Fenestral pore size in the internal elastic lamina affects transmural flow distribution in the artery wall.

Interstitial flow through the subendothelial intima and media of an artery wall was simulated numerically to investigate the water flow distribution through fenestral pores which affects the wall shear stress on smooth muscle cells right beneath the internal elastic lamina (IEL). A two-dimensional analysis using the Brinkman model of porous media flow was performed. It was observed that the hydraulic permeability of the intimal layer should be much greater than that of the media in order to predict a reasonable magnitude for the pressure drop across the subendothelial intima and IEL (about 23 mostly at a 70 mm Hg luminal pressure). When Ki was set equal to the value in the media, this pressure drop was unrealistically high. Furthermore, the higher value of Ki produced a nearly uniform distribution of water flow through a simple array of fenestral pores all having the same diameters (1.2 microm), whereas when Ki was set at the value in the media, the flow distribution through fenestral pores was highly nonuniform and nonphysiologic. A deformable intima model predicted a nonuniform flow distribution at high pressure (180 mm Hg). Damage to the IEL was simulated by introducing a large fenestral pore (up to 17.8 microm) into the array. A dramatic increase in flow through the large pore was observed implying an altered fluid mechanical environment on the smooth muscle cells near the large pore which has implications for intimal hyperplasia and atherosclerosis. The model also predicted that the fluid shear stress on the bottom surface of an endothelial cell is on the order of 10 dyne/cm2, a level which can affect cell function.