Numerical simulations of patient-specific models with multiple plaques in human peripheral artery: a fluid-structure interaction analysis

Abstract

Atherosclerotic plaque in the femoral is the leading cause of peripheral artery disease (PAD), the worse consequence of which may lead to ulceration and gangrene of the feet. Numerical studies on fluid-structure interactions (FSI) of atherosclerotic femoral arteries enable quantitative analysis of biomechanical features in arteries. This study aims to investigate the hemodynamic performance and its interaction with femoral arterial wall based on the patient-specific model with multiple plaques (calcified and lipid plaques). Three types of models, calcification-only, lipid-only and calcification-lipid models, are established. Hyperelastic material coefficients of the human femoral arteries obtained from experimental studies are employed for all simulations. Oscillation of WSS is observed in the healthy downstream region in the lipid-only model. The pressure around the plaques in the two-plaque model is lower than that in the corresponding one-plaque models due to the reduction of blood flow domain, which consequently diminishes the loading forces on both plaques. Therefore, we found that stress acting on the plaques in the two-plaque model is lower than that in the corresponding one-plaque models. This finding implies that the lipid plaque, accompanied by the calcified plaque around, might reduce its risk of rupture due to the reduced the stress acting on it.

Cardiovascular fluid dynamics: a journey through our circulation

“…Similar to the cerebral flow, wall shear stress has been emphasized to play an important role in peripheral artery disease: low wall shear stress may promote the build-up of plaque while high wall shear stress could increase the vulnerability of plaques (Samady et al 2011;Casa, Deaton & Ku 2015). Simulations of local flow through thrombosis have quantified abnormal mean and oscillatory wall shear stress, which, when combined, may serve as risk factors for rupture (Xu et al 2016;Ferrarini et al 2021;Wang, Serracino-Inglott & Feng 2021). Additionally, simulations have highlighted the importance of patient specificity of peripheral vascular anatomies.…”

“…2016; Ferrarini et al. 2021; Wang, Serracino-Inglott & Feng 2021). Additionally, simulations have highlighted the importance of patient specificity of peripheral vascular anatomies.…”

Numerical Approach for The Evaluation of Hemodynamic Behaviour in Peripheral Arterial Disease: A Systematic Review

“…Only a few studies have focused at other arteries besides the carotid and coronary arteries. Wang et al, [40] conducted 1/19 FSI tests on stenosed femoral artery to assess hemodynamic performance with multiple plaques (calcified and lipid plaques) utilising Mooney-Rivlin material property. Besides, Nematzadeh [98] also discussed regarding Mooney-Rivlin model which performed better mechanically in generation of stress-strain distribution compared to Ogen model.…”

“…Despite patient-specific geometries, the existence of restriction is evident due to the complex composition of the artery wall, which includes smooth muscle cells, elastin, and collagen fibrils [40]. Furthermore, FSI must still adhere to various boundary requirements that limit output precision in a manner similar to that of a realistic vascular model [31,34,36].…”

Fluid-Structure Interactions of Peripheral Arteries Using a Coupledin silicoandin vitroApproach

“…In systems with large deformations such as blood flow in arteries, a computationally more expensive two-way coupling is usually required [30] and is becoming more standard as sufficient computational power is becoming more accessible [31][32][33][34][35]. However, some studies on peripheral arteries apply one-way coupling with the argument that the deformation of the arterial wall in these locations is negligible [36][37][38][39].…”