EFFECTS OF HEMATOCRIT LEVEL ON THE BLOOD FLOW IN THE CORRUGATED VESSEL DUE TO THE IMPLANTATION OF INTRAVASCULAR STENTS

Abstract

The vascular stenting has been accepted as a very effective treatment of occlusive vascular disease. But the implantation of vascular stent will change the geometric shape of stenosed vessel to be corrugated and create some local hemodynamic features characterized by the flow separation, recirculation in the area close to the stent. Under the physiological conditions of left coronary artery and specific geometric shapes created by the implantation of stent, the numerical method has been used to solve the blood flow and the shear stress distribution patterns in the vicinity of the stent. The non-Newtonian fluids with different levels of hematocrit (H), 25%, 45%, 65% are employed for the numerical simulation and compared with the numerical results of the Newtonian fluid in which the blood viscosity is assumed to be constant. The simulations have revealed that the surface of stent and atheroma bumps experience lower time-averaged wall shear stress by the non-Newtonian fluid with lower level of hematocrit. The value of wall shear stress on the peak of atheroma bumps has also been studied because it may associate with the cause the rupture of atheroma plaque. The numerical results of Newtonian fluid were compared with those of non-Newtonian fluid with hematocrit level of 45%, the average hematocrit value inherent in normal person. It is noted that non-Newtonian effect on the time-averaged wall shear stress distribution along the stent surface is not significant. The outline of bulged atheroma experiences almost same time-averaged shear stress distribution acting by the fluid with or without the non-Newtonian property. It means that for the non-Newtonian fluid with hematocrit level of 45% the property of changing viscosity in the flow field didn't affect the results of wall shear stress distribution on the surfaces of stent and atheroma bump resulted from the simulation of Newtonian fluid flow. These results will provide insight into the effects of different levels of hematocrit on the blood flow in the corrugated vessel due to the implantation of stent. Our findings suggest that the level of hematocrit is closely associated with the value of wall shear stress distribution. It is particularly significant to acute stage of atherogenesis, intimal hyperplasia, platelet deposition, thrombosis, endothelial cell orientation and the rupture of atheroma plaque after the implantation of stent. Some of the results presented can be used to explain the clinical performance of vascular stenting.