Low Wall Shear Stress Values Research Articles

Numerical simulation of cellular blood flow in curved micro-vessels with saccular aneurysms: Effect of curvature degree and hematocrit level.

The dynamics of cellular blood flow in curved vessels considerably differ from those in straight vessels. It is reported that clotting development is significantly affected by vessel shape irregularities. Thus, the current study aims to investigate the effect of curvature degree and hematocrit level on cellular blood flow in a curved micro-vessel with a saccular aneurysm. Accordingly, a three-dimensional numerical simulation is performed using a validated code developed for cellular blood flow problems. The obtained results show that the cell-free layer thickness is highly dependent on the curvature degree and hematocrit level, which may have a remarkable impact on the apparent viscosity of blood as well as the dynamics of other particles such as drug particulates. The near-wall region exhibits the highest degree of cell deformation, whereas the red blood cells within the aneurysm zone remain nearly undeformed. Meanwhile, the velocity of the red blood cells decreases with the increase in curvature degree, which can affect the quality of the oxygenation process. Because of the saccular aneurysm, a considerable decrease in plasma velocity is predicted. Moreover, no secondary flows are detected in the curved vessel except in the aneurysm zone. An increase in the curvature degree is expected to reduce the blood flow rate by about 10%. Furthermore, low wall shear stress values are predicted in the straight case compared to the values at the apex of the curved vessel, which may affect the structure and function of the endothelial cells of the vessel wall and, hence, increase the aneurysm rupture possibility.

INVESTIGATION OF FLOW IN AN IDEALIZED CURVED ARTERY: COMPARATIVE STUDY USING CFD AND FSI WITH NEWTONIAN AND NON-NEWTONIAN FLUIDS

Artery curvatures, where disturbed flow patterns are expected, are preferred sites of formation of atherosclerosis. Experimental studies have shown that low and oscillating wall shear stress (WSS) plays an important role in the development and progression of atherosclerosis. Accurate estimation of these biomechanical parameters is important to assess the risk of atherosclerosis formation. The coupled effects of non-Newtonian behavior of blood and artery wall flexibility for the transient blood flow through an idealized curved coronary artery are investigated using computational fluid dynamics (CFD) as well as fluid–structure interaction (FSI) simulations. The choice of fluid model, Carreau and Newtonian, was found to impact the time averaged and minimum WSS values. The effects of wall deformation on time averaged wall shear tress were negligible. However, a comparison of temporal minima of WSS along the curvature showed significant variations between CFD and FSI simulations. Since low WSS values are crucial in the prediction of atherosclerosis development, it is concluded that both the non-Newtonian behavior of blood and the wall flexibility should be considered for computational studies.

Computational fluid dynamics simulations of cerebral aneurysm using Newtonian, power-law and quasi-mechanistic blood viscosity models.

Cerebral aneurysm is a fatal neurovascular disorder. Computational fluid dynamics simulation of aneurysm haemodynamics is one of the most important research tools which provide increasing potential for clinical applications. However, computational fluid dynamics modelling of such delicate neurovascular disorder involves physical complexities that cannot be easily simplified. Recently, it was shown that the Newtonian simplification used to close the shear stress tensor of the Navier-Stokes equation is not sufficient to explore aneurysm haemodynamics. This article explores the differences between the latter simplification, non-Newtonian power-law model and a newly proposed quasi-mechanistic model. The modified Krieger model, which treats blood as a suspension of plasma and particles, was implemented in computational fluid dynamics context here for the first time and is made available to the readers in a C# code in the supplementary material of this article. Two middle-cerebral artery and two anterior-communicating artery aneurysms, all ruptured, were utilized here as case studies. It was shown that the modified Krieger model had higher sensitivity for wall shear stress calculations in comparison with the other two models. The modified Krieger model yielded lower wall shear stress values consistently in comparison with the other two models. Moreover, the modified Krieger model has generally predicted higher pressure in the aneurysm models. Based on published aneurysm rupture studies, it is believed that ruptured aneurysms are usually correlated with lower wall shear stress values than unruptured ones. Therefore, this work concludes that the modified Krieger model is a potential candidate for providing better clinical relevance to aneurysm computational fluid dynamics simulations.

Optimal Site for Proximal Optimization Technique in Complex Coronary Bifurcation Stenting: A Computational Fluid Dynamics Study

Background/purposeThe optimal position of the balloon distal radio-opaque marker during the post optimization technique (POT) remains debated. We analyzed three potential different balloon positions for the final POT in two different two-stenting techniques, to compare the hemodynamic effects in terms of wall shear stress (WSS) in patients with complex left main (LM) coronary bifurcation. Methods/materialsWe reconstructed the patient-specific coronary bifurcation anatomy using the coronary computed tomography angiography (CCTA) data of 8 consecutive patients (6 males, mean age 68.2± 18.6 years) affected by complex LM bifurcation disease. Subsequently a virtual bench test was performed in each patient using two different double stenting techniques represented by the DK and Nano crush using the reconstruction of Orsiro stents (Biotronik IC, Bulack, Switzerland). ResultsA significant reduction in the mean WSS values in all the lesion's sites was observed when the final POT was performed 1 mm distally the carina cut plane in both techniques. Moreover, a significant improvement in the mean WSS values of the entire SB (e.g. LCX) was obtained performing the POT 1 mm distally to the carina cut plane. The proximal POT resulted in larger area of lower WSS values at the carina using both the Nano crush and the DK crush techniques. ConclusionsIn patients with complex LM bifurcation disease the use of a final POT performed 1 mm distally to the carina cut plane might results in more favorable WSS patterns (i.e. higher WSS values) along all stented segments and, especially, along the entire LCX lesions.

In-Vitro Simulation of the Blood Flow in an Axisymmetric Abdominal Aortic Aneurysm

We investigated the blood flow patterns and the hemodynamics associated with an abdominal aortic aneurysm detected in an in vitro measurement campaign performed in a laboratory model of an aneurysm with rigid walls and an axisymmetric shape. Experiments were run in steady flow conditions and by varying the Reynolds number in the range 410 < Re < 2650. High spatial and temporal resolution 2D optical measurements of the velocity field were obtained through a particle tracking technique known as Hybrid Lagrangian Particle Tracking. Conversely to classical Particle Image Velocimetry, both the fluid particle trajectories and the instantaneous and time-averaged velocity fields are provided without constraints on the grid size and very close to the vessel boundary. All the most relevant quantities needed to investigate the flow features were evaluated, and in particular, we focused on the wall shear stress distribution both in the healthy aortic portion and within the aneurysm. Results show that the recirculation zone in correspondence of the cavity moves downstream, and this displacement is found to increase with Re. Very low wall shear stress values are recovered in correspondence of the aneurysmal cavity, while a sharp peak occurs in correspondence of the reattachment point. In agreement with the literature data, the peak value is found to decrease with Re and to be about equal to twice the upstream value.

High-Sensitivity Single Thermopile SOI CMOS MEMS Thermal Wall Shear Stress Sensor

In this paper, we present a novel silicon-on-insulator (SOI) complementary metal–oxide–semiconductor (CMOS) microelectromechanical-system thermal wall shear stress sensor based on a tungsten hot-wire and a single thermopile. Devices were fabricated using a commercial 1- $\mu \text{m}$ SOI-CMOS process followed by a deep reactive ion etching back-etch step to release a silicon dioxide membrane, which mechanically supports and thermally isolates heating and sensing elements. The sensors show an electrothermal transduction efficiency of $50~\mu \text{W}$ /°C, and a very small zero flow offset. Calibration for wall shear stress measurement in air in the range of 0–0.48 Pa was performed using a suction type, 2-D flow wind tunnel. The sensors were found to be extremely sensitive, up to 4 V/Pa for low wall shear stress values. Furthermore, we demonstrate the superior signal-to-noise ratio (up to five times higher) of a single thermopile readout configuration compared with a double thermopile readout configuration (embedded for comparison purposes within the same device). Finally, we verify that the output of the sensor is proportional to the cube root of the wall shear stress and we propose an accurate semiempirical formula for its modeling.

Temporal Correlation between Wall Shear Stress and In-Stent Stenosis after Wingspan Stent in Swine Model

A recent randomized clinical trial on intracranial atherosclerosis was discontinued because of the higher frequency of stroke and death in the angioplasty and stent placement group than in the medical treatment group. An in-depth understanding of the relationship between biologic responses and flow dynamics is still required to identify the current limitations of intracranial stent placement. Five Wingspan stents were deployed in tapered swine ascending pharyngeal arteries. Temporal wall shear stress distributions and in-stent stenosis were evaluated at days 0, 7, 14, and 28 after stent placement. The physiologic role of wall shear stress was analyzed regarding its correlation with in-stent stenosis. In-stent stenosis reached a peak of nearly 40% at day 14 and decreased mainly at the distal stent segment until day 28. The wall shear stress demonstrated a characteristic pattern with time on the basis of the in-stent stenosis change. The wall shear stress gradient increased from the proximal to distal segment until day 14. At day 28, the trend was reversed dramatically, decreasing from the proximal to the distal segment. A significant correlation between the in-stent stenosis growth until day 14 and low wall shear stress values just after stent placement was detected. In-stent stenosis regression between days 14 and 28 was also associated with the high wall shear stress values at day 14. These data suggest that the physiologic wall shear stress can control the biphasic in-stent stenosis change in tapered arteries.

On the creation of wall shear stress by helical flow structures in stented coronary vessels

AbstractThe post-operative situation in a stented vessel is characterised by struts which extend into the vessel lumen. These barriers on the surface provoke a topological change of the blood flow inducing flow deceleration and stagnation zones. Low values of wall shear stress (WSS) especially up- and downstream of the struts are found accordingly. Clinical studies correlate the occurrence of complications like restenosis and thrombosis with the alteration of the spatial WSS distribution. In this study 3D computational models were used to characterise the flow topology of three different stent types. For this purpose steady state simulations of the flow field within a simplified stented coronary artery were performed. The stent types differ in their strut patterns so that the variation of the induced flow structures can be observed. The aim of these investigations is to evaluate the effect of a purposeful flow control by altering the design of the struts. An improved alignment of the struts will be able to guide the flow to benefit the spatial WSS distribution. To compare the performance of the different stent types the size of the area charged with a WSS value below 0.5 Pa is used as a criterion. We will demonstrate that those strut pattern which generate helical flow structures significantly reduce the critical region of low WSS values.

Noninvasive determination of spatial distribution and temporal gradient of wall shear stress at common carotid artery

Wall shear stress (WSS) has been proved to play a critical role in formation and development of atherosclerotic plaques. Our objective was to quantify local WSS in vivo in normal subjects, and to analyze spatial distribution patterns and determine the temporal gradient of WSS. Seventy-eight CCAs of 42 healthy volunteers at common carotid arteries (CCAs) were studied. Cine phase-contrast MR sequence was used to acquire the flow velocity information. Three-dimensional paraboloid modeling was applied to fit the velocity profiles and WSS values were calculated. Mean WSS value for CCAs was 0.783±0.209, with the range of WSS value from −0.541 to 3.464 N/m 2. The 95% confidence interval for mean WSS value in CCA was (0.736–0.830) N/m 2. Different WSS spatial distribution patterns were classified into three types according to the location of low WSS values during a cardiac cycle. Mean value of maximum temporal gradient of WSS was 14.12±5.46, with the range from 5.87 to 33.23 N/m 2 s −1. Skewed velocity profiles were displayed in most CCAs, indicating the flow patterns in CCA were more complicated than commonly assumed. Obvious inter-subject variation were found in magnitude, spatial distribution and the temporal gradient of WSS in CCAs, and the blood flow patterns as well.

Blood flow pattern and wall shear stress in the internal carotid arteries of healthy subjects

The carotid bifurcation is one of the most susceptible locations for atherosclerotic plaques. It is important to assess wall shear stress (WSS) and blood flow patterns in this area. To assess local WSS and blood flow patterns at the origin of the internal carotid artery (ICA). Twenty-eight ICAs of 16 healthy volunteers were studied. A cine phase-contrast magnetic resonance (MR) sequence combined with a three-dimensional paraboloid model was applied to calculate WSS values and to obtain flow parameters. WSS spatial distribution features and local flow patterns were analyzed. Mean WSS was 0.560 +/- 0.180 (range -0.745 to 3.563) N/m2 at the origin of 28 ICAs. Error points were found in six vessels. Four WSS spatial distribution patterns were classified according to the location of low WSS values. Reverse WSS was found in 20 vessels. The mean oscillatory shear index (OSI) for these vessels was 0.089 +/- 0.094 (range 1.00 x 10(-6) to 0.490). Complex flow status including reverse velocity, flow stagnancy, and high oscillating WSS was displayed in the end systole of this area. Flow patterns were variant and complicated at the origin of the ICAs. Different types of local WSS spatial distributions were found around the vessel circumference.

Spatial and phasic oscillation of non-Newtonian wall shear stress in human left coronary artery bifurcation: an insight to atherogenesis

To investigate the wall shear stress oscillation in a normal human left coronary artery bifurcation computational model by applying non-Newtonian blood properties and phasic flow. The three-dimensional geometry of the investigated model included the left main coronary artery along with its two main branches, namely the left anterior descending and the left circumflex artery. For the computational analyses a pulsatile non-Newtonian flow was applied. To evaluate the cyclic variations in wall shear stress, six characteristic time-points of the cardiac cycle were selected. The non-Newtonian wall shear stress variation was compared with the Newtonian one. The wall shear stress varied remarkably in time and space. The flow divider region encountered higher wall shear stress values than the lateral walls throughout the entire cardiac cycle. The wall shear stress exhibited remarkably lower and oscillatory values in systole as compared with that in diastole in the entire bifurcation region, especially in the lateral walls. Although the Newtonian wall shear stress experienced consistently lower values throughout the entire cardiac cycle than the non-Newtonian wall shear stress, the general pattern of lower wall shear stress values at the lateral walls, particularly during systole, was evident regardless of the blood properties. The lateral walls of the bifurcation, where low and oscillating wall shear stress is observed, are more susceptible to atherosclerosis. The systolic period, rather than the diastolic one, favors the development and progression of atherosclerosis. The blood viscosity properties do not seem to qualitatively affect the spatial and temporal distribution of the wall shear stress.

Wall shear stress in normal left coronary artery tree

Despite the fact that the role of wall shear stress (WSS) as a local mechanical factor in atherogenesis is well established, its distribution over the entire normal human left coronary artery (LCA) tree has not yet been studied. A three-dimensional computer generated model of the epicardial LCA tree, based on averaged human data set extracted from angiographies, was adopted for finite-element analysis of the Navier–Stokes flow equations treating blood as non-Newtonian fluid. The LCA tree includes the left main coronary artery (LMCA), the left anterior descending (LAD), the left circumflex artery (LCxA) and their major branches. In proximal LCA tree regions where atherosclerosis frequently occurs, low WSS appears. Low WSS regions occur at bifurcations in regions opposite the flow dividers, which are anatomic sites predisposed for atherosclerotic development. On the LMCA bifurcation, at regions opposite to the flow divider, dominant low WSS values occur ranging from 0.75 to 2.25 N/m 2. High WSS values are encountered at all flow dividers. This work determines, probably for the first time, the topography of the WSS in the entire normal human LCA epicardial tree. It is also the first work determining the spatial WSS differentiation between proximal and distal normal human LCA parts. The haemodynamic analysis of the entire epicardial LCA tree further verifies the implications of the WSS in atherosclerosis mechanisms.

Relation between non-uniform hemodynamics and sites of altered permeability and lesion growth at the rabbit aorto-celiac junction

Using the rabbit’s aorto-celiac junction as a representative atherosclerotic model, the hemodynamics of a bifurcating blood vessel are numerically simulated and three hemodynamic parameters are compared. The wall shear stress (WSS), the oscillatory shear index (OSI), and the spatial wall shear stress gradient (WSSG) are considered in this study. Locally enhanced wall permeabilities and intimal macrophages are generally considered to be involved in atherogenesis, and here the primary concern is with the hemodynamic influence on these early stages of the disease process. In comparing the segmental averages of the indicator functions and previously published intimal white blood cell densities, only the WSSG shows a statistically significant correlation. All three indicators have selective strengths in determining sites of early lesion growth around the aorto-celiac flow divider. At the proximal end of the flow divider on the lateral side of the orifice, there are elevated values of the OSI as well as WSSG and low WSS values. Regions of elevated wall permeabilities compare with the regions of elevated WSSG along the lateral and distal portions of the flow divider. Largely dependent upon the present input pulse with reverse flow, the OSI indicates relatively high values throughout the flow domain, however, it is important when utilized in conjunction with low WSS regions. This study presents a rationale for further quantitative correlative studies in the rabbit model based on additional histological data sets.

Wall shear stress distribution in the human carotid siphon during pulsatile flow

Wall shear stress distribution in the carotid siphon, which is a multiple curved segment of the internal carotid artery, is investigated numerically under physiological flow conditions. The computer simulation of flow through the model segment is based on the time-dependent, three-dimensional Navier-Stokes equations, solved numerically with a finite element method. The study shows the behavior of the wall shear stress-vector field and identifies the zones of high and low wall shear stress values during the cardiac cycle.