scholarly journals Optimization of stent designs regarding the thrombosis risk using computational fluid dynamics

2018 ◽  
Vol 4 (1) ◽  
pp. 93-96
Author(s):  
Carolin Wüstenhagen ◽  
Sylvia Pfensig ◽  
Stefan Siewert ◽  
Sebastian Kaule ◽  
Niels Grabow ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Stent Thrombosis ◽  
Fluid Simulation ◽  
Design Parameters ◽  
Stent Design ◽  
Thrombosis Risk ◽  
Wall Shear

AbstractIn-stent thrombosis is a major complication of stent implantations. Unlike pathological occurrences as in-stent restenosis for instance, thrombosis represents an acute event associated with high mortality rates. Experiments show that low wall shear stress promotes undirected endothelial cell coverage of the vessel wall and therefore increases the risk of thrombus formation. Stent design represents a crucial factor influencing the surface areas of low wall shear stress and thus the incidence of acute in-stent thrombosis. In this study, we present an optimization method for stent designs with minimized thrombosis risk. A generic stent design was developed, based on five different stent design parameters. Optimization was conducted based on computational fluid dynamics analysis and the gradient-free Nelder-Mead approach. For each optimization step, a numerical fluid simulation was performed in a vessel with a reference vessel diameter of 2.70 mm with stent-overexpansion ratio of 1.0:1.1. For each numerical fluid simulation a physiological Reynolds number of 250, resulting in a mean velocity of 0.331 m/s at the inlet and a laminar flow as well as stiff vessel walls were assumed. The impact of different stent designs was analyzed based on the wall shear stress distribution. As a basis for the comparison of different stent designs, a dimensionless thrombosis risk number was calculated from the area of low wall shear stress and the overall stented area. The first two optimization steps already provide a decrease of thrombosis risk of approximately 83%. In conclusion, computational fluid dynamic analyses and optimization methods usind the Nelder-Mead approach represent a useful tool for the development of hemodynamically optimized stent designs with minimized thrombosis risk.

Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study

Vascular ◽  
2014 ◽  
Vol 23 (5) ◽  
pp. 474-482 ◽  
Author(s):  
S Demirel ◽  
D Chen ◽  
Y Mei ◽  
S Partovi ◽  
H von Tengg-Kobligk ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Carotid Endarterectomy ◽  
Patient Specific ◽  
Specific Data ◽  
Computational Fluid Dynamics Analysis ◽  
Carotid Bulb ◽  
Wall Shear

Purpose: To compare postoperative morphological and rheological conditions after eversion carotid endarterectomy versus conventional carotid endarterectomy using computational fluid dynamics. Basic methods: Hemodynamic metrics (velocity, wall shear stress, time-averaged wall shear stress and temporal gradient wall shear stress) in the carotid arteries were simulated in one patient after conventional carotid endarterectomy and one patient after eversion carotid endarterectomy by computational fluid dynamics analysis based on patient specific data. Principal findings: Systolic peak of the eversion carotid endarterectomy model showed a gradually decreased pressure along the stream path, the conventional carotid endarterectomy model revealed high pressure (about 180 Pa) at the carotid bulb. Regions of low wall shear stress in the conventional carotid endarterectomy model were much larger than that in the eversion carotid endarterectomy model and with lower time-averaged wall shear stress values (conventional carotid endarterectomy: 0.03–5.46 Pa vs. eversion carotid endarterectomy: 0.12–5.22 Pa). Conclusions: Computational fluid dynamics after conventional carotid endarterectomy and eversion carotid endarterectomy disclosed differences in hemodynamic patterns. Larger studies are necessary to assess whether these differences are consistent and might explain different rates of restenosis in both techniques.

NUMERICAL SIMULATION OF HEMODYNAMICS IN PORTAL VEIN WITH THROMBOSIS BY COMPUTATIONAL FLUID DYNAMICS

2014 ◽  
Vol 14 (06) ◽  
pp. 1440006 ◽  
Author(s):  
XINKAI WANG ◽  
GUOJIE LI ◽  
BIN CHEN ◽  
YANSONG PU ◽  
PENG NIE ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Portal Vein ◽  
Mechanical Damage ◽  
Maximum Velocity ◽  
Vein System ◽  
Vein Thrombosis ◽  
Wall Shear

Portal vein thrombosis (PVT) is an important complication that is associated with cirrhotic portal hypertension. The etiology is as yet unclear but could be closely related to the hemodynamics of the portal vein system. This paper investigated the hemodynamics in the portal vein model, both with and without thrombosis, as well as the effect of obstructions on the hemodynamics of the portal vein system using the computational fluid dynamics (CFD) method. PVT can probably develop in the inlets of the portal vein as well as the left/right branches of the portal vein because the distribution of wall shear stress satisfies the conditions for PVT formation based upon the simulation of the hemodynamics in the normal portal vein model. According to the above results, geometric models for a portal vein with a thrombus were constructed and the influence of different degrees (26%, 39%, 53% and 64%) of obstructions was studied. In the model with the maximum obstruction (64% blocked), the maximum velocity of portal vein (PV) increased up to twice than in the model without thrombosis, and the maximum wall shear stress of PV in the model with thrombosis (64% blocked) increased up to 9.4 Pa, whereas it was only 1.9 Pa in the model without thrombosis (nearly one fifth of the maximum wall shear stress). Excessive wall shear stress may cause mechanical damage to the blood vessels and induce physiological changes.

Computational Fluid Dynamics of a Vascular Access Case for Hemodialysis

2000 ◽  
Vol 123 (3) ◽  
pp. 284-292 ◽  
Author(s):  
Bogdan Ene-Iordache ◽  
Lidia Mosconi ◽  
Giuseppe Remuzzi ◽  
Andrea Remuzzi
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Blood Flow ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Radial Artery ◽  
Stress Gradient ◽  
Vascular Lesions ◽  
Patient Specific ◽  
Wall Shear

Vascular accesses (VA) for hemodialysis are usually created by native arteriovenous fistulas (AVF) or synthetic grafts. Maintaining patency of VA continues to be a major problem for patients with end-stage renal disease, since in these vessels thrombosis and intimal hyperplasia often occur. These lesions are frequently associated with disturbed flow that develops near bifurcations or sharp curvatures. We explored the possibility of investigating blood flow dynamics in a patient-specific model of end-to-end native AVF using computational fluid dynamics (CFD). Using digital subtraction angiographies of an AVF, we generated a three-dimensional meshwork for numerical analysis of blood flow. As input condition, a time-dependent blood waveform in the radial artery was derived from centerline velocity obtained during echo-color-Doppler ultrasound examination. The finite element solution was calculated using a fluid-dynamic software package. In the straight, afferent side of the radial artery wall shear stress ranged between 20 and 36 dynes/cm2, while on the inner surface of the bending zone it increased up to 350 dynes/cm2. On the venous side, proximal to the anastomosis, wall shear stress was oscillating between negative and positive values (from −12 dynes/cm2 to 112 dynes/cm2), while distal from the anastomosis, the wall shear stress returned within the physiologic range, ranging from 8 to 22 dynes/cm2. Areas of the vessel wall with very high shear stress gradient were identified on the bending zone of the radial artery and on the venous side, after the arteriovenous shunt. Secondary blood flows were also observed in these regions. CFD gave a detailed description of blood flow field and showed that this approach can be used for patient-specific analysis of blood vessels, to understand better the role of local hemodynamic conditions in the development of vascular lesions.

scholarly journals Aerodynamic effects of inferior turbinate surgery on nasal airflow--a computational fluid dynamics model

2010 ◽  
Vol 48 (4) ◽  
pp. 394-400
Author(s):  
X.B. Chen ◽  
S.C. Leong ◽  
H.P. Lee ◽  
V.F.H. Chong ◽  
D.Y. Wang
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Atrophic Rhinitis ◽  
Single Individual ◽  
Cfd Simulations ◽  
Wall Shear

BACKGROUND: Turbinate reduction surgery may be indicated for inferior turbinate enlargement when conservative treatment fails. The aim of this study was to evaluate the effects of inferior turbinate surgery on nasal aerodynamics using computational fluid dynamics (CFD) simulations. METHODS: CFD simulations were performed for the normal nose, enlarged inferior turbinate and following three surgical procedures: (1) resection of the lower third free edge of the inferior turbinate, (2) excision of the head of the inferior turbinate and (3) radical inferior turbinate resection. The models were constructed from MRI scans of a healthy human subject and a turbulent flow model was used for the numerical simulation. The consequences of the three turbinate surgeries were compared with originally healthy nasal model as well as the one with severe nasal obstruction. RESULTS: In the normal nose, the bulk of streamlines traversed the common meatus adjacent to the inferior and middle turbinate in a relatively vortex free flow. When the inferior turbinate was enlarged, the streamlines were directed superiorly at higher velocity and increased wall shear stress in the nasopharynx. Of the three surgical techniques simulated, wall shear stress and intranasal pressures achieved near-normal levels after resection of the lower third. In addition, airflow streamlines and turbulence improved although it did not return to normal conditions. As expected, radical turbinate resection resulted in intra-nasal aerodynamics of atrophic rhinitis demonstrated in previous CFD studies. CONCLUSION: There is little evidence that inspired air is appropriately conditioned following radical turbinate surgery. Partial reduction of the hypertropic turbinate results in improved nasal aerodynamics, which was most evident following resection of the lower third. The results were based on a single individual and cannot be generalised without similar studies in other subjects.

The Application of Computational Fluid Dynamics to Define a Relationship Between Wall Shear Stress and Pseudointima Formation Within a Porous ePTFE Graft Implanted Within a Baboon

2003 ◽  
Author(s):  
James R. Costello ◽  
Changyi Chen ◽  
Don P. Giddens ◽  
Stephen R. Hanson
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Vascular Grafts ◽  
Adverse Outcomes ◽  
Graft Material ◽  
Short Term ◽  
Eptfe Graft ◽  
Wall Shear

Local hemodynamics and wall shear stress (WSS) impact healing of implanted expanded polytetrafluoroethylene (ePTFE) vascular grafts. Since adverse outcomes occur shortly after implantation, we documented the effect of local hemodynamics on short-term healing. We implanted a control or a stenotic ePTFE graft with a 60 μm internodal porosity into the abdominal aorta of 15–20 kg juvenile male baboons. At one month we harvested all grafts using in situ pressure perfusion. We interrogated the local hemodynamics with aid of computational fluid dynamics. We constructed three different geometric grids of the vascular grafts. We defined the first grid based on the material specifications of the graft material. We constructed the second grid by outlining the contours of the graft from the sectioned and stained histologic slides. Lastly, we created the third grid by capturing the graft contours from axial sections of the in vivo grafts acquired with a 1.5 T Phillips® MRI. Using volumetric flow rate and PC-MRI data, we performed steady state and pulsatile simulations. We then correlated the calculated wall shear stress and the measured pseudointima formation. The results demonstrated that high wall shear stress fails to inhibit intimal thickening during short term graft healing.

Relation Between Wall Shear Stress and Plaque Necrotic Core in the Left Coronary Arteries of Patients Using Intravascular Ultrasound and Computational Fluid Dynamics

2008 ◽  
Author(s):  
Jin Suo ◽  
Michael McDaniel ◽  
Habib Samady ◽  
Don Giddens
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Intravascular Ultrasound ◽  
Coronary Arteries ◽  
Plaque Rupture ◽  
Necrotic Core ◽  
Elastic Membrane ◽  
Wall Shear

Atherosclerosis is a disease characterized by arterial plaques that include several components of which the necrotic core has been recognized as an important indicator of the likelihood of plaque rupture [1]. In the present study, the relation of hemodynamic wall shear stress (WSS) to necrotic core localization in the left coronary artery of patients was investigated using intravascular ultrasound (IVUS) and computational fluid dynamics (CFD). An innovative 3D measuring technique was developed and was successfully used to reconstruct coronary arteries in patients based on angiographic images and echo ultrasound slices from IVUS. The reconstruction includes lumen, external elastic membrane (EEM) and spatial distribution of plaque components such as fibrous tissue, necrotic core and calcium. WSS distribution in the vessel segment was computed by CFD, and the relative locations of necrotic core and WSS were determined. Results to date support the hypothesis that a greater necrotic core in coronary plaques is associated with areas of low WSS. The methodology developed has implications for the study of plaque progression and the prediction of likelihood of plaque rupture.

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