Hemodynamic Analysis of Coronary Circulation in Angulated Coronary Stenosis Following Stenting

The present study in angulated coronary stenosis used human in vivo hemodynamic parameters and computed simulation, both qualitatively and qualitatively, to evaluate the influence of flow velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, and their effect on evolving in-stent restenosis. Initial and follow-up coronary angiographies in patients with angulated coronary stenosis were performed (n=60). The optimal degree of coronary stenting for angulated coronary stenosis had two models, the less than 50% angle changed group (model 1, n=33) and the more than 50% angle changed group (model 2, n=27). This angle change was based on the percentage change of vascular angle between pre- and post-intracoronary stenting. The flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of the flow-velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre- and post-intracoronary stenting was calculated from three-dimensional computer simulation. As results, follow-up coronary angiogram demonstrated significant difference in the percentage of diameter stenosis between the two groups (group 1: 40.3 +/- 30.2 vs. group 2: 25.5 +/- 22.5%, p < 0.05). Negative shear area on 3D simulation, which is consistent with the re-circulation area of flow vector, was noted on the inner wall of the post-stenotic area before stenting. The negative WSS disappeared after stenting. High spatial and temporal WSS before stenting fell within the range of physiologic WSS after stenting. This finding was more prominent in model 2 (p < 0.01). The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation, termed WSS, might affect the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric characteristics, such as the angular difference between pre- and post- intracoronary stenting might define optimal rheologic properties for vascular repair after stenting.

Analysis of Hemodynamic Characteristics in End-to-Side Anastomoses with Miller Cuff

The hemodynamic characteristics of the cuff end-to-side anastomosis model are investigated using by the finite volume predictions. The flow rates and the impedance indices through of the cuff anastomosis model are compared with those of the anastomosis model without the cuff. Blood flow increased through the cuff anastomosis model than the standard anastomosis model. The impedance index decreased with the increase of flow rate. The impedance index at a given flow rate is reduced by the increase of anastomosis angle and further reduced by the addition of the cuff. The results suggest that the cuff anastomosis model should be applied for the low Reynolds number flow and/or the small artery anastomosis model.

Visualization of Pulsatile Flow of the Blood Substitute Fluids Using the Particle Image Velocimetry

PURPOSE: The objective of the present study is to investigate the steady and pulsatile flow phenomena of the blood substitute fluids in the circular and bifurcated vessels numerically and experimentally. METHODS: The particle image velocimetry (PIV) is adopted to visualize the flow fields in the circular and bifurcated vessels. In order to analyse the complex flow phenomena of the blood substitute fluids in the bifurcated vessel, the constitutive equations which are suitable to describe the rheological properties of the non-Newtonian fluids are determined and the steady and unsteady momentum equations are solved by the finite volume prediction. RESULTS AND CONCLUSION: Velocity vectors of the steady flow in the bifurcated tube obtained by the PIV system are in good agreement with those obtained by the numerical analysis. The experimental and numerical results show the recirculation zone in the outer wall distal to bifurcation.

Modelling of Elastic Blood Vessel under the Pulsatile Flow

PURPOSE: Characteristics of pulsatile flow in 3-dimensional arterial geometry and elastic vessel wall should be investigated in order to understand the physiological blood flow in human body. In this study, the modelling of the physiological blood flow in the elastic blood vessel is proposed. METHODS: The finite volume predictions are used to analyse the pulsatile flow characteristics in the elastic blood vessel. RESULTS AND CONCLUSION: Variations of the pressure and the velocity waveforms are obtained using the proposed modelling. The magnitudes of the pressure waveforms in the elastic blood vessel model are bigger than those of the rigid blood vessel model.

Analysis of Hemodynamic Characteristics in Anastomotic Sites of Femoral Artery Implantation

The objective of the present study is to obtain information on the hemodynamic characteristics in the anastomotic sites of femoral artery through the vascular implantation. Three dimensional steady and physiological blood flows in the femoral artery are simulated using the finite volume method. The geometrical shape of the anastomotic sites is made based on the vascular anatomy of a white rabbit. Wall shear stress distributions in the anastomotic sites for the physiological flow are compared with those for steady flow. Blood flow phenomena in the anastomotic sites of the femoral artery are discussed extensively.

Computed numerical analysis of the biomechanical effects on coronary atherogenesis using human hemodynamic and dimensional variables

The objectives of this investigation were to evaluate biomechanical factors in the atherosclerotic process using human in vivo hemodynamic parameters and computed numerical simulation qualitatively and quantitatively. The three-dimensional spatial patterns of steady and pulsatile flows in the left coronary artery were simulated, using a finite volume method. Coronary angiogram and Doppler ultrasound measurement of the proximal left coronary flow velocity were performed in humans. Inlet wave velocity distribution obtained from in vivo data of the intravascular Doppler study allowed for input of in vitro numerical simulation. Hemodynamic variables, such as flow velocity, pressure and shear stress of the left anterior descending coronary bifurcation site were calculated. We found that there were spatial fluctuation of flow-velocity and recirculation areas at the curved outer wall of the left anterior descending coronary artery, which were due to the differences of flow-velocity and shear stress, especially during the declaration phase of pulsatile flow. This study suggests that rheologic properties may be a part of the atherogenic process in the coronary bifurcated and curved areas.