Bend Sweep Angle and Reynolds Number Effects on Hemodynamics of S-Shaped Arteries

A NUMERICAL STUDY ON THE HEMODYNAMIC AND SHEAR STRESS OF DOUBLE ANEURYSM THROUGH S-SHAPED VESSEL

Abdominal aortic aneurysm (AAA) is a degenerative disease defined as the abnormal ballooning of the abdominal aorta (AA) wall which is usually caused by atherosclerosis. The aneurysm grows larger and eventually ruptures if it is not diagnosed and treated. Aneurysms occur mostly in the aorta, the main artery of the chest and abdomen. The aorta carries blood flow from the heart to all parts of the body, including the vital organs, the legs, and feet. The objective of the present study is to investigate the combined effects of aneurysm and curvature on flow characteristics in S-shaped bends with sweep angle of 90° at Reynolds number of 900. The fluid mechanics of blood flow in a curved artery with abnormal aortic is studied through a mathematical analysis and employing Cosmos flow simulation. Blood is modeled as an incompressible non-Newtonian fluid and the flow is assumed to be steady and laminar. Hemodynamic characteristics are analyzed. Grid independence is tested on three successively refined meshes. It is observed that the abrupt expansion induced by AAA results in an immensely disturbed regime. The results may have implications not only for understanding the mechanical behavior of the blood flow inside an aneurysm artery but also for investigating the mechanical behavior of the blood flow in different arterial diseases, such as atherosclerosis.

Influence of temporal variation in wall shear stress on intima-media thickening in arteriovenous fistulae

Arteriovenous fistula (AVF) failure is mainly due to venous stenosis characterized by significant amount of intima-media thickening (IMT), probably in the presence of negative (inward) remodeling. Our hypothesis is that the longitudinal changes in wall shear stress (WSS) within different configurations of AVF can influence remodeling factors (changes in luminal diameter (ΔDh ) and IMT) during its maturation process. Dh is an equivalent diameter for a noncircular conduit. A total of six AVFs with curved (C-AVF; n = 3) and straight (S-AVF; n = 3) configurations were created between the femoral artery and vein of three pigs, bilaterally. CT scans and ultrasounds were utilized to calculate local WSS at 2D (D: days), 7D, and 28D postsurgery. For each AVF, IMT was measured at four regions along the vein using morphometric analyses. At these regions, repeated measurements of WSS and luminal diameter of each AVF were obtained over time. The ΔD(h) between 7D and 28D was significantly larger for C-AVF than for S-AVF (2.27 ± 0.67 mm vs. 0.02 ± 0.55 mm; p < 0.05). Also, at 28D the amount of IMT in C-AVF (77.46 ± 7.10 units) was significantly greater (p < 0.05) when compared with S-AVF (53.71 ± 8.23 units). These structural changes were accompanied by significantly different gradients of WSS over time (τ') for C-AVF (-0.56 ± 0.60 dyne/cm(2)/day) in comparison with S-AVF (0.71 ± 0.39 dyne/cm(2)/day). Negative τ' for C-AVF corresponded to reduction in WSS level over time resulting in a physiological level of WSS at 28D (4.08 ± 5.08 dyne/cm(2)). In contrast, a positive τ' for S-AVF was associated with the increase in WSS levels over time causing high levels of WSS at 28D (36.68 ± 5.32 dyne/cm(2)). The decrease in WSS levels for the C-AVF over time was associated with outward remodeling of the venous wall (favorable to maturation). In contrast, for S-AVF, the increase in WSS levels over time was associated with inward remodeling and subsequently, venous stenosis. Thus, temporal gradients of WSS, which could be altered by the surgical configuration of AVF, may provide important information on the remodeling behavior of AVFs. Identification of an optimal AVF configuration, which results in a temporal decrease in WSS and an outward remodeling of the venous wall, may reduce AVF maturation failure.