• Journal of Mechanical Science and Technology
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• v.19 no.3
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• pp.836-845
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• 2005

Atherosclerosis, which is a degenerative vascular disease, is believed to occur in the blood vessels due to deposition of cholesterol or low density lipoprotein (LDL). Atherosclerotic lumen narrowing causes reduction of blood flow due to hemodynamic features. Several hypothetical theories related to the hemodynamic effects have been reported : high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory, and high pressure theory. However, no one theory clearly explains, the causes of atherosclerosis. The objective of the present study was to investigate the mechanism of the generation of atherosclerosis. In the study, the database of Korean carotid and coronary arteries for geometrical and hemodynamic clinical data was established. The atherosclerotic sites were predicted by the computer simulations. The results of the computer simulation were compared with the in vivo experimental results, and then the pathogenesis of atherosclerosis by using the clinical data and several hypothetical theories were investigated. From the investigation, it was concluded carefully that the mechanism of the generation of atherosclerosis was related to the hemodynamic effects such as flow separation and oscillatory wall shear stress on the vessel walls.

• International Journal of Vascular Biomedical Engineering
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• v.1 no.1
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• pp.32-40
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• 2003

Axillo-bifemoral (Ax-Fem) bypass are now well accepted for bilateral iliac artery occlusion as the second best option. This extra-anatomical (unnatural) bypasses, however, have various hemodynamic liabilities affecting the patency. Hemodynamic conditions of each different type of Ax-Fem bypass were assessed with computer simulation model to determine the hemodynamically more sound type. Simulation models of five different types of Ax-Fem bypass were constructed. Our investigation based on the computer simulation models have shown distinct differences between two most popular Lazy-S type and Inverted-C type on the distribution of flow volume, shear stress and recirculation zone, etc., though both types have shown similar clinical results. Lazy-S type has shown better hemodyanmic status than inverted-C type. The theoretical advantage of "Lazy-S" type has never been adequately proved for its superiority clinically over the inverted-C type. Inverted-C type is now in more favor with clinically better results in spite of many hemodynamic liabilities including retrograde flow to the branching graft. The improvement of over-all long-term patency rate of various extra-anatomical bypasses is still warranted through proper correction of the hemodynamic liability. Even though clinical outcome of the extra-anatomical bypass has been equal regardless of the type of crossover femoral graft configuration, there are distinct differences on the hemodynamic characteristics among various types of configuration. Further hemodynamic study in the pulsatile flow status is warranted to correct hemodynamic defects with proper modification of various hemodynamic factors of each model.

• 한국전산유체공학회:학술대회논문집
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• 2008.03b
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• pp.6-9
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• 2008

Analyzing the characteristics of blood flow in the blood vessels is very important to diagnose the circulatory diseases. In order to investigate the hemodynamic characteristics in vivo, the measurements of blood flows inside the extraembryonic arterial and venous blood vessels of chicken embryos were carried out using an in vivo micro-PIV technique. The circulatory diseases are closely related with the formation of abnormal hemodynamic shear stress regions, thereby it is important to get blood velocity and vessel's morphological information according to the vessel configuration and the flow conditions. In this study, the flow images of RBCs in blood vessels were obtained using a high-speed CMOS camera with a spatial resolution of approximately 14.6${\mu}$m${\times}$14.6${\mu}$m in the whole circulation network of blood vessels. The blood flows in the veins and arteries show steady laminar and unsteady pulsatile flow characteristics, respectively. The mean blood flows merged (in veins) and bifurcated (in arteries) smoothly into the main blood vessel and branches, respectively, without any flow separation or secondary flow which accompanying large variation of shear stress. Vorticity was high in the inner regions for both types of vessels, where the radius of curvature varied greatly. The instantaneous flows in the arterial blood vessels showed noticeable pulsatility due to the heart beat, and the main features of the velocity waveforms, including pulsatile shape, retrograde flow, mean velocity, maximum velocity and pulsatile frequency, were significantly dependent on the pulsatile condition which dominates the arterial blood flow. In near future, these in vivo experimental results of blood flow measured in various extraembryonic blood vessels would be very useful to understand the hemodynamic characteristics of human blood flows and various blood flow researches for clinically useful hemodynamic discoveries as well.

• Proceedings of the KSME Conference
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• 2005.11a
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• pp.59.2-59.2
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• 2005

• Proceedings of the KSME Conference
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• 2003.11a
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• pp.753-758
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• 2003

The purpose of the present study was to establish the mechanism of the generation of atherosclerosis by analyzing the hemodynamic variables in the coronary artery where atherosclerosis occurs frequently. From the previous results, the stenosis phenomena due to atherosclerosis were related to not only biochemical reaction between blood and blood vessel but also the hemodynamic factors like flow separation and oscillatory wall shear stress. The present study aimed to investigate the causes of the generation and progression of atherosclerosis in the coronary artery. This study also aimed to develop the softwares which generate automatically three dimensional vascular models obtained by the angiogram images and the computer vision techniques. In the present study, the flow patterns for full three-dimensional hemodynamic characteristics were analyzed. To understand the three-dimensional hemodynamic characteristics, the wall shear stress distributions and secondary flows were investigated quantitatively.

• Journal of Biomedical Engineering Research
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• v.36 no.6
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• pp.264-270
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• 2015

A mock circulatory loop system has been developed to construct a simulator for trainees in cardiopulmonary bypass systems or to simulate a test environment for cardiac-assist devices. This paper proposes a computerized mock circulatory loop system whose node is modularized by using a servo control flow regulator to simulate dynamic change of the hemodynamic status. To observe the effect of time-varying resistance, one with hemodynamic properties, the proposed system replicates the planned cross-sectional areas of the outlet of a ventricular assist device in terms of voltage input of a servo valve. The experiment is performed (1) for steady-input commands of selected area sizes and (2) for dynamic commands such as monotonous increase and decrease, and oscillatory functions of the voltage input, and a computer program based on LabVIEW (National Instruments, Austin, USA) processes every measured data and control command to the servo valve. The results show that the pressure and flow at the target points with respect to time-varying resistance match intuitive estimation: the pressure at the outlet and the pressure drop between both sides of the valve increased and the flow at the outlet decreased for increased resistance.

• Journal of computational fluids engineering
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• v.16 no.2
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• pp.81-87
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• 2011

The importance of shear thinning non-Newtonian blood rheology on the hemodynamic characteristics of idealized cerebral saccular aneurysms were investigated by carrying out CFD simulations assuming two different non-Newtonian rheology models (Carreau and Ballyk models). To explore effects of vessel curvature, a straight and a curved vessel geometry were considered. The wall shear stress(WSS), relative residence time(RRT) and velocity distribution were compared at the different phases of cardiac cycle. As expected, blood entered the aneurysm at the distal neck and created large vortex in both aneurysms, but with higher momentum on the curved vessel. Hemodynamic characteristics such as WSS, and RRT exhibited only minor effects by choice of different rheological models although Ballyk model produced relatively higher effects. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the hemodynamic characteristics, in particular, WSS-based parameters, considering the current accuracy level of medical image of cerebral aneurysm.

• 한국가시화정보학회:학술대회논문집
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• 2006.12a
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• pp.121-124
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• 2006

The arteries are very important in cardiovascular system and easily adapt to varying flow and pressure conditions by enlarging or shrinking to meet the given hemodynamic demands. The blood flow in arteries is dominated by unsteady flow phenomena due to heart beating. In certain circumstances, however, unusual hemodynamic conditions cause an abnormal biological response and often induce circulatory diseases such as atherosclerosis, thrombosis and inflammation. Therefore quantitative analysis of the unsteady pulsatile flow characteristics in the arterial blood vessels plays important roles in diagnosing these circulatory diseases. In order to verify the hemodynamic characteristics, in-vivo measurements of blood flow inside the extraembryonic arterial bifurcation cascade of chicken embryo were carried out using a micro-PIV technique. To analyze the unsteady pulsatile flow temporally, the (low images of RBCs were obtained using a high-speed CMOS camera at 250fps with a spatial resolution of $30{\mu}m\times30{\mu}m$ in the whole blood vessels. In this study, the unusual flow conditions such as flow separation or secondary flow were not observed in the arterial bifurcations. However, the vorticity has large values in the inner side of curvature of vessels. In addition, the mean velocity in the arterial blood vessel was decreased and pulsating frequency obtained by FFT analysis of velocity data extracted in front of the each bifurcation was also decreased as the bifurcation cascaded.

• International Journal of Vascular Biomedical Engineering
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• v.1 no.1
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• pp.13-23
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• 2003

Backgrounds: The present study in angulated coronary stenosis was to evaluate the influence of velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, as well as their effect of evolving in-stent restenosis using human in vivo hemodynamic parameters and computed simulation quantitatively and qualitatively. Methods: Initial and follow-up coronary angiographies in the patients with angulated coronary stenosis were performed (n=80). Optimal coronary stenting in angulated coronary stenosis had two models: < 50 % angle changed(model 1, n=43), > 50% angle changed group (model 2, n=37) according to percent change of vascular angle between pre- and post-intracoronary stenting. Flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre/post-intracoronary stenting were calculated from three-dimensional computer simulation. Results: Follow-up coronary angiogram demonstrated significant difference in the percent of diameter stenosis between two groups (group 1: $40.3{\pm}30.2$ vs. group 2: $25.5{\pm}22.5%$, p<0.05). Negative WSS area on 3D simulation, which is consistent with re-circulation area of velocity vector, was noted on the inner wall of post-stenotic area before stenting. The negative WSS was disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2 (p<0.01) Conclusions: The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation termed as WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric change, such as angular difference between pre / post-intracoronary stenting might give proper information of optimal hemodynamic charateristics for vascular repair after stenting.

• Proceedings of the KSME Conference
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• 2002.08a
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• pp.9-10
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• 2002

Human circulatory system between heart and tissue is not directly connected in normal condition but mandatory to go through the capillary system in order to fulfill its physiologic aim to deliver oxygen and nutrients, etc. to the tissue and retrieve used blood together with waste products from the tissue properly. When abnormal connection between arterial and venous system (AV fistula), these two circulatory systems respond differently to the hemodynamic impact of this abnormal connection between high pressure (artery) and low pressure (vein) system. Depending upon the location and/or degree (e.g. size and flow) of fistulous condition, each circulatory system exerts different compensatory hemodynamic response to this newly developed abnormal inter-relationship between two systems in order to minimize its hemodynamic impact to own system of different hemodynamic characteristics. Pump action of the heart can assist the failing arterial system directly to maintain arterial circulation against newly established low peripheral resistance by the AV fistula during the compensation period, while it affects venous system in negative way with increased venous loading. However, the negative impact of increased heart action to the venous system is partly compensated by the lymphatic system which is the third circulatory system to assist venous system independently with different hemodynamics. The lymphatic system with own unique Iymphodynamics based on peristaltic circulation from low resistance to high resistance condition, also increases its circulation to assist the compensation of overloaded venous system. Once these compensation mechanisms should fail to fight to newly established hemodynamic condition due to this abnormal AV connection, each system start to show different physiologic ${\underline{de}compensation}$ including heart and lymphatic system. The vicious cycle of decompensation between arterial and vein, two circulatory system affecting each other by mutually negative way steadily progresses to show series of hemodynamic change throughout entire circulation system altogether including heart. Clinical outcome of AV fistula from the compensated status to decompensated status is closely affected by various biological and mechanical factors to make the hemodynmic status more complicated. Proper understanding of these crucial biomechanical factors iii particular on hemodyanmic point of view is mandatory for the advanced assessment of biomechanical impact of AV fistula, since this new advanced concept of AY fistula based on blomechanical information will be able to improve clinical control of the complicated AV fistula, either congenital or acquired.