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Experimental Investigation of Secondary Flow Structures Downstream of a Model Type IV Stent Failure in a 180° Curved Artery Test Section
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Three dimensional numerical analysis of hemodynamic of stenosed artery considering realistic outlet boundary

Arindam Bit1, Adel Alblawi2, Himadri Chattopadhyay3

  • 1Department of Biomedical Engineering, National Institute of Technology, Raipur, India.

Computer Methods and Programs in Biomedicine
|November 12, 2019
PubMed

Insights

Numerical simulations reveal that primary stenosis severity and specific outlet boundary conditions significantly influence secondary stenosis progression in the aortic arch. Understanding these hemodynamics aids in predicting and managing vascular disease.

Area of Science:

  • Cardiovascular fluid dynamics
  • Biomedical engineering
  • Medical imaging analysis

Background:

  • Vascular diseases, particularly those affecting blood vessels, contribute significantly to global mortality.
  • Late diagnosis of severe stenoses (narrowing) in blood vessels hinders effective treatment due to assessment difficulties.
  • Secondary stenoses often develop downstream from primary stenoses, their proliferation influenced by the primary lesion's severity.

Purpose of the Study:

  • To numerically investigate blood flow dynamics in patient-specific aortic arch geometries with descending aorta stenoses.
  • To predict the distribution of secondary stenoses based on primary stenosis severity and defined flow domain boundary conditions.
  • To analyze the impact of various inlet and outlet boundary conditions on flow parameters.

Main Methods:

  • Utilized patient-specific aortic arch geometry with descending aorta stenoses for biofluid dynamics estimation.
  • Extracted boundary conditions from time-resolved pulsed Doppler Ultrasound imaging.
  • Evaluated flow parameters such as wall shear stress and oscillatory shear index under different boundary condition combinations.

Main Results:

  • Outlet boundary conditions were found to significantly affect secondary stenosis progression.
  • The severity of primary stenoses directly influenced the development of secondary stenoses.
  • Specific outlets, namely the Left Subclavian Artery and Left Common Carotid Artery, critically impacted flow dynamics. The lower aortic arch wall showed a higher propensity for secondary stenosis development.

Conclusions:

  • The aortic arch is susceptible to secondary stenoses progression when primary stenoses are present in the ascending or descending aorta.
  • Findings suggest a potential influence of aneurysms in the descending aorta on the aortic arch's vulnerability.
  • This study highlights the importance of considering hemodynamic factors in understanding stenotic lesion development.
Abstract

Keywords:
Aortic archNon-newtonianOscillatory shear indexRe-stenosesRelative residual timeWall shear stress

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