Variation of Shear Stresses and Flow Dynamics in Stented Patient Specific Carotid Bifurcation Model using Numerical Investigation

Authors

  • Neil Ricardo Almeida Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India
  • Shah Mohammed Abdul Khader Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India
  • Hebbandi Ningappa Abhilash Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India
  • Yoshiki Yamaguchi Department of Biological Functions Engineering, Graduate School of Life Sciences and System Engineering, Kyushu Institute of Technology, Kitakyushu, Fukuoka 808-0196, Japan
  • Raghuvir Pai Ballambat Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India
  • Mohammad Zuber Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal-576104, India
  • Prakashini K Department of Radiology and Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104, India
  • Ganesh Kamath S Department of Cardio-Vascular and Thoracic Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104, India
  • Masaaki Tamagawa Department of Biological Functions Engineering, Graduate School of Life Sciences and System Engineering, Kyushu Institute of Technology, Kitakyushu, Fukuoka 808-0196, Japan
  • Padmakumar R Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104, India
  • VRK Rao Department of Radiodiagnosis, Krishna Institute of Medical Sciences, Secunderabad-500004, India
  • A B V Barboza Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India

DOI:

https://doi.org/10.37934/cfdl.15.6.98114

Keywords:

Carotid Stenosis, Carotid Artery Stenting, Pre and post-stenting, Haemodynamics

Abstract

The carotid artery is a clinically important site in the human circulatory system as the consequences of its disease results in adverse outcomes like ischemic strokes, or death for too prolonged ischemia. Understanding the hemodynamics of this artery and its bifurcation are important. A method of treating the stenosis of this artery is Carotid Angioplasty and Stenting (CAS). This procedure results in a heavily modified hemodynamics or state of flow. To understand and predict this flow field modification Computational Fluid Dynamics (CFD) is an important computational tool. Further, the presence of a stent would affect hemodynamics. The aim of this work is to study these effects in patient-specific cases. The reconstructed patient-specific models will form the basis of the construction of the post-stenting carotid bifurcation models. A transient analysis was carried out to estimate the time-varying parameters in the fluid domains over a cardiac cycle as well as to gauge time average values over a cardiac cycle. Results are obtained for hemodynamic parameters, like wall shear stress, velocity, pressure, vorticity, and helicity, in both the prepared stenosed and stented geometries. It is seen that the stenting procedure leads to the renewal of the CCA to ICA flow path. But simultaneously the region in which the stent is present becomes a region of low TAWSS and contains areas of high OSI. These areas of low TAWSS and high OSI within the stented portions of the carotid bifurcations are indications for regions of possible restenosis. Therefore, the investigation demonstrates the likely region for future plaque growth. Further, the effects of widening of the lumen are also noted in comparison to the pre-stent cases

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Author Biography

Shah Mohammed Abdul Khader, Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal – 576104, India

smak.quadri@gmail.com

References

Aristokleous, Nicolas, Ioannis Seimenis, Yannis Papaharilaou, Georgios C. Georgiou, Brigitta C. Brott, Eleni Eracleous, and Andreas S. Anayiotos. "Effect of posture change on the geometric features of the healthy carotid bifurcation." IEEE transactions on information technology in biomedicine 15, no. 1 (2010): 148-154. https://doi.org/10.1109/TITB.2010.2091417

Caro, Colin Gerald, Timothy J. Pedley, R. C. Schroter, and WA (eds Seed. The mechanics of the circulation. Cambridge University Press, 2012. https://doi.org/10.1017/CBO9781139013406

Townsend, Courtney M., R. Daniel Beauchamp, and B. M. Evers. "Mattox KL Sabiston Textbook of Surgery." (2017): 789-91.

“Wingspan Stent System.” Stryker. Accessed November 3, 2021. https://www.stryker.com/ir/en/neurovascular/products/wingspan-stent-system.html

“Deployment Sequence | Tryton Medical - International”. Accessed October 30, 2021 https://trytonmedical.com/international/deployment-sequence-2/

Stone, Peter H., Ahmet U. Coskun, Scott Kinlay, Maureen E. Clark, Milan Sonka, Andreas Wahle, Olusegun J. Ilegbusi et al. "Effect of endothelial shear stress on the progression of coronary artery disease, vascular remodeling, and in-stent restenosis in humans: in vivo 6-month follow-up study." Circulation 108, no. 4 (2003): 438-444. https://doi.org/10.1161/01.CIR.0000080882.35274.AD

Chatzizisis, Yiannis S., Ahmet Umit Coskun, Michael Jonas, Elazer R. Edelman, Charles L. Feldman, and Peter H. Stone. "Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior." Journal of the American College of Cardiology 49, no. 25 (2007): 2379-2393. https://doi.org/10.1016/j.jacc.2007.02.059

Cameron, James N., Ojas H. Mehta, Michael Michail, Jasmine Chan, Stephen J. Nicholls, Martin R. Bennett, and Adam J. Brown. "Exploring the relationship between biomechanical stresses and coronary atherosclerosis." Atherosclerosis 302 (2020): 43-51. https://doi.org/10.1016/j.atherosclerosis.2020.04.011

Lee, Sang-Wook, Luca Antiga, J. David Spence, and David A. Steinman. "Geometry of the carotid bifurcation predicts its exposure to disturbed flow." Stroke 39, no. 8 (2008): 2341-2347. https://doi.org/10.1161/STROKEAHA.107.510644

Gallo, Diego, David A. Steinman, Payam B. Bijari, and Umberto Morbiducci. "Helical flow in carotid bifurcation as surrogate marker of exposure to disturbed shear." Journal of biomechanics 45, no. 14 (2012): 2398-2404. https://doi.org/10.1016/j.jbiomech.2012.07.007

Harrison, Gareth J., Thien V. How, Robert J. Poole, John A. Brennan, Jagjeeth B. Naik, S. Rao Vallabhaneni, and Robert K. Fisher. "Closure technique after carotid endarterectomy influences local hemodynamics." Journal of Vascular Surgery 60, no. 2 (2014): 418-427. https://doi.org/10.1016/j.jvs.2014.01.069

Esmaeili Monir, Hamed, Hiroshi Yamada, and Noriyuki Sakata. "Finite element modelling of the common carotid artery in the elderly with physiological intimal thickening using layer-specific stress-released geometries and nonlinear elastic properties." Computer methods in biomechanics and biomedical engineering 19, no. 12 (2016): 1286-1296. https://doi.org/10.1080/10255842.2015.1128530

Savabi, Reza, Malikeh Nabaei, Sami Farajollahi, and Nasser Fatouraee. "Fluid structure interaction modeling of aortic arch and carotid bifurcation as the location of baroreceptors." International Journal of Mechanical Sciences 165 (2020): 105222. https://doi.org/10.1016/j.ijmecsci.2019.105222

Filipovic, Nenad, Zhongzhao Teng, Milos Radovic, Igor Saveljic, Dimitris Fotiadis, and Oberdan Parodi. "Computer simulation of three-dimensional plaque formation and progression in the carotid artery." Medical & biological engineering & computing 51 (2013): 607-616. https://doi.org/10.1007/s11517-012-1031-4

Yang, Chun, Gador Canton, Chun Yuan, Marina Ferguson, Thomas S. Hatsukami, and Dalin Tang. "Advanced human carotid plaque progression correlates positively with flow shear stress using follow-up scan data: an in vivo MRI multi-patient 3D FSI study." Journal of biomechanics 43, no. 13 (2010): 2530-2538. https://doi.org/10.1007/s11517-012-1031-4

Algabri, Yousif A., Surapong Chatpun, and Ishkrizat Taib. "An investigation of pulsatile blood flow in an angulated neck of abdominal aortic aneurysm using computational fluid dynamics." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 57, no. 2 (2019): 265-274.

Ku, David N., Don P. Giddens, Christopher K. Zarins, and Seymour Glagov. "Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress." Arteriosclerosis: An Official Journal of the American Heart Association, Inc. 5, no. 3 (1985): 293-302. https://doi.org/10.1161/01.ATV.5.3.293

Azar, Dara, William M. Torres, Lindsey A. Davis, Taylor Shaw, John F. Eberth, Vijaya B. Kolachalama, Susan M. Lessner, and Tarek Shazly. "Geometric determinants of local hemodynamics in severe carotid artery stenosis." Computers in biology and medicine 114 (2019): 103436. https://doi.org/10.1016/j.compbiomed.2019.103436

Pan, Chen, Yafeng Han, and Jiping Lu. "Structural design of vascular stents: A review." Micromachines 12, no. 7 (2021): 770. https://doi.org/10.3390/mi12070770

Paisal, Muhammad Sufyan Amir, Ishkrizat Taib, Ahmad Mubarak Tajul Arifin, and Nofrizalidris Darlis. "An analysis of blood pressure waveform using windkessel model for normotensive and hypertensive conditions in carotid artery." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 57, no. 1 (2019): 69-85.

Hegde, Pranav, A. B. V. Barboza, SM Abdul Khader, Raghuvir Pai, Masaaki Tamagawa, Ravindra Prabhu, and D. Srikanth Rao. "Numerical Analysis on A Non-Critical Stenosis in Renal Artery." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 88, no. 3 (2021): 31-48. https://doi.org/10.37934/arfmts.88.3.3148

Hegde, Pranav, SM Abdul Khader, Raghuvir Pai, Masaaki Tamagawa, Ravindra Prabhu, Nitesh Kumar, and Kamarul Arifin Ahmad. "CFD Analysis on Effect of Angulation in A Healthy Abdominal Aorta-Renal Artery Junction." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 88, no. 1 (2021): 149-165. https://doi.org/10.37934/arfmts.88.1.149165

Jamali, Muhammad Sabaruddin Ahmad, Zuhaila Ismail, and Norsarahaida Saidina Amin. "Effect of Different Types of Stenosis on Generalized Power Law Model of Blood Flow in a Bifurcated Artery." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 87, no. 3 (2021): 172-183. https://doi.org/10.37934/arfmts.87.3.172183

Ningappa, Abhilash Hebbandi, Suraj Patil, Gowrava Shenoy Belur, Augustine Benjamin Valerian Barboza, Nitesh Kumar, Raghuvir Pai Ballambat, Adi Azriff Basri, Shah Mohammed Abdul Khader, and Masaaki Tamagawa. "Influence of altered pressures on flow dynamics in carotid bifurcation system using numerical methods." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 97, no. 1 (2022): 47-61. https://doi.org/10.37934/arfmts.97.1.4761

Ramdan, Salman Aslam, Mohammad Rasidi Rasani, Thinesh Subramaniam, Ahmad Sobri Muda, Ahmad Fazli Abdul Aziz, Tuan Mohammad Yusoff Shah Tuan Ya, Hazim Moria, Mohd Faizal Mat Tahir, and Mohd Zaki Nuawi. "Blood Flow Acoustics in Carotid Artery." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 94, no. 1 (2022): 28-44. https://doi.org/10.37934/arfmts.94.1.2844

Subramaniam, Thineshwaran, and Mohammad Rasidi Rasani. "Pulsatile CFD Numerical Simulation to investigate the effect of various degree and position of stenosis on carotid artery hemodynamics." Journal of Advanced Research in Applied Sciences and Engineering Technology 26, no. 2 (2022): 29-40. https://doi.org/10.37934/araset.26.2.2940

Milner, Jaques S., Jennifer A. Moore, Brian K. Rutt, and David A. Steinman. "Hemodynamics of human carotid artery bifurcations: computational studies with models reconstructed from magnetic resonance imaging of normal subjects." Journal of vascular surgery 28, no. 1 (1998): 143-156. https://doi.org/10.1016/S0741-5214(98)70210-1

Botnar, René, Gerhard Rappitsch, Markus Beat Scheidegger, Dieter Liepsch, Karl Perktold, and Peter Boesiger. "Hemodynamics in the carotid artery bifurcation:: a comparison between numerical simulations and in vitro MRI measurements." Journal of biomechanics 33, no. 2 (2000): 137-144. https://doi.org/10.1016/S0021-9290(99)00164-5

Long, Q., B. Ariff, S. Z. Zhao, S. A. Thom, A. D. Hughes, and X. Y. Xu. "Reproducibility study of 3D geometrical reconstruction of the human carotid bifurcation from magnetic resonance images." Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine 49, no. 4 (2003): 665-674. https://doi.org/10.1002/mrm.10401

Marshall, Ian, Shunzhi Zhao, Panorea Papathanasopoulou, Peter Hoskins, and X. Yun Xu. "MRI and CFD studies of pulsatile flow in healthy and stenosed carotid bifurcation models." Journal of biomechanics 37, no. 5 (2004): 679-687. https://doi.org/10.1016/j.jbiomech.2003.09.032

Steinman, David A., Jonathan B. Thomas, Hanif M. Ladak, Jaques S. Milner, Brian K. Rutt, and J. David Spence. "Reconstruction of carotid bifurcation hemodynamics and wall thickness using computational fluid dynamics and MRI." Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine 47, no. 1 (2002): 149-159. https://doi.org/10.1002/mrm.10025

Glor, Fadi P., B. Ariff, L. A. Crowe, A. D. Hughes, P. L. Cheong, SA McG Thom, P. R. Verdonck, David N. Firmin, D. C. Barratt, and X. Y. Xu. "Carotid geometry reconstruction: a comparison between MRI and ultrasound." Medical physics 30, no. 12 (2003): 3251-3261. https://doi.org/10.1118/1.1628412

Li, Xiao, Beibei Sun, Huilin Zhao, Xiaoqian Ge, Fuyou Liang, Xuanyu Li, Jianrong Xu, and Xiaosheng Liu. "Retrospective study of hemodynamic changes before and after carotid stenosis formation by vessel surface repairing." Scientific reports 8, no. 1 (2018): 5493. https://doi.org/10.1038/s41598-018-23842-0

Wong, Kelvin KL, Pongpat Thavornpattanapong, Sherman CP Cheung, and J. Y. Tu. "Biomechanical investigation of pulsatile flow in a three-dimensional atherosclerotic carotid bifurcation model." Journal of Mechanics in Medicine and Biology 13, no. 01 (2013): 1350001. https://doi.org/10.1142/S0219519413500012

Seong, Jaehoon, Woowon Jeong, Nataliya Smith, and Rheal A. Towner. "Hemodynamic effects of long-term morphological changes in the human carotid sinus." Journal of biomechanics 48, no. 6 (2015): 956-962. https://doi.org/10.1016/j.jbiomech.2015.02.009

Li, Zhi-Yong, Simon Howarth, Rikin A. Trivedi, Jean M. U-King-Im, Martin J. Graves, Andrew Brown, Liqun Wang, and Jonathan H. Gillard. "Stress analysis of carotid plaque rupture based on in vivo high resolution MRI." Journal of biomechanics 39, no. 14 (2006): 2611-2622. https://doi.org/10.1016/j.jbiomech.2005.08.022

Domanin, Maurizio, Diego Gallo, Christian Vergara, Pietro Biondetti, Laura V. Forzenigo, and Umberto Morbiducci. "Prediction of long term restenosis risk after surgery in the carotid bifurcation by hemodynamic and geometric analysis." Annals of biomedical engineering 47 (2019): 1129-1140. https://doi.org/10.1007/s10439-019-02201-8

Liu, Xin, Heye Zhang, Lijie Ren, Huahua Xiong, Zhifan Gao, Pengcheng Xu, Wenhua Huang, and Wanqing Wu. "Functional assessment of the stenotic carotid artery by CFD-based pressure gradient evaluation." American Journal of Physiology-Heart and Circulatory Physiology 311, no. 3 (2016): H645-H653. https://doi.org/10.1152/ajpheart.00888.2015

Xu, Pengcheng, Xin Liu, Heye Zhang, Dhanjoo Ghista, Dong Zhang, Changzheng Shi, and Wenhua Huang. "Assessment of boundary conditions for CFD simulation in human carotid artery." Biomechanics and Modeling in Mechanobiology 17 (2018): 1581-1597. https://doi.org/10.1007/s10237-018-1045-4

Sousa, Luísa C., Catarina F. Castro, Carlos C. António, André Miguel F. Santos, Rosa Maria Dos Santos, Pedro Miguel AC Castro, Elsa Azevedo, and João Manuel RS Tavares. "Toward hemodynamic diagnosis of carotid artery stenosis based on ultrasound image data and computational modeling." Medical & biological engineering & computing 52 (2014): 971-983. https://doi.org/10.1007/s11517-014-1197-z

Zain, Norliza Mohd, Zuhaila Ismail, and Peter Johnston. "A Stabilized Finite Element Formulation of Non-Newtonian Fluid Model of Blood Flow in A Bifurcated Channel with Overlapping Stenosis." Journal of Advanced Research in Fluid Mechanics and Thermal Sciences 88, no. 1 (2021): 126-139. https://doi.org/10.37934/arfmts.88.1.126139

Hoi, Yiemeng, Bruce A. Wasserman, Yuanyuan J. Xie, Samer S. Najjar, Luigi Ferruci, Edward G. Lakatta, Gary Gerstenblith, and David A. Steinman. "Characterization of volumetric flow rate waveforms at the carotid bifurcations of older adults." Physiological measurement 31, no. 3 (2010): 291. https://doi.org/10.1088/0967-3334/31/3/002

Lancellotti, Rocco Michele, Christian Vergara, Lorenzo Valdettaro, Sanjeeb Bose, and Alfio Quarteroni. "Large eddy simulations for blood dynamics in realistic stenotic carotids." International journal for numerical methods in biomedical engineering 33, no. 11 (2017): e2868. https://doi.org/10.1002/cnm.2868

Moradicheghamahi, Jafar, Jaber Sadeghiseraji, and Mehdi Jahangiri. "Numerical solution of the Pulsatile, non-Newtonian and turbulent blood flow in a patient specific elastic carotid artery." International Journal of Mechanical Sciences 150 (2019): 393-403. https://doi.org/10.1016/j.ijmecsci.2018.10.046

Kumar, Nitesh, SM Abdul Khader, R. Pai, S. H. Khan, and P. A. Kyriacou. "Fluid structure interaction study of stenosed carotid artery considering the effects of blood pressure." International Journal of Engineering Science 154 (2020): 103341. https://doi.org/10.1016/j.ijengsci.2020.103341

Guerciotti, Bruno, and Christian Vergara. "Computational comparison between Newtonian and non-Newtonian blood rheologies in stenotic vessels." Biomedical Technology: Modeling, Experiments and Simulation (2018): 169-183. https://doi.org/10.1007/978-3-319-59548-1_10

Liu, Haipeng, Linfang Lan, Jill Abrigo, Hing Lung Ip, Yannie Soo, Dingchang Zheng, Ka Sing Wong et al. "Comparison of Newtonian and non-Newtonian fluid models in blood flow simulation in patients with intracranial arterial stenosis." Frontiers in Physiology (2021): 1464. https://doi.org/10.3389/fphys.2021.782647

Cho, Young I., and Kenneth R. Kensey. "Effects of the non-Newtonian viscosity of blood on flows in a diseased arterial vessel. Part 1: Steady flows." Biorheology 28, no. 3-4 (1991): 241-262. https://doi.org/10.3233/BIR-1991-283-415

“Composition of the Blood | SEER Training”. Accessed July 28, 2022 https://www.training.seer.cancer.gov/leukemia/anatomy/composition.html

“Xact Carotid Stent System | Abbott”. Accessed March 7, 2022 https://www.cardiovascular.abbott/int/en/hcp/products/peripheral-intervention/carotid-family/xact-carotid-stent-system.html

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2023-04-20

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