Analysis of Blood Flow Patterns to Estimate Atherosclerosis Formation in the Left Carotid Artery by CFD Simulation

Abstract

Abstract The purpose of this computational fluid dynamics (CFD) study is to simulate left carotid artery models to evaluate the influence of hematocrit (Hct) level and angle of bifurcation on the formation of atherosclerosis. Bifurcation angle can vary from person to person based on sex, age or diseased condition which has an impact on hemo-dynamic parameters. From the anatomical study, it is seen that the carotid artery bifurcation is the preferential region for atherosclerosis formation. The combination of bifurcation, curvature and diameter change in this bifurcation region causes the blood flow to be complex with recirculation regions and secondary flows which influence hemodynamic changes and the formation of atherosclerosis. Along with the bifurcation angle, the Hct level also influences on changing hemodynamic parameters. As the viscosity of blood is mainly controlled by the Hct level, the hemodynamic parameters of blood are changed on the basis of change in percentage of the Hct level. Therefore, the Hct percentage can act as a risk factor for atherosclerosis formation. We have assessed the probability of vulnerable atherosclerosis formation based on the change of both bifurcation angle and hematocrit level. In this study, three different carotid artery geometries with 40 degree, 48.5 degree, and 63.6 degree angles were simulated at a varying percentage of the Hct level. We discerned these models by using CFD simulation to calculate wall shear stress (WSS), time-averaged wall shear stress (TAWSS) and velocity. The effects of angulation and Hct percentage on the velocity of blood were studied on the plane of the bifurcation region. The carotid artery with 63.6 degree angulation faces more recirculation areas and peak recirculation areas are observed at 25% Hct level. This justifies the reason behind atherosclerosis formation in the artery. We observed low WSS at wider angled models and a high WSS at narrow angled models. WSS value is also affected by the percentage of Hct. In this study, we noticed a lower value of WSS at a lower percentage of Hct which is responsible for atherosclerosis formation. The WSS value of 0.4 Pa was considered as the critical point for the atherosclerosis formation. We also calculated time-averaged wall shear stress (TAWSS) which is similar to the WSS contour plot. Overall, after analyzing the results of velocity, WSS and TAWSS, we concluded that low Hct (around 25% or lower) along with higher bifurcation angle (around 63.6 degree or higher) are more accountable for atherosclerosis formation.