow in a straight elastic tube: effects of phase angles

Numerical simulations of flow in straight elastic (moving wall) tubes subjected to a sinusoidal pressure gradient were performed for conditions prevailing in large and medium sized arteries. The effects of varying the phase angle between the pressure gradient and the tube radius, the amplitude of wall motion, and the unsteadiness parameter (alpha) on flow rate and wall shear stress were investigated. Mean and peak flow rates and shear stresses were found to be strongly affected by the phase angle between the pressure gradient and the tube radius with greater sensitivity at higher diameter variation and higher alpha. In large artery simulations (alpha = 12), means flow rate was found to be 60% higher and peak flow rate to be 73% higher than corresponding rigid tube values for certain phase angles, while a threefold increase in mean wall shear stress and sevenfold increase in peak wall shear stress were observed in a sensitive phase angle range. Significant reversal in the wall shear stress direction occurred in the sensitive phase angle range even when there was negligible flow rate reversal. All effects were greatly diminished in simulations of medium sized vessels (alpha = 4). Some experimental evidence to support the predictions of a strong effect of phase angle on wall shear stress in large vessels is presented. Finally, physiological implications of the present work are discussed from a basis of aortic input impedance data, and a physical explanation for the extreme sensitivity of the flow field to small amplitude wall motion at high alpha is given.     

The effect of compliance on wall shear in casts of a human aortic bifurcation

Rigid and compliant casts of a human aortic bifurcation were subjected to physiologically realistic pulsatile fluid flows. At a number of sites near the wall in the approximate median plane of the bifurcation of these models, fluid velocity was measured with a laser Doppler velocimeter, and wall motion (in the case of the compliant cast) was determined with a Reticon linescan camera. The velocity and wall motion data were combined to estimate the instantaneous shear rates at the cast wall. Analysis showed that at the outer walls the cast compliance reduced shear rates, while at the walls of the flow divider the shear rate was increased.     

Comparison of axisymmetric and three-dimensional models for gas uptake in a single bifurcation during steady expiration

Reactive gas uptake is predicted and compared in a single bifurcation at steady expiratory flow in terms of Sherwood number using an axisymmetric single-path model (ASPM) and a three-dimensional computational fluid dynamics model (CFDM). ASPM is validated in a two-generation geometry by comparing the average gas-phase mass transfer coefficients with the experimental values. ASPM predicted mass transfer coefficients within 20% of the experimental values. The flow and concentration variables in the ASPM were solved using Galerkin finite element method and in the CFDM using commercial finite element software FIDAP. The simulations were performed for reactive gas flowing at Reynolds numbers ranging from 60 to 350 in both symmetric bifurcation for three bifurcation angles, 30 deg, 70 deg, and 90 deg, and in an asymmetric bifurcation. The numerical models compared with each other qualitatively but quantitatively they were within 0.4-8% due to nonfully developed flow in the parent branch predicted by the CFDM. The radially averaged concentration variation along the axial location matched qualitatively between the CFDM and ASPM but quantitatively they were within 32% due to differences in the flow field. ASPM predictions compared well with the CFDM predictions for an asymmetric bifurcation. These results validate the simplified ASPM and the complex CFDM. ASPM predicts higher Sherwood number with a flat velocity inlet profile compared to a parabolic inlet velocity profile. Sherwood number increases with the inlet average velocity, wall mass transfer coefficient, and bifurcation angle since the boundary layer grows slower in the parent and daughter branches.     

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.     

Experimental investigation of branch flow ratio, angle, and Reynolds number effects on the pressure and flow fields in arterial branch models

An experimental investigation was carried out to acquire an understanding of local pressure changes and flow along the main lumen of arterial branch models similar to the femoral artery of man with three different branch angles (30, 60, and 90 deg) and side branch to the main lumen diameter ratio of 0.4. Effects of branch to main lumen flow rate ratios and physiological Reynolds numbers were found to be significant on the local pressure changes, while that of branch angle was also found to be important. The flow visualization study revealed that the flow separated in the main lumen near the branch junction when the pressure rise coefficient along the main lumen was above a critical value (i.e., 0.35 - 0.46), which was observed to be a function of the Reynolds number. The critical value of the branch to main lumen flow rate ratio was found to be about 0.38 - 0.44 also depending on the Reynolds number. Time averaged pressure distributions for pulsatile flow were similar in trend to steady flow values although they differed somewhat in detail in the main lumen in the branch region.     

Experimental determination of mechanical shear stress about an anastomotic junction

The present study is undertaken to determine whether the elastic tube model originally developed by Kuchar and Ostrach (Biomedical Fluid Mechanics Symposium, pp. 45-69, 1966) accurately provides a first approximation of the biomechanics of the anastomotic junction. The experimental protocol involves the use of canine carotid arteries as the host vessel and several graft materials including autogenous and prosthetic substitutes. The host artery-graft combinations are perfused in vitro in a pulsatile perfusion apparatus which simulates the natural hemodynamic environment. This apparatus provides accurate dynamic measurements of radial wall motion (measured at various longitudinal increments), associated pressures and rates of fluid flow. These data are then applied to the theoretical model for calculation of anastomotic induced bending stresses. The results indicate that the predictions derived from the elastic model consistently overestimate the measured radial change adjacent to the anastomotic junction. As a result shear stresses based on elastic theory deviate from values derived from a numerical curve fit to the experimental data.