Toward a Mesoscopic Modeling Approach of Magnetohydrodynamic Blood Flow in Pathological Vessels: A Comprehensive Review

The investigation of magnetohydrodynamic (MHD) blood flow within configurations that are pertinent to the human anatomy holds significant importance in the realm of scientific inquiry because of its practical implications within the medical field. This article presents an exhaustive appraisal of the diverse applications of magnetohydrodynamics and their computational modeling in biological contexts. These applications are classified into two categories: simple flow and pulsatile flow. An alternative approach of traditional CFD methods called Lattice Boltzmann Method (LBM), a mesoscopic method based on kinetic theory, is introduced to solve complex problems, such as hemodynamics. The results show that the flow velocity reduces considerably by increasing the magnetic field intensity, and the flow separation area is minimized by the increase of magnetic field strength. The LBM with BGK collision model has shown good results in terms of precision. Finally, this literature review has revealed a number of potential avenues for further research. Suggestions for future works are proposed accordingly.

A review on non-Newtonian fluid models for multi-layered blood rheology in constricted arteries

Haemodynamics is a branch of fluid mechanics which investigates the features of blood when it flows not only via blood vessels of smaller/larger diameter, but also under normal as well as abnormal flow states, such as in the presence of stenosis, aneurysm, and thrombosis. This review aims to discuss the rheological properties of blood, geometry of constrictions, dilations and the emergence of single-layered fluid to four-layered fluid models. To discuss further the influence of the aforesaid parameters on the physiologically important flow quantities, the mathematical formulation and solution methodology of the two-layered and four layered arterial blood flow problems studied by the authors (Afiqah and Sankar in ARPN J Eng Appl Sci 15:1129--1143, 2020, Comput Methods Programs Biomed 199:105907, 2021. 10.1016/j.cmpb.2020.105907) are recalled. It should be pointed out that the increasing resistive impedance to flow in three distinct states encompassing healthy, anaemic, and diabetic demonstrates that the greater the restriction in the artery, very few blood is carried to the pathetic organs, leading to subjects' death. It is also discovered that the pulsatile nature of blood movement produces a dynamic environment that poses a slew of intriguing and unstable fluid mechanical state. It is hoped that the intriguing results gathered from this literature survey and review conducted may help the medical practitioners to forecast blood behaviour mobility in stenotic arteries. Furthermore, the physiological information gathered from the available clinical data from the literature on patients diagnosed with diabetes and anaemia may be beneficial to doctors in deciding the therapeutic procedure for treating some particular cardiovascular disease.

Interaction of the Blood Components with Ascending Thoracic Aortic Aneurysm Wall: Biomechanical and Fluid Analyses

Background: Ascending thoracic aortic aneurysm (ATAA) is an asymptomatic localized dilation of the aorta that is prone to rupture with a high rate of mortality. While diameter is the main risk factor for rupture assessment, it has been shown that the peak wall stress from finite element (FE) simulations may contribute to refinement of clinical decisions. In FE simulations, the intraluminal boundary condition is a single-phase blood flow that interacts with the thoracic aorta (TA). However, the blood is consisted of red blood cells (RBCs), white blood cells (WBCs), and plasma that interacts with the TA wall, so it may affect the resultant stresses and strains in the TA, as well as hemodynamics of the blood. Methods: In this study, discrete elements were distributed in the TA lumen to represent the blood components and mechanically coupled using fluid–structure interaction (FSI). Healthy and aneurysmal human TA tissues were subjected to axial and circumferential tensile loadings, and the hyperelastic mechanical properties were assigned to the TA and ATAA FE models. Results: The ATAA showed larger tensile and shear stresses but smaller fluid velocity compared to the ATA. The blood components experienced smaller shear stress in interaction with the ATAA wall compared to TA. The computational fluid dynamics showed smaller blood velocity and wall shear stress compared to the FSI. Conclusions: This study is a first proof of concept, and future investigations will aim at validating the novel methodology to derive a more reliable ATAA rupture risk assessment considering the interaction of the blood components with the TA wall.

Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography

Background: The three-dimensional (3D) geometry of coronary atherosclerotic plaques is associated with plaque growth and the occurrence of coronary artery disease. However, there is a lack of studies on the 3D geometric properties of coronary plaques. We aim to investigate if coronary plaques of different sizes are consistent in geometric properties.

Methods: Nineteen cases with symptomatic stenosis caused by atherosclerotic plaques in the left coronary artery were included. Based on attenuation values on computed tomography angiography images, coronary atherosclerotic plaques and calcifications were identified, 3D reconstructed, and manually revised. Multidimensional geometric parameters were measured on the 3D models of plaques and calcifications. Linear and non-linear (i.e., power function) fittings were used to investigate the relationship between multidimensional geometric parameters (length, surface area, volume, etc.). Pearson correlation coefficient (r), R-squared, and p-values were used to evaluate the significance of the relationship. The analysis was performed based on cases and plaques, respectively. Significant linear relationship was defined as R-squared > 0.25 and p < 0.05.

Results: In total, 49 atherosclerotic plaques and 56 calcifications were extracted. In the case-based analysis, significant linear relationships were found between number of plaques and number of calcifications (r = 0.650, p = 0.003) as well as total volume of plaques (r = 0.538, p = 0.018), between number of calcifications and total volume of plaques (r = 0.703, p = 0.001) as well as total volume of calcification (r = 0.646, p = 0.003), and between the total volumes of plaques and calcifications (r = 0.872, p < 0.001). In plaque-based analysis, the power function showed higher R-squared values than the linear function in fitting the relationships of multidimensional geometric parameters. Two presumptions of plaque geometry in different growth stages were proposed with simplified geometric models developed. In the proposed models, the exponents in the power functions of geometric parameters were in accordance with the fitted values.

Conclusion: In patients with coronary artery disease, coronary plaques and calcifications are positively related in number and volume. Different coronary plaques are consistent in the relationship between geometry parameters in different dimensions.

Effect of plaque compositions on fractional flow reserve in a fluid-structure interaction analysis

Coronary artery disease involves the reduction of blood flow to the myocardium due to atherosclerotic plaques. The findings of myocardial ischemia may indicate severe coronary stenosis, but many studies have demonstrated a mismatch between lumen stenosis and fractional flow reserve (FFR). Recently, some clinical studies have found that the composition of atherosclerotic plaques may be a potential missing link between stenosis and ischemia. To investigate the relationship between myocardial ischemia and plaque composition, we have developed and adopted a new fluid-structure interaction (FSI) patient-specific coronary plaque model, based on computed tomography angiography data, to assess the impact on FFR as a biomechanical indicator of ischemia. A total of 180 analyses have been performed in 3D-FSI coronary artery disease models based on plaque compositions, plaque location, and stenosis degree. Hemodynamic analysis of simulation results and comparisons with other methods has been conducted to validate our models. Our results have successfully verified that the different compositions of plaques have resulted in differences in the calculated FFR. The mean FFR values with lipid plaques are [Formula: see text] as compared to the mean FFR values in lesions with fibrous plaques [Formula: see text] and calcified plaques [Formula: see text]. Besides, FFR differences between the three different plaque compositions have been shown to increase as the diameter stenosis increased. Plaque composition affects vascular stiffness and vascular dilation ability, and thereby affects the stenosis degree, resulting in abnormal FFR leading to myocardial ischemia. This interrelationship can help to diagnose the cause of high-risk coronary artery disease, leading to myocardial ischemia.

Role of the left coronary artery geometry configuration in atherosusceptibility: CFD simulations considering sPTT model for blood

The achievement of clinically viable methodologies to simulate the hemodynamics in patient-specific coronary arteries is still a major challenge. Therefore, the novelty of this work is attained by the introduction of the viscoelastic property of blood in the numerical simulations, to study the role of the left coronary artery (LCA) geometry configuration in the atherosusceptibility. Apparently healthy patients were used and four different methodologies were tested. The methodology giving the most accurate results at the same time of having the lowest computational time is the one considering the viscoelastic property of blood and computational fluid dynamics. A Pearson correlation analysis was used to highlight relationships between geometric configuration and hemodynamic descriptors based on the simulated wall shear stress (WSS). The left main stem (LMS) has the greatest atherosusceptibility followed by the left anterior descending artery (LAD) since the relative residence time (RRT) average values are 3.81 and 3.70 Pa^-1, respectively. The geometric parameters with relevant contribution to directional flow change are the cross-sectional areas, especially the one of LMS segment (A_LMS), and the curvature of LMS segment. For LMS and LAD segments, when A_LMS increases, blood flow disturbance (r = 0.81 in LMS and r = 0.74 in LAD) and atherosusceptibility (r = 0.84 in LMS and r = 0.85 in LAD) increases. When the LMS curvature decreases, the WSS magnitude (r = 0.80 in LMS and r = 0.83 in LAD) decreases, and disturbance (r=-0.80 in LMS and r=-0.91 in LAD) and atherosusceptibility (r=-0.74 in LMS and r=-0.74 in LAD) increases.

Effect of Material and Population on the Delivery of Nanoparticles to an Atherosclerotic Plaque: A Patient-specific In Silico Study

Coronary artery disease (CAD) is the prevalent reason of mortality all around the world. Targeting CAD, specifically atherosclerosis, with controlled delivery of micro and nanoparticles, as drug carriers, is a very proficient approach. In this work, a patient-specific and realistic model of an atherosclerotic plaque in the left anterior descending (LAD) artery was created by image-processing of CT-scan images and implementing a finite-element mesh. Next, a fluid-solid interaction simulation considering the physiological boundary conditions was conducted. By considering the simulated force fields and particle-particle interactions, the correlation between injected particles at each cardiac cycle and the surface density of adhered particles over the atherosclerotic plaque (SDP) were examined. For large particles (800 and 1000 nm) the amount of SDP on the plaque increased significantly when the number of the injected particles became higher. However, by increasing the number of the injected particles, for the larger particles (800 and 1000 nm) the increase in SDP was about 50% greater than that of the smaller ones (400 and 600 nm). Furthermore, for constant number of particles, depending on their size, different trends in SDP were observed. Subsequently, the distribution and adhesion of metal-based nanoparticles including SiO₂, Fe₃O₄, NiO₂, silver and gold with different properties were simulated. The injection of metal particles with medium density among the considered particles resulted in the highest SDP. Remarkably, the affinity, the geometrical features, and the biophysical factors involved in the adhesion outweighed the effect of difference in the density of particles on the SDP. Finally, the consideration of the lift force in the simulations significantly reduced the SDP and consistently decreased the particle residence time in the studied domain.

Blood Flow Modeling in Coronary Arteries: A Review

Atherosclerosis is one of the main causes of cardiovascular events, namely, myocardium infarction and cerebral stroke, responsible for a great number of deaths every year worldwide. This pathology is caused by the progressive accumulation of low-density lipoproteins, cholesterol, and other substances on the arterial wall, narrowing its lumen. To date, many hemodynamic studies have been conducted experimentally and/or numerically; however, this disease is not yet fully understood. For this reason, the research of this pathology is still ongoing, mainly, resorting to computational methods. These have been increasingly used in biomedical research of atherosclerosis because of their high-performance hardware and software. Taking into account the attempts that have been made in computational techniques to simulate realistic conditions of blood flow in both diseased and healthy arteries, the present review aims to give an overview of the most recent numerical studies focused on coronary arteries, by addressing the blood viscosity models, and applied physiological flow conditions. In general, regardless of the boundary conditions, numerical studies have been contributed to a better understanding of the development of this disease, its diagnosis, and its treatment.

Stress distribution analysis in healthy and stenosed carotid artery models reconstructed from in vivo ultrasonography

Purpose

This study investigated the accuracy of models reconstructed from ultrasound image processing by comparing the radial displacement waveforms of a subject-specific artery model and evaluated stress changes in the proximal shoulder, throat, and distal shoulder of the plaques depending on the degree of carotid artery stenosis.

Methods

Three groups of subjects (healthy and with less than 50% or more carotid stenosis) were evaluated with ultrasonography. Two-dimensional transverse imaging of the common carotid artery was performed to reconstruct the geometry. A longitudinal view of the same region was recorded to extract the Kelvin viscoelastic model parameters. The pulse pressure waveform and the effective pressure of perivascular tissue were loaded onto the internal and external walls of the model. Effective, circumferential, and principal stresses applied to the plaque throat, proximal shoulder, and distal shoulder in the transverse planes were extracted.

Results

The radial displacement waveforms of the model were closely correlated with those of image processing in all three groups. The mean of the effective, circumferential, and principal stresses of the healthy arteries were 15.01±4.93, 12.97±5.07, and 12.39±2.86 kPa, respectively. As stenosis increased from mild to significant, the mean values of the effective, circumferential, and first principal stresses increased significantly (97%, 74%, and 103% at the plaque throat, respectively) (P<0.05). The minimum effective stress was at the lipid pool. The effective stress in calcified areas was higher than in other parts of the artery wall.

Conclusion

This model can discriminate differences in stresses applied to mildly and severely stenotic plaques.

In vitro Biomodels in Stenotic Arteries to Perform Blood Analogues Flow Visualizations and Measurements: A Review

Cardiovascular diseases are one of the leading causes of death globally and the most common pathological process is atherosclerosis. Over the years, these cardiovascular complications have been extensively studied by applying in vivo, in vitro and numerical methods (in silico). In vivo studies represent more accurately the physiological conditions and provide the most realistic data. Nevertheless, these approaches are expensive, and it is complex to control several physiological variables. Hence, the continuous effort to find reliable alternative methods has been growing. In the last decades, numerical simulations have been widely used to assess the blood flow behavior in stenotic arteries and, consequently, providing insights into the cardiovascular disease condition, its progression and therapeutic optimization. However, it is necessary to ensure its accuracy and reliability by comparing the numerical simulations with clinical and experimental data. For this reason, with the progress of the in vitro flow measurement techniques and rapid prototyping, experimental investigation of hemodynamics has gained widespread attention. The present work reviews state-of-the-art in vitro macro-scale arterial stenotic biomodels for flow measurements, summarizing the different fabrication methods, blood analogues and highlighting advantages and limitations of the most used techniques.

Numerical simulation of magnetic nano drug targeting to atherosclerosis: Effect of plaque morphology (stenosis degree and shoulder length)

BACKGROUND AND OBJECTIVE

Nanoparticle-mediated targeted drug delivery is a promising option for treatment of atherosclerosis. However, the drug targeting may be affected by multiple factors. Considerable attentions have been focused on the influences of external factors, e.g., magnetic field, drug-loaded particle, but internal factors, e.g., plaque morphology (stenosis degree and shoulder length), have not received any attention yet. Therefore, we investigate the impact of plaque morphology on magnetic nanoparticles targeting under the action of an external field.

METHOD

Numerical simulation, based on Eulerian-Lagrangian coupled Fluid-Solid Interaction, is performed in ANSYS Workbench platform. Blood flow is solved by Navier-Stokes equation, particles are tracked by discrete phase model, and the incorporated effect is obtained by two-way method. Plaques with varying stenosis degrees and shoulder lengths are acquired by manually modifying the geometry of patient-specific. The quantified variables include targeted delivery efficiency (deposition+adhesive strength) of particles and plaque injury characterized by temporal-spatial averaged shear stress (TAWSS¯) during the process of drug transport, in which the critical deposition velocity is determined by plaques and particles, the DEFINE_DPM_BC and User Defined Memory are employed to evaluate whether the particles are deposited, and to store the total number and the adhesive strength of particles deposited on the plaque.

RESULTS

Results signify that, with an increment of plaque stenosis degree, the deposition of particle and the adhesive strength between particle and plaque decrease, while the TAWSS¯ increases. Furthermore, for the same stenosis degree, with the increase of plaque shoulder length, the deposition and the adhesive strength of particle increase, and the TAWSS¯ decreases.

CONCLUSIONS

Results demonstrates that the plaque with smaller stenosis degree or longer shoulder length may achieve a better treatment effect in view of the higher targeted delivery efficiency of particles and the lighter shear damage to plaque itself during the process of drug transport.

Numerical simulations of patient-specific models with multiple plaques in human peripheral artery: a fluid-structure interaction analysis

Atherosclerotic plaque in the femoral is the leading cause of peripheral artery disease (PAD), the worse consequence of which may lead to ulceration and gangrene of the feet. Numerical studies on fluid-structure interactions (FSI) of atherosclerotic femoral arteries enable quantitative analysis of biomechanical features in arteries. This study aims to investigate the hemodynamic performance and its interaction with femoral arterial wall based on the patient-specific model with multiple plaques (calcified and lipid plaques). Three types of models, calcification-only, lipid-only and calcification-lipid models, are established. Hyperelastic material coefficients of the human femoral arteries obtained from experimental studies are employed for all simulations. Oscillation of WSS is observed in the healthy downstream region in the lipid-only model. The pressure around the plaques in the two-plaque model is lower than that in the corresponding one-plaque models due to the reduction of blood flow domain, which consequently diminishes the loading forces on both plaques. Therefore, we found that stress acting on the plaques in the two-plaque model is lower than that in the corresponding one-plaque models. This finding implies that the lipid plaque, accompanied by the calcified plaque around, might reduce its risk of rupture due to the reduced the stress acting on it.

Numerical study to identify the effect of fluid presence on the mechanical behavior of the stents during coronary stent expansion

In this study, structural analysis and one-way fluid-structure interaction (FSI) analysis were performed to identify the effect of fluid presence on the mechanical behavior of the stents during stent expansion. An idealized vessel model with stenosis was used for simulation, and stents made of metal and polymer were assumed, respectively. The bilinear model was applied to the stents, and the Mooney-Rivlin model was applied to the arterial wall and plaque. The blood used in the FSI analysis was assumed to be a non-Newtonian fluid. As a result of all numerical simulations, the von Mises stress, the first principal stress and the displacement were calculated as the mechanical behaviors. Through the comparison of the results of the structural analysis with those of the one-way FSI analysis, our results indicated the fluid had no significant influence on the expansion of the metal stent. However, it was found that the expansion of the polymer stent affected by the presence of fluid. These findings meant the one-way FSI technique was suggested to achieve an accurate analysis when targeting a polymer stent for numerical simulation.

A patient-specific fluid–structure interaction model of the cerebrovascular damage in relation to traumatic brain injury

Background

There is a lack of knowledge on the magnitudes of the biomechanical stresses and deformations occurring in the cerebral arterial wall after traumatic brain injury (TBI). Experimental techniques are unable to calculate the stresses and deformations in the cerebral arterial wall after TBI; therefore, the application of numerical simulations, such as finite element modeling, is preferred.

Methods

This study was aimed to calculate the stresses and deformations as well as the alteration in the pressure and velocity of the blood in the cerebrovascular artery using a fluid–structure interaction model.

Results

The results revealed considerable increase in the pressure and velocity of the blood which might lead to cerebrovascular damage followed by hemorrhage. The arterial wall showed the highest deformation of 0.047 mm in the X direction which was higher than that in the Y (0.035–0.050 mm) and Z (0.019–0.030 mm) directions.

Conclusions

These results have implications not only for the understanding of the stresses and deformations in the cerebral artery because of TBI, but also for providing a comprehensive knowledge for biomechanical and medical experts in regard to thresholds of cerebrovascular damage for use in establishing preventive and/or treatment methods.

Risk of rupture of the cerebral aneurysm in relation to traumatic brain injury using a patient-specific fluid-structure interaction model

BACKGROUND AND OBJECTIVE

Cerebral aneurysm, which is defined as one of the weakened area in the wall of an artery in the brain, ruptures when wall tension exceeds its mechanical strength. Traumatic brain injury (TBI) by exerting a sudden impact load to the brain can lead to mechanical failure of the cerebral blood vessels followed by an alteration in not only the structure but also the function of the cerebrovascular. TBI also alters the hemodynamics of the blood flow in the cerebrovascular, while it has been shown that hemodynamics has a key asset in the progression and rupture of the cerebral aneurysms. So far, there is a lack of knowledge on the risk of rupture of the cerebral aneurysm in relation to TBI. Therefore, this study aimed to calculate the mechanical stresses and deformations in the arterial wall as well as the pressure and velocity of the blood using a fluid-structure interaction (FSI) model of the cerebral aneurysm located in the anterior circulation region of the circle of Willis.

METHOD

A patient-specific FSI model of the human skull, brain, and cerebral aneurysm, was established using human computed tomography (CT)/ magnetic resonance imaging (MRI) data and subjected to a frontal TBI.

RESULTS

The results revealed considerable increasing of ∼ 8 kPa (60 mmHg) and 0.40 m/s in the pressure and velocity of the blood in the intraluminal of the cerebral artery after TBI. The von Mises stress, shear stress, and deformation of the cerebral aneurysm wall also showed the increasing of 56.03 kPa, 15.66 Pa, and 0.072 mm after TBI, respectively.

CONCLUSIONS

Although the injury to the aneurysm wall after TBI is lower than that of the aneurysm wall mechanical strength, it still can alter the stress pattern in the wall and disrupt the hemodynamics of the blood. These results have implications in understanding the rupture risk of the cerebral aneurysm due to TBI, which may contribute in establishing preventive and/or treatment methods.

Development of asymmetric stent for treatment of eccentric plaque

The selection of stent and balloon type is decisive in the stenting process. In the treatment of an eccentric plaque obstruction, a symmetric expansion from stent dilatation generates nonuniform stress distribution, which may aggravate fibrous cap prone to rupture. This paper developed a new stent design to treat eccentric plaque using structural transient dynamic analysis in ANSYS. A non-symmetric structural geometry of stent is generated to obtain reasonable stress distribution safe for the arterial layer surrounding the stent. To derive the novel structural geometry, a Sinusoidal stent type is modified by varying struts length and width, adding bridges, and varying curvature width of struts. An end ring of stent struts was also modified to eliminate dogboning phenomenon and to reduce the Ectropion angle. Two balloon types were used to deploy the stent, an ordinary cylindrical and offset balloon. Positive modification results were used to construct the final non-symmetric stent design, called an Asymmetric stent. Analyses of the deformation characteristics, changes in surface roughness and induced stresses within intact arterial layer were subsequently examined. Interaction between the stent and vessel wall was implemented by means of changes in surface roughness and stress distribution analyses. The Palmaz and the Sinusoidal stent were used for a comparative study. This study indicated that the Asymmetric stent types reduced the central radial recoiling and the dogboning phenomenon. In terms of changes in surface roughness and induced stresses, the Asymmetric stent has a comparable effect with that of the Sinusoidal stent. In addition, it could enhance the distribution of surface roughening as expanded by an offset balloon.

A numerical study on the effect of geometrical parameters and loading profile on the expansion of stent

BACKGROUND

Stenting has been proposed as an effective treatment to restore blood flow in obstructed arteries by plaques. Although several modified designs for stents have been suggested, most designs have the risk of disturbing blood flow.

OBJECTIVE

The main objective is to propose a stent design to attain a uniform lumen section after stent deployment.

METHODS

Mechanical response of five different designs of J & J Palmaz-Schatz stent with the presence of plaque and artery are investigated; four stents have variable strut thickness of different magnitudes and the rest one is a uniform-strut-thickness stent. Nonlinear finite element is employed to simulate the expansion procedure of the intended designs using ABAQUS explicit.

RESULTS

The stent design whose first cell thickness linearly increases by 35 percent, exhibits the best performance, that is it has the lowest recoiling and stress induced in the intima for a given lumen gain. It also enjoys the minimal discrepancy between the final at the distal and proximal ends.

CONCLUSIONS

A uniform widened artery can be achieved by using the stent design with 35 percent increase in its first cell, which provides the possibility to prevent from disturbing blood flow and consequently post-operation complications.

A numerical study on the application of the functionally graded materials in the stent design

Undesirable deformation of the stent can induce a significant amount of injure not only to the blood vessel but also to the plaque. The objective of this study was to reduce/minimize these undesirable deformations by the application of Functionally Graded Materials (FGM). To do this, Finite Element (FE) method was employed to simulate the expansion of a stent and the corresponding displacement of the stenosis plaque. Three hyperelastic plaque types as well as five elastoplastic stents were simulated. Dogboning, foreshortening, maximum stress in the plaque, and the pressure which is needed to fully expand the stent for different stent materials, were acquired. While all FGMs had lower dogboning in comparison to the stents made of the uniform materials, the stent with the lowest heterogeneous index displayed the lowest amount of dogboning. Steel stent showed the lowest foreshortening and fully expansion pressure but the difference was much lower than that the one for dogboning. Therefore, the FGM with the heterogeneous index of 0.5 is expected to exhibit the most suitable results. In addition, the results revealed that the material parameters has crucial effects on the deformation of the stent and, as a result, as a design point of view the FGM parameters can be tailored to achieve the goal of the biomechanical optimization.

A Combination of Constitutive Damage Model and Artificial Neural Networks to Characterize the Mechanical Properties of the Healthy and Atherosclerotic Human Coronary Arteries

It has been indicated that the content and structure of the elastin and collagen of the arterial wall can subject to a significant alteration due to the atherosclerosis. Consequently, a high tissue stiffness, stress, and even damage/rupture are triggered in the arterial wall. Although many studies so far have been conducted to quantify the mechanical properties of the coronary arteries, none of them consider the role of collagen damage of the healthy and atherosclerotic human coronary arterial walls. Recently, a fiber family-based constitutive equation was proposed to capture the anisotropic mechanical response of the healthy and atherosclerotic human coronary arteries via both the histostructural and uniaxial data. In this study, experimental mechanical measurements along with histological data of the healthy and atherosclerotic arterial walls were employed to determine the constitutive damage parameters and remodeling of the collagen fibers. To do this, the preconditioned arterial tissues were excised from human cadavers within 5-h postmortem, and the mean angle of their collagen fibers was precisely determined. Thereafter, a group of quasistatic axial and circumferential loadings were applied to the arterial walls, and the constrained nonlinear minimization method was employed to identify the arterial parameters according to the axial and circumferential extension data. The remodeling of the collagen fibers during the tensile test was also predicted via Artificial Neural Networks algorithm. Regardless of loading direction, the results presented a noteworthy load-bearing capability and stiffness of the atherosclerotic arteries compared to the healthy ones (P < 0.005). Theoretical fiber angles were found to be consistent with the experimental histological data with less than 2 and 5° difference for the healthy and atherosclerotic arterial walls, respectively. The pseudoelastic damage model data were also compared with that of the experimental data, and interestingly, the arterial mechanical behavior for both the primary loading (up to the elastic region) and the discontinuous softening (up to the ultimate stress) was well addressed. The proposed model predicted well the mechanical response of the arterial tissue considering the damage of collagen fibers for both the healthy and atherosclerotic arterial walls.

Numerical study to indicate the vulnerability of plaques using an idealized 2D plaque model based on plaque classification in the human coronary artery

Atherosclerosis is one of the leading causes of death in the world. In this study, an idealized 2D plaque model based on plaque classification in the coronary artery is developed. When creating the idealized 2D model for each plaque type (fibrocalcic, FC; fibrofatty, FT; calcified fibroatheroma, CaFA; fibroatheroma, FA; calcified thin-cap fibroatheroma, CaTCFA; thin-cap fibroatheroma, TCFA), the cap thickness and stenosis by diameter were set as variables. In order to establish the correlation between each plaque type and plaque rupture, a numerical simulation was performed and the stress and stress gradient were reviewed to analyze the mechanical behavior. Results show that both the TCFA and CaTCFA plaque types, which have the smallest cap thicknesses of the different types of plaque, showed relatively high stress values in the thin membrane when compared with the FT type. The FT type is considered to be relatively stable since it does not have necrotic core or a thin membrane. With a stenosis rate of 50% and a cap thickness of 60 μm, the TCFA and CaTCFA types showed approximately 11 and 110% higher stress values, respectively, and 679 and 1568% higher negative stress gradient values, respectively. In other words, the plaque types with thin caps, which have weak load-bearing capacities, showed high stress values and high negative stress gradients in the radial direction. It is understood that this result could indicate the possibility of plaque rupture.

A computational fluid-structure interaction model to predict the biomechanical properties of the artificial functionally graded aorta

In the present study, three layers of the ascending aorta in respect to the time and space at various blood pressures have been simulated. Two well-known commercial finite element (FE) software have used to be able to provide a range of reliable numerical results while independent on the software type. The radial displacement compared with the time as well as the peripheral stress and von Mises stress of the aorta have calculated. The aorta model was validated using the differential quadrature method (DQM) solution and, then, in order to design functionally graded materials (FGMs) with different heterogeneous indexes for the artificial vessel, two different materials have been employed. Fluid-structure interaction (FSI) simulation has been carried out on the FGM and a natural vessel of the human body. The heterogeneous index defines the variation of the length in a function. The blood pressure was considered to be a function of both the time and location. Finally, the response characteristics of functionally graded biomaterials (FGBMs) models with different values of heterogeneous material parameters were determined and compared with the behaviour of a natural vessel. The results showed a very good agreement between the numerical findings of the FGM materials and that of the natural vessel. The findings of the present study may have implications not only to understand the performance of different FGMs in bearing the stress and deformation in comparison with the natural human vessels, but also to provide information for the biomaterials expert to be able to select a suitable material as an implant for the aorta.

A combination of experimental and numerical methods to investigate the role of strain rate on the mechanical properties and collagen fiber orientations of the healthy and atherosclerotic human coronary arteries

Atherosclerosis enables to alter not only the microstructural but also the physical properties of the arterial walls by plaque forming. Few studies so far have been conducted to calculate the isotropic or anisotropic mechanical properties of the healthy and atherosclerotic human coronary arteries. To date there is a paucity of knowledge on the mechanical response of the arteries under different strain rates. Therefore, the objective of the concurrent research was to comprehend whether the alteration in the strain rates of the human atherosclerotic arteries in comparison with the healthy ones contribute to the biomechanical behaviors. To do this, healthy and atherosclerotic human coronary arteries were removed from 18 individuals during autopsy. Histological analyses by both an expert histopathologist and an imaged-based recognizer software were performed to figure out the average angle of collagen fibers in the healthy and atherosclerotic arterial walls. Thereafter, the samples were subjected to 3 diverse strain rates, i.e., 5, 20, and 50 mm/min, until the material failure occurs. The stress-strain diagrams of the arterial tissues were calculated in order to capture their linear elastic and nonlinear hyperelastic mechanical properties. In addition, Artificial Neural Networks (ANNs) was employed to predict the alteration of mean angle of collagen fibers during load bearing up to failure. The findings suggest that strain rate has a significant (p < 0.05) role in the linear elastic and nonlinear hyperelastic mechanical properties as well as the mean angle of collagen fibers of the atherosclerotic arteries, whereas no specific impact on the healthy ones. Furthermore, the mean angle of collagen fibers during the load bearing up to the failure at each strain rate was well predicted by the proposed ANNs code.

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.

A combination of histological analyses and uniaxial tensile tests to determine the material coefficients of the healthy and atherosclerotic human coronary arteries

Atherosclerosis is considered as the most severe form of cardiovascular diseases as it alters the structure of the elastin and collagen and, consequently, the mechanical properties of the artery wall. The role of collagen fibers orientations in the mechanical properties of the healthy and atherosclerotic human coronary arteries so far has not been well determined. In this study, a fiber family based constitutive equation was employed to address the mechanical behavior of healthy and atherosclerotic human coronary arteries using the combination of histostructural and uniaxial data. A group of six healthy and atherosclerotic human coronary arteries was excised at autopsy and histological analyses were performed on each artery to determine the mean angle of collagen fibers. The preconditioned arterial tissues were then subjected to a series of quasi-static axial and circumferential loadings. The key role of fiber orientation was explicitly added into a proposed strain energy density function. The constrained nonlinear optimization method was used to determine the material coefficients based on the axial and circumferential extension data of the arteries. The material coefficients of coronary arteries were given with R(2)≥0.991. The results regardless of loading direction revealed a significant load-bearing capacity and stiffness of atherosclerotic arteries compared to the healthy ones (p<0.005). The optimized fiber angles were in good agreement with the experimental histological data as only 2.52% and 10.10% differences were observed for the healthy and atherosclerotic arteries, respectively. The stored energy function of the healthy arteries was found to be higher than that of atherosclerotic ones. These findings help us to understand the directional mechanical properties of coronary arteries which may have implications for different types of interventions and surgeries, including bypass, stenting, and balloon-angioplasty.

A NONLINEAR HYPERELASTIC BEHAVIOR TO IDENTIFY THE MECHANICAL PROPERTIES OF RAT SKIN UNDER UNIAXIAL LOADING

Skin is a thin membrane which provides many biological functions, such as thermoregulation and protection from mechanical, bacterial, and viral insults. The mechanical properties of skin tissue are extremely hard to measure and may vary according to the anatomical locations of a body. However, the mechanical properties of skin at different anatomical regions have not been satisfactorily simulated by conventional engineering models. In this study, the linear elastic and nonlinear hyperelastic mechanical properties of rat skin at different anatomical locations, including back and abdomen, are investigated using a series of tensile tests. The Young's modulus and maximum stress of skin tissue are measured before the incidence of failure. The nonlinear mechanical behavior of skin tissue is also experimentally and computationally investigated through constitutive equations. Hyperelastic strain energy density functions are adjusted using the experimental results. A hyperelastic constitutive model is selected to suitably represent the axial behavior of the skin. The results reveal that the maximum stress (20%) and Young's modulus (35%) of back skin are significantly higher than that of abdomen skin. The Ogden model is selected to closely address the nonlinear mechanical behavior of the skin which can be used in further biomechanical simulations of the skin tissue. The results might have implications not only for understanding of the mechanical behavior of skin tissue at different anatomical locations, but also to give an engineering insight for a diversity of disciplines, such as dermatology, cosmetics industry, clinical decision making, and clinical intervention.