Experimental flow studies in exact-replica phantoms of atherosclerotic carotid bifurcations under steady input conditions.

Extensive flow studies are conducted in two carotid bifurcation flow phantoms. These phantoms exactly replicate the lumen of the plaque excised intact from two patients with severe carotid atherosclerosis. The input flow into the phantom's common carotid artery is steady. Novel scanning techniques for flow visualization and particle image velocimetry are used. In addition, a novel boundary treatment technique is employed in velocimetry to extract first order accurate velocity gradients at walls. The data show that the flow fields are highly three-dimensional. Numerous separation and recirculation zones dominate the flow domain, except at the lowest Reynolds numbers. The separation regions are often so severe that highly directed internal jets form. At high Reynolds numbers, the flows become unsteady and chaotic, even though the input flow is steady. Flow fields have large regions of energetic flow and almost stagnant recirculation zones. These recirculation zones range in size from the full size of the arteries to zones within crevasses smaller than 1 mm. Velocity field and streamline patterns conform well to the lumen geometry. The streamlines are highly tortuous. Stagnation points correlate well with the topological features of the stenosis. Vorticity maps confirm the highly complex and three dimensional nature of the flow. Wall shear stresses at the stenoses are estimated to be on the order of 10 Pa. These studies conclusively show that the nature of the flow in the diseased bifurcation is primarily dictated by the lumen geometry.