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Biomedical subjects

K Perktold

Publications and source records attributed to K Perktold.

At least 19 recordsLinked to original sources
PubMed2005

Mathematical and numerical models for transfer of low-density lipoproteins through the arterial walls: a new methodology for the model set up with applications to the study of disturbed lumenal flow.

In this work we introduce and discuss several mathematical models, based on partial differential equations, devised to study the coupled transport of macromolecules as low-density lipoproteins in the blood stream and in the arterial walls. These models are accurate provided that a suitable set of physical parameters characterizing the physical properties of the molecules and of the wall layers are available. Here we turn our attention on this aspect, and propose a new methodology to compute the physical parameters needed for the model set up, starting from available in vivo measurements. Then, we focus on the study of the accumulation of low-density lipoproteins in vascular districts featuring a highly disturbed flow. Our results demonstrate that mathematical models whose set up procedure benefits from an experimental feedback provide reliable information not only qualitatively, but also quantitatively. Their application to geometrically perturbed vascular districts (as for example a severe stenosis) shows that geometrical parameters such as curvature and variations of the lumenal section strongly influence the accumulation of low-density lipoproteins within the wall. For instance, in a stenotic segment with 75% area constriction, the LDL concentration at the lumenal side of the wall is about 10% higher than for the undisturbed segment.

Arterial Occlusive Diseases↗
PubMed2004

Experimental comparison of four methods of end-to-side anastomosis with expanded polytetrafluoroethylene.

BACKGROUND: Four established techniques of distal end-to-side anastomosis (direct anastomosis, Linton patch, Taylor patch and Miller cuff) were compared to investigate the local distribution of anastomotic intimal hyperplasia. The study aimed to elucidate whether mechanical factors or flow alterations are mainly responsible for the improved patency rates reported for vein cuff interposition techniques in infrainguinal arterial reconstructions using prosthetic graft material. METHODS: Thirty-two expanded polytetrafluoroethylene (ePTFE) femoropopliteal bypass grafts were implanted in 16 sheep using the four anastomotic techniques. After 6 months the grafts were explanted and examined histologically. The local distribution of intimal hyperplasia was determined, particularly for areas of material transition and of high and low shear stress. RESULTS: The mean amount and distribution of intimal hyperplasia were similar for all anastomotic types. Intimal hyperplasia was greatest along all transitions between ePTFE and venous patches, and between ePTFE and recipient artery. It was lower along the transitions between venous patches and artery, and was lowest at the host artery floor. CONCLUSION: Vein interposition did not reduce anastomotic intimal hyperplasia and did not change the distribution patterns of hyperplasia, which were influenced mainly by mechanical factors. The effect of vein interposition is to move areas of maximum intimal hyperplasia away from the small recipient artery up to the more capacious graft-patch anastomosis.

Anastomosis, Surgical↗
PubMed2003

Numerical simulation of carotid hemodynamics in patients with rotary blood pump cardiac assist.

In recipients of rotary blood pumps for cardiac assist, the pulsatility of arterial flow is considerably diminished. This influences the shear stress patterns and streamlines in the arterial bed, with potential influence on washout and subsequent plaque growth. To study these effects, a three-dimensional computer simulation of the carotid bifurcation at various levels of flow pulsatility was performed. The results showed that as expected pulsatile shear stress varied considerably, whereas local mean shear stress levels were nearly identical for all degrees of pulsatility. Particle residence time in the carotid bulb did only increase for less than 15%, with secondary washout patterns contributing to good washout also in nonpulsatile conditions. It is concluded that also under continuous pump support the local flow patterns in the carotids provide sufficient washout and fluid exchange to prevent excessive plaque growth.

Carotid Arteries↗
PubMed2001

Computer simulation of non-newtonian effects on blood flow in large arteries.

The influence of viscoelastic effects on blood flow in large arteries is studied numerically. The description of the blood flow uses the conservation of mass and momentum and a constitutive relation of Jeffreys' type (Oldroyd-B) and appropriate relations to describe the shear thinning behaviour. The steady flow studies are carried out in an axisymmetric tube with a local constriction modelling a stenosed blood vessel and in a three-dimensional 90 degrees curved tube. The numerical approach applies a decoupled technique where the computation of kinematics and stresses is separated. The governing equations are solved by means of an upwind stabilised Galerkin finite element method. The numerical results indicate significant influence of viscoelastic effects in the stenosed model. The flow through the curved tube shows minor quantitative viscoelastic influence. The influence of the shear thinning effect can be observed in both geometries. The results demonstrate that the viscoelastic behaviour of the local flow patterns in large arteries is dependent on the shape of the flow domain.

Arteries↗
PubMed2000

Hemodynamics in the carotid artery bifurcation: a comparison between numerical simulations and in vitro MRI measurements.

The presence of atherosclerotic plaques has been shown to be closely related to the vessel geometry. Studies on postmortem human arteries and on the experimental animal show positive correlation between the presence of plaque thickness and low shear stress, departure of unidirectional flow and regions of flow separation and recirculation. Numerical simulations of arterial blood flow and direct blood flow velocity measurements by magnetic resonance imaging (MRI) are two approaches for the assessment of arterial blood flow patterns. In order to verify that both approaches give equivalent results magnetic resonance velocity data measured in a compliant anatomical carotid bifurcation model were compared to the results of numerical simulations performed for a corresponding computational vessel model. Cross sectional axial velocity profiles were calculated and measured for the midsinus and endsinus internal carotid artery. At both locations a skewed velocity profile with slow velocities at the outer vessel wall, medium velocities at the side walls and high velocities at the flow divider (inner) wall were observed. Qualitative comparison of the axial velocity patterns revealed no significant differences between simulations and in vitro measurements. Even quantitative differences such as for axial peak flow velocities were less than 10%. Secondary flow patterns revealed some minor differences concerning the form of the vortices but maximum circumferential velocities were in the same range for both methods.

Animals↗
PubMed2000

Effect of endothelial injury and increased blood pressure on albumin accumulation in the arterial wall: a numerical study.

The present study investigates the influence of endothelial damage and of blood pressure on albumin accumulation in the arterial wall. For this purpose a numerical model for the coupled mass transport processes in the arterial lumen and in the various layers of the arterial wall is developed. The model considers the transport in the endothelium, intima, internal elastic lamina (IEL) and media of a straight axisymmetric arterial segment. In the arterial lumen fully developed stationary blood flow is assumed, the filtration velocity in the wall layers is calculated applying Darcy's law. The description of the luminal mass transport uses the stationary convection-diffusion equation, the transport in the porous intima and media is modelled applying the volume-averaged stationary convection-diffusion-reaction equation. The transport processes in the lumen, intima and media are coupled by the flux across the endothelium and IEL, which is mathematically described using the Kedem-Katchalsky equations. The numerical solution of the transport equations applies the finite element method. The results demonstrate a high resistance of the healthy endothelium to macromolecule exchange between blood and the artery wall. The reduced resistance of an injured endothelium causes an increased mass flux into the wall which results in higher concentration levels within the wall. The effect of the blood pressure on the wall concentration level is different for a helathy and an injured endothelium. In the case of a healthy endothelium a blood pressure increase causes a decrease of the intimal concentration and an increase of the medial concentration, whereas in the case of an injured endothelium an increased blood pressure results in higher concentration levels within the intima and media.

Algorithms↗
PubMed1999

Blood flow in distal end-to-side anastomoses with PTFE and a venous patch: results of an in vitro flow visualisation study.

OBJECTIVES: non-physiological flow behaviour plays a significant role in the development of distal anastomotic intimal hyperplasia. To investigate flow patterns in four anastomotic types of femoral end-to-side distal bypass graft anastomoses, a flow visualisation study was performed. METHODS: transparent 1:1 casted replicas of distal vascular graft anastomoses created by conventional technique, Miller-cuff, Taylor- and Linton-patch were fabricated. A pulsatile mock circulation with a high-speed video system was constructed. Flow pattern was determined at mean Reynolds numbers 100-500. Migrations of the stagnation points on the bottom of the anastomoses at mean Reynolds numbers 100, 230, and 350 were measured. RESULTS: a vortex forms during early systole and increases to maximum systole in all anastomoses. During the diastolic phase the vortex moves in the Miller-cuff distally to the toe of the anastomosis and remains standing, while in the other anastomotic types the vortex moves proximally to the heal of the junction and breaks down. The shift of the stagnation point in the Miller-cuff was considerably smaller than in the other anastomoses. CONCLUSION: conventional, Linton and Taylor anastomoses show similar flow patterns. The Miller-cuff with its wider cavity shows lower shift of the bottom stagnation point, but a persistent washout of the anastomotic cavity, which may contribute to its reported good clinical performance.

Anastomosis, Surgical↗
PubMed1998

Validated computation of physiologic flow in a realistic coronary artery branch.

The pulsatile flow field in an anatomically realistic model of the bifurcation of the left anterior descending coronary artery (LAD) and its first diagonal branch (D1) was simulated numerically and measured by laser Doppler anemometry. The inlet velocity profiles used in the computer simulation and in the physical experiments were physiologically realistic. The computational geometric model was developed on the basis of a digitized arterial cast. The curvature of the LAD over the cardiac surface leads to axial velocity profiles which are slightly skewed towards the epicardial wall. Downstream of the bifurcation, a strong skewing occurs towards the flow divider walls as a result of branching. Locally, the wall shear stress component caused by the complex secondary velocity can be as high as the axial component. The wall shear stress representation from a cell-based perspective exhibits low shear stress and large deviation from the time-averaged shear stress direction during systole. In diastole, the instantaneous wall shear stress direction nearly corresponds to the mean direction. The comparison of computed and measured axial velocity results shows generally good agreement. In contrast to computed flow patterns in simpler geometries constructed from cylindrical tubes, the flow field is found to be smoother, presumably reflecting the adaptation of the vascular contour to the contained flow.

Algorithms↗
PubMed1996

Computer simulation of convective diffusion processes in large arteries.

A numerical analysis of flow and convection-dominated diffusion processes in an axi-symmetric tube with a local constriction simulating a stenosed artery is carried out. The primary aim of this study is to demonstrate the effect of wall shear stress and recirculating flow on the concentration distribution in the vessel lumen and on wall mass transfer. The applied physical parameters describe the convective-diffusive transport of oxygen in the human abdominal aorta. The flow dynamics is described applying the incompressible Navier-Stokes equations for Newtonian fluids, the mass transport is modelled by the convection diffusion equation. For the solute flux at the wall a model with shear-dependent permeability and a model with constant wall permeability are compared. The results demonstrate a strong influence of the mural permeability characteristics on the shape of the flux and interfacial concentration profiles along the wall. The numerical solution of the flow equations and the coupled mass transport equation uses the finite element method. The application of a streamline upwind procedure for the transport equation and a special subelement technique enable a stable solution in the convection-dominated diffusion process. The analysis illustrates an essential influence of the flow patterns on the mass transport. In the reversed flow region downstream of the stenosis the oxygen concentration is decreased to 75% of the inlet concentration value.

Algorithms↗
PubMed1996

Numerical study of wall mechanics and fluid dynamics in end-to-side anastomoses and correlation to intimal hyperplasia.

In order to analyse the wall mechanics and the flow dynamics in compliant vascular distal end-to-side anastomoses, computer simulation has been performed. In a model study the effect of compliance mismatch on the wall displacements and on the intramural stresses as well as the influence of wall distensibility on the flow patterns are demonstrated applying two distensible models with different graft elasticity. In addition, the flow in a rigid model simulating a vein graft without adaption of the venous lumen has been investigated. The geometries for these models were obtained from a concurrent experimental study, where the formation of distal anastomotic intimal hyperplasia (DAIH) was studied in untreated and externally stiffened autologous venous grafts in sheep. In the flow study the time-dependent, three-dimensional Navier-Stokes equations describing the motion of an incompressible Newtonian fluid are applied. The vessel wall is modelled using a geometrically non-linear shell structure. In an iteratively coupled approach the transient shell equations and the governing fluid equations are solved numerically using the finite element method. In both compliant models maximum displacement and areas of steep stress gradients are observed in the junction region along the graft-artery intersection. The comparison of the normal deformations and the distribution and magnitude of intramural stress shows quantitative differences. The graft elasticity acts as a regulating factor for the deformability and the stress concentration in the junction area: In the model with high graft-elasticity maximum normal deformation at the side wall is 17%. This is twice as large as in the stiff graft model and maximum principle stress at the inner surface differs by one order of magnitude. The numerical results concerning the flow patterns indicate strongly skewed axial velocity profiles downstream of the junction, large secondary motion, flow separation and recirculation on the artery floor opposite the junction and at the inner wall downstream of the toe. In these regions a correlation between the time-averaged fluid wall shear stress and intimal thickening found in the animal experiment can be observed, whereas the pronounced formation of DAIH at the suture line seems to be mainly dependent on wall mechanical factors such as intramural stress and strain.

Adaptation, Physiological↗
PubMed1996

Pulsatile albumin transport in large arteries: a numerical simulation study.

Albumin transport in a stenosed artery configuration is analyzed numerically under steady and pulsatile flow conditions. The flow dynamics is described applying the incompressible Navier-Stokes equations for Newtonian fluids, the mass transport is modelled using the convection diffusion equation. The boundary conditions describing the solute wall flux take into account the concept of endothelial resistance to albumin flux by means of a shear dependent permeability model based on experimental data. The study concentrates on the influence of steady and pulsatile flow patterns and of regional variations in vascular geometry on the solute wall flux and on the ratio of endothelial resistance to concentration boundary layer resistance. The numerical solution of the Navier-Stokes equations and of the transport equation applies the finite element method where stability of the convection dominated transport process is achieved by using an upwind procedure and a special subelement technique. Numerical simulations are carried out for albumin transport in a stenosed artery segment with 75 percent area reduction representing a late stage in the progression of an atherosclerotic disease. It is shown that albumin wall flux varies significantly along the arterial section, is strongly dependent upon the different flow regimes and varies considerably during a cardiac cycle. The comparison of steady results and pulsatile results shows differences up to 30 percent between time-averaged flux and steady flux in the separated flow region downstream the stenosis.

Arteries↗
PubMed1995

Computer simulation of local blood flow and vessel mechanics in a compliant carotid artery bifurcation model.

To investigate the effect of the distensible artery wall on the local flow field and to determine the mechanical stresses in the artery wall, a numerical model for the blood flow in the human carotid artery bifurcation has been developed. The wall displacement and stress analysis use geometrically non-linear shell theory where incrementally linearly elastic wall behavior is assumed. The flow analysis applies the time-dependent, three-dimensional, incompressible Navier-Stokes equations for non-Newtonian inelastic fluids. In an iteratively coupled approach the equations of the fluid motion and the transient shell equations are numerically solved using the finite element method. The study shows the occurring characteristics in carotid artery bifurcation flow, such as strongly skewed axial velocity in the carotid sinus with high velocity gradients at the internal divider wall and with flow separation at the outer common-internal carotid wall and at the bifurcation side wall. Flow separation results in locally low oscillating wall shear stress. Further strong secondary motion in the sinus is found. The comparison of the results for a rigid and a distensible wall model demonstrates quantitative influence of the vessel wall motion. With respect to the quantities of main interest, it can be seen, that flow separation and recirculation slightly decrease in the sinus and somewhat increase in the bifurcation side region, and the wall shear stress magnitude decreases by 25% in the distensible model. The global structure of the flow and stress patterns remains unchanged. The deformation analysis shows that the tangential displacements are generally lower by one order of magnitude than the normal directed displacements. The maximum deformation is about 16% of the vessel radius and occurs at the side wall region of the intersection of the two branches. The analysis of the maximum principal stresses at the inner vessel surface shows a complicated stress field with locally high gradients and indicates a stress concentration factor of 6.3 in the apex region.

Algorithms↗
PubMed1995

Mathematical modeling of arterial blood flow and correlation to atherosclerosis.

The importance of arterial flow phenomena with regard to atherosclerosis motivates detailed studies of local cardiovascular flow dynamics. The quantitative analysis of flow characteristics can contribute to the understanding of fluid dynamic induced and favored mechanisms in atherogenesis. Numerical methods are very useful in supporting experimental methods and often enable the determination of flow variables which are difficult to obtain in experiments. Due to the development of improved numerical procedures for the blood specific flow equations and due to the application of modern computer technology, the calculations can be carried out under conditions describing the physiological situation in a realistic manner including essential effects. Here various aspects of arterial flow simulation are presented and discussed. The possibilities and difficulties of numerical simulation of arterial flow using finite element approximations are illustrated with the aid of the human carotid artery bifurcation and a distal end-to-side anastomosis model. Further convective-diffusive mass transport in a curved tube model is considered.

Algorithms↗
PubMed1994

Flow and stress characteristics in rigid walled and compliant carotid artery bifurcation models.

Computer simulation of pulsatile non-Newtonian blood flow has been carried out in different human carotid artery bifurcation models. In the first part of the investigation, two rigid walled models are analysed, differing in the bifurcation angle (wide angle and acute angle bifurcation) and in the shape of both the sinus (narrow and larger sinus width) and the bifurcation region (small and larger rounding of the flow divider), in order to contribute to the study of the geometric factor in atherosclerosis. The results show a significant difference in the wall shear stress and in the flow separation. Flow recirculation in the sinus is much more pronounced in the acute angle carotid. An important factor in flow separation is the sinus width. In the second part of the study, flow velocity and wall shear stress distribution have been analysed in a compliant carotid artery bifurcation model. In the mathematical model, the non-Newtonian flow field and the idealized elastic wall displacement are coupled and calculated iteratively at each time step. Maximum displacement of approximately 6% of the diastolic vessel diameter occurs at the side wall of the bifurcation region. The investigation demonstrates that the wall distensibility alters the flow field and the wall shear stress during the systolic phase. Comparison with corresponding rigid wall results shows that flow separation and wall shear stress are reduced in the distensible wall model.

Arteriosclerosis↗
PubMed1991

Three-dimensional numerical analysis of pulsatile flow and wall shear stress in the carotid artery bifurcation.

To analyse the pulsatile flow field and the mechanical stresses in a three-dimensional carotid artery bifurcation model, computer simulation is applied. The approximation of the Navier-Stokes equations uses a pressure correction finite element method. Numerical results are presented for axial and secondary flow velocity and wall shear stresses with special emphasis on the fluid dynamics in the carotid sinus. This region is of major interest because it is affected preferentially by lesions. Detailed local flow studies as carried out here should lead to a further insight into the mechanisms of atherogenesis. The flow conditions used in the study were chosen according to Ku et al. (Arteriosclerosis 5, 293-302, 1985). The results of this numerical analysis agree in the essential features with their experimental results.

Blood Flow Velocity↗
PubMed1991

A numerical calculation of flow in a curved tube model of the left main coronary artery.

The flow pattern in the left main coronary artery has been calculated using an idealized geometry and by numerically solving the full Navier-Stokes equations for a Newtonian fluid. Two different forms for the entrance velocity profile were used, one a time-varying, flat profile and the other a time-varying, less flat velocity profile. The results obtained demonstrate the presence of secondary motions for conditions simulating flow in the left main coronary artery, with maximum secondary flow velocities being on the order of three to four percent of the maximum axial velocity. This secondary flow phenomenon has an important influence on the wall shear stress distribution, in spite of the fact that there is virtually no alteration in the axial velocity profile. The maximum ratio of the outer wall shear stress to that on the inner wall is 1.4 at a Reynolds number of Re = 270, and it increases with increasing Reynolds number, reaching a value of 1.7 at Re = 810. Although there are significant differences in the results in the immediate vicinity of the inlet for the two different forms of the entrance velocity profile used, this difference does not persist far into the tube. Independent of the choice of the entrance velocity profile, it appears that there will be significant secondary flow effects on the wall shear stress.

Blood Flow Velocity↗