Haemodynamic flow: symmetry and synthesis

This paper is presented as a summary and synthesis of the presentations at the conference entitled "Breaking Symmetry in Haemodynamics". As the accompanying papers will attest, there has been enormous progress in understanding the effects of fluid flow on the arterial endothelium and the consequential effects on the vessel wall. It is now clearly understood that the focal lesions found in atherosclerotic arteries are the product of asymmetrical flow and the resulting disturbed flow that occurs near arterial bifurcations and other selected points around the human vasculature. The flow in large vessels can now be determined accurately with MR and in vitro cast models. Although theory allows arterial flow to be characterized by asymmetry in time and space, our understanding of the processes that act to translate this asymmetry into pathology is becoming much more symmetric, or complete. The new frontiers of research in arterial flow are now translating to smaller scales, at the cellular level and below.