Hewlin Rodward L, Kizito John P
University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA.
North Carolina Agricultural and Technical State University, 1601 East Market Street, Greensboro, NC, 27411, USA.
Cardiovasc Eng Technol. 2018 Mar;9(1):1-31. doi: 10.1007/s13239-017-0332-z. Epub 2017 Nov 9.
The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques. The experimental and digital arterial models used in the present study are the first 3-D systems reported in literature to incorporate the major arterial vessels that deliver blood from the heart to the cranial and femoral arteries. These models are also the first reported in literature to be used for flow parameter assessment via medical drug delivery and orthostatic postural change studies. The present work addresses the design of the experimental and digital arterial model in addition to the design of measuring tools used to measure hemodynamic parameters. The experimental and digital arterial model analyzed in the present study was developed from patient specific computed tomography angiography (CTA) scans and simplified geometric data. Segments such as the aorta (ascending and descending) and carotid bifurcation arteries of the experimental and digital arterial model was created from online available patient-specific CTA scan data provided by Charite' Clinical and Research Hospital. The cranial and coronary arteries were simplified arterial geometries developed from dimensional specification data used in previous work. For the patient specific geometries, a MATLAB code was written to upload the CTA scans of each artery, calculate the centroids, and produce surface splines at each discrete cross section along the lumen centerline to create the patient specific arterial geometries. The MATLAB code worked in conjunction with computer aided software (CAD) Solidworks to produce solid models of the patient specific geometries and united them with the simplified geometries to produce the full arterial model (CAD model). The CAD model was also used as a blueprint to fabricate the experimental model which was used for flow visualization via particle imaging velocimetry (PIV) and postural change studies. A custom pulse duplicator (pulsatile pump) was also designed and developed for the present work. The pulse duplicator is capable of producing patient-specific volumetric waveforms for inlet flow to the experimental arterial model. A simple fluid structure interaction (FSI) study was also conducted via optical techniques to establish the magnitude of vessel diameter change due to the pulsatile flow. A medical drug delivery (dye dispersion and tracing) case was simulated via a dye being dispersed into the pulsatile flow stream to measure the transit time of the dye front. Pressure waveforms for diseased cases (hypertension & stenotic cases) were also obtained from the experimental arterial model during postural changes from bedrest (0°) to upright position (90°). The postural changes were simulated via attaching the experimental model to a tile table the can transition from 0° to 90°. The PIV results obtained from the experimental model provided parametric data such as velocity and wall shear stress data. The medical drug delivery simulations (experimental and numerical) studies produce time dependent data which is useful for predicting flow trajectory and transit time of medical drug dispersion. In the case of postural change studies, pressure waveforms were obtained from the common carotid artery and the femoral sections to yield pressure difference data useful for orthostatic hypotension analysis. Flow parametric data such as vorticity (flow reversal), wall shear stress, normal stress, and medical drug transit data was also obtained from the digital arterial model CFD simulations. Although the present work is preliminary work, the experimental and digital models proves to be useful in providing flow parametric data of interest such as: (1) normal stress which is useful for predicting the magnitude of forces which could promote arterial rupture or dislodging of medical implants, (2) wall shear stress which is useful for analyzing the magnitude of drug transport at the arterial wall, (3) vorticity which is useful for predicting the magnitude of flow reversal, and (4) arterial compliance in the case of the experimental model which could be useful in the efforts of developing FSI numerical simulations that incorporates compliance which realistically models the flow in the arterial system.
本研究的最终目标是助力开发用于辅助治疗心血管疾病的工具。了解医疗植入物的血流动力学参数,能让临床医生针对干预计划提出一些针对特定患者的建议。在本研究中,制作了一个由多条主要动脉(主动脉、颈动脉分叉处、颅内动脉、股动脉、空肠动脉和锁骨下动脉)组成的实验性和数字计算流体动力学(CFD)动脉模型,以研究:(1)局部血流动力学(流动参数)对整体血流动力学的影响;(2)从卧床休息到直立姿势(体位变化)对血流动力学的影响;以及(3)通过实验和数值技术研究染料在动脉系统中的扩散(药物扩散模拟)。本研究中使用的实验性和数字动脉模型是文献中首次报道的3D系统,纳入了从心脏向颅内和股动脉供血的主要动脉血管。这些模型也是文献中首次报道用于通过药物输送和体位性姿势变化研究来评估流动参数的模型。除了用于测量血流动力学参数的测量工具的设计外,本研究还涉及实验性和数字动脉模型的设计。本研究中分析的实验性和数字动脉模型是根据患者特定的计算机断层血管造影(CTA)扫描和简化的几何数据开发的。实验性和数字动脉模型的主动脉(升主动脉和降主动脉)和颈动脉分叉等部分,是根据Charite临床与研究医院提供的在线患者特定CTA扫描数据创建的。颅内动脉和冠状动脉是根据先前工作中使用的尺寸规格数据开发的简化动脉几何形状。对于患者特定的几何形状,编写了一个MATLAB代码,用于上传每条动脉的CTA扫描数据,计算质心,并在沿管腔中心线的每个离散横截面处生成表面样条,以创建患者特定的动脉几何形状。MATLAB代码与计算机辅助软件(CAD)Solidworks协同工作,以生成患者特定几何形状的实体模型,并将它们与简化的几何形状合并,以生成完整的动脉模型(CAD模型)。CAD模型还用作制造实验模型的蓝图,该实验模型用于通过粒子图像测速技术(PIV)进行流动可视化和体位变化研究。还为当前工作设计并开发了一个定制的脉冲复制器(脉动泵)。该脉冲复制器能够为实验性动脉模型的入口流动生成特定于患者的体积波形。还通过光学技术进行了一项简单的流固相互作用(FSI)研究,以确定由于脉动流引起的血管直径变化的大小。通过将染料分散到脉动流中模拟了一个药物输送(染料分散和追踪)案例,以测量染料前沿的传输时间。在从卧床休息(0°)到直立姿势(90°)的体位变化过程中,还从实验性动脉模型获得了患病病例(高血压和狭窄病例)的压力波形。通过将实验模型连接到可以从0°转换到90°的瓷砖桌上模拟体位变化。从实验模型获得的PIV结果提供了诸如速度和壁面剪应力数据等参数数据。药物输送模拟(实验性和数值性)研究产生了随时间变化的数据,这对于预测药物扩散的流动轨迹和传输时间很有用。在体位变化研究中,从颈总动脉和股部区域获得压力波形,以产生对体位性低血压分析有用的压力差数据。还从数字动脉模型的CFD模拟中获得了诸如涡度(流动逆转)、壁面剪应力和法向应力等流动参数数据以及药物传输数据。尽管本研究是初步工作,但实验性和数字模型被证明在提供感兴趣的流动参数数据方面很有用,例如:(1)法向应力,可用于预测可能促进动脉破裂或医疗植入物移位的力的大小;(2)壁面剪应力,可用于分析动脉壁处药物传输的大小;(3)涡度,可用于预测流动逆转的大小;以及(4)在实验模型的情况下,动脉顺应性,这对于开发纳入顺应性的FSI数值模拟可能有用,该模拟能真实地模拟动脉系统中的流动。