CFD Projects

-Artificial Blood Vessels

2022_BFE Lab
Part 2-1,

Vascular Bypass
Surgery
2022_BFE Lab
Part 2-1
Vascular Bypass Surgery

Introduction
• Atherosclerosis is a leading cause of death around the world, a
disease caused by the deposition of plaques in inner walls of arteries.

• In severe cases of atherosclerosis, invasive procedures such as vascul

ar bypass surgery is required.

• To achieve higher patency in the procedure, it is important to control

the wall shear stress produced by blood flow to be above a certain l
evel, as it was previously discovered that low wall shear stress is signi
ficantly correlated with atherosclerosis.
Figure 1. Development of Atherosclerosis
Image source : Cleveland Clinic
• Aim : to understand the correlation between anastomosis angle and
wall shear stress distributions in a totally occluded vessel.
2022_BFE Lab
Part 2-1
Vascular Bypass Surgery

Numerical Model

Figure 1. Common dimensions of simplified models.

• Produced six simplified models of bypassed blood vessel to view the velocity Anastomosis angle (α) were used as only variable.
distribution and the following wall shear stress according to anastomosis angle.

• The diameter of host vessel (𝐷! ) was set to 4mm and the bypass graft thickness
(𝐷" ) was set to 0.9𝐷! . (figure 1)

• The proximal host vessel length (𝑙# ), distal host vessel length (𝑙$ ) and bypass le
ngth were all set to 10𝐷! .

• The anastomosis angles (α) were set to 15°, 30°, 45°, 60°, 75°, and 90° respectiv
ely, for models A, B, C, D, E and F (figure 2). Figure 2. Anastomosis angles in model A~F
a) model A (α = 15°). b) model B (α = 30°). c) model C (α = 45°).
d) model D (α = 60°). e) model E (α = 75°). f) model F (α = 90°).

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Part 2-1
Vascular Bypass Surgery

Numerical Method

• Assumptions:

• Blood flow was assumed to be laminar.

• The effects of cardiac movements (i.e. contraction and relaxation) were neglected, the flow was assumed to be steady.
• Blood was assumed to be incompressible Newtonian fluid.

• Numerical simulation:

• Finite volume method was used to solve the governing equations: continuity equations and Navier-Stokes equations.
• Inlet boundary conditions as fully-developed laminar flow with Reynolds number (Re) of 250.
• Neumann outlet conditions, and pressure to be zero at both outlets.

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Part 2-1
Vascular Bypass Surgery

Result - Velocity Contour & Streamlines • Flow with low velocity was observed in graft
𝛼 =15° 𝛼 =30° 𝛼 =45° anastomosis in model i and ii (15° and 30° )

• Velocity in proximal area was faster in models with

(i) ( ii ) ( iii )
anastomosis angle above 45°.

𝛼 =60° 𝛼 =75° 𝛼 =90°

• Anastomosis angle had no effect on high velocity
flow (above 0.3m/s).

( iv ) (v) ( vi ) • Recirculating flow was formed in proximal

Velocity 0.1 m/s 0.25 m/s 0.4 m/s
anastomosis area in models with anastomosis
angle below 45°.

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Vascular Bypass Surgery

Result – Wall Shear Stress Contour

𝛼 =15° 𝛼 =30° 𝛼 =45°

Result
• Low wall shear stress was concentrated near
anastomosis in all models.
(i) ( ii ) ( iii ) • The size of low wall shear stress region
decreased as anastomosis angle increased.
𝛼 =60° 𝛼 =75° 𝛼 =90°

( iv ) (v) ( vi )

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Vascular Bypass Surgery
Conclusion

• As the size of low wall shear stress region decreases near anastomosis, increasing anastomosis
angle may reduce the risk of restenosis near anastomosis.

2022_BFE Lab
Part 2-1 The effects of anastomosis angle

Vascular Bypass Surgery

on blood flow in bypassed blood vessel
이건우 , # 이경은
인하대학교 기계공학과
Kunwoo Lee , # Kyung Eun Lee ([email protected])
2022 순환기의공학회 하계학술대회 6.17 - 6.18 Department of Mechanical Engineering, Inha University, Republic of Korea

Figure 2. Endothelial Cell Morphology

Figure 1. Development of Atherosclerosis
according to Shear Stress level
Image source : UR Medicine Image source : Malek et al, “Hemodynamic Shear Stress and its Role in Atherosclerosis”

Introduction
 Severe atherosclerosis have been treated with vascular bypass surgery.

 It is known that wall shear stress effects on the patency of surgery.

*Poster for the project

 Aim of this study: to understand the correlation between anastomosis angle

and wall shear stress distributions in a totally occluded vessel.

Modeling Result
Figure 4. Velocity Contour in Axial Section
Figure 3. Dimensions of model i ~ vi : anastomosis angle (𝛼) 15° ~ 90° with 15° interval

𝛼 =15° 𝛼 =30° 𝛼 =45°

A A

(i) ( ii ) ( iii )

Made poster of the project for the 𝛼 =60° 𝛼 =75° 𝛼 =90°

(i) ( ii ) ( iii )

summer conference 2022 of Velocity

( iv )

0.1 m/s
(v)

0.25 m/s
( vi )

0.4 m/s

( iv ) (v) ( vi )

Biomedical Engineering Society for Circulation

• Flows with high velocity(above 0.3m/s) were not affected by anastomosis angle.
• Slow moving flows were observed in graft anastomosis(area A ) in model i and ii (15° and 30°)
• Velocity in proximal area was faster in models with anastomosis angle above 45°, compared to
models below 45 °.
• Recirculating flow was formed in proximal anastomosis area in models with anastomosis
 Governing Equations angle below 45°.

• Continuity Equation Figure 5. Wall Shear Stress Distributions

• Navier-Stokes Equation of Incompressible Newtonian Fluid 𝛼 =15° 𝛼 =30° 𝛼 =45°

(i) ( ii ) ( iii )

 Numerical Analysis Method 𝛼 =60° 𝛼 =75° 𝛼 =90°

• Finite Volume Method ( Ansys Fluent 2021 R1)

 Mesh
Number of Mesh
( iv ) (v) ( vi )
• Tetrahedral Mesh Model i : 558,678 , Model ii : 326,014, Model iii : 331,453
Model iv : 581,301, Model v : 649,433 , Model vi : 662,149
• Low wall shear stress regions were observed near anastomosis in all models.
 Assumptions • The increase of anastomosis angle decreased the size of low wall shear stress region.

• Steady Flow, Incompressible Newtonian Fluid, Rigid Wall,

No Gravitational Effect Conclusion
 Boundary Condition
 As the size of low wall shear stress region decreases near anastomosis,
• Inlet : Re = 250, V = 0.26984 m/s , Fully Developed Laminar Flow
increasing anastomosis angle may reduce the risk of restenosis near
• Outlet : Neumann Boundary, Zero Traction
anastomosis.

Acknowledgments
This work was partly supported by INHA UNIVERSITY Research Grant,the National Research foundation of Korea(NRF) grant (NRF2018R1D1 바이오 유체공학 연구실
2022_BFE Lab
A1B0704452814) and the Institute of Information & communications Technology Planning & Evaluation (IITP) grant funded by the Korea go Bio Fluid Engineering Laboratory (http://bioflow.inha.ac.kr)
vernment(MSIT) (No.20200002280022002)
Part 2-2,

Artificial Blood
Vessel w/ Pattern
2022_BFE Lab
Part 2-2

Introduction Artificial Blood Vessel w/ Pattern

Synthetic Non-Degradable Polymers

• Dacron, Teflon(ePTFE) or Polyurethane is used for synthetic

non-degradable polymer artificial vessel.

• Healthy autologous vessel has limit in its supply, raising the

need for polymer artificial vessel.

• Synthetic Non-degradable Polymers is widely used as it has

advantage in the ease at changing mechanical properties. ↑Example of Dacron artificial vessel.

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Introduction Artificial Blood Vessel w/ Pattern

Challenges of Non-Degradable Polymers

• Poor Patency Rates

ex) Only 45% of standard ePTFE grafts are patent at 5 years as femoropopliteal bypass grafts

↔ 60-80% in autologous vein grafts. [1]

• Compliance Mismatch
The compliance of polymer may be dozens of times bigger than soft tissues in our body, so leaving the compliance mismatch may cause
problems in healing process or cause intimal hyperplasia. [2]

• Enhancing biocompatibility of synthetic material

Low biocompatibility cause inflammatory responses. We can enhance biocompatibility via surface modification, coatings,
chemical and protein modifications, endothelial cell seeding ...

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Part 2-2

Introduction Artificial Blood Vessel w/ Pattern

Advantages of Porous Synthetic Blood Vessel

1. Positive effect on biocompatibility

• Endothelial cell has a shape with certain direction. Thus, having similar pattern in inner wall can have positive effect on
endothelialization, increasing patency rate. [3]

• Putting substances such as nitric oxide(NO), dopamine, heparin may help control inflammatory responses, inhibiting the
formation of thrombus. [4]

2. Help solve compliance mismatch

• Having porosity can help match human body’s compliance.

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Part 2-2

Introduction Artificial Blood Vessel w/ Pattern

Hemodynamic Factors and Patency

• Having porosity may have previously discussed pros, but flow disturbance due to porosity may
cause side effects in hemodynamic aspects.

• Low wall shear stress may cause restenosis by intimal thickening

In our body, blood vessels react to low shear stress by contraction, causing the blood velocity to temporally rise. Synthetic
blood vessels can’t react the same way, causing the endothelial cell in the area produce certain vasoactive substance, which
leads to intimal thickening. [5]

• Recirculation may be formed.

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Part 2-2

Introduction Artificial Blood Vessel w/ Pattern

Aim of the Study

Model porous artificial blood vessel with a simplified model with pattern on the inner
wall and investigate the effect of porosity on patency rate in the aspect of
hemodynamics.

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Modeling

Models ↑Model I
• Produced 3 models. Model I (No pattern), Model II (Cubic shaped pattern),
Modell III (Cuboid shaped pattern)

• The cube pattern of Model II has a side of 45 𝜇𝑚, and 47 pieces in the
circumferential direction and 80 pieces in the axial direction are attached to
the surface of a cylinder with a diameter of 4mm and a length of 7.16mm. ↑Model II
For stability of analysis, cylinders were added to both ends forming a model
with a total length of 17.3 mm.

• The cuboid pattern of Model III has the shape of the cube of Model II
stretched 40 times in the axial direction. 31 cuboids are in the
circumferential direction and 3 cuboids are in the axial direction, attached to
the surface of a 7.16mm long cylinder. As in Model II, cylinders were added
at both ends for stability.
↑Model III
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Part 2-2
Modeling

Method
• Governing Equation : Continuity Eq. & Navier-Stokes Eq.

• Finite Volume Method (Fluent v.2021 R1) ↑Model II

• Tetrahedral Mesh
Number of Mesh - Model I : 1,025,564 / Model II : 11,311,373 / Model III : 6,071,591

• Assumptions
Steady Flow, Incompressible Newtonian Fluid, Rigid Wall, No Gravitational Effect

• Boundary Condition
Inlet : Re = 250, 𝑉+,- = 0.242857 𝑚/𝑠, Fully Developed Laminar Flow

Outlet : Neumann Boundary

↑Model III
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Results – Model I Artificial Blood Vessel w/ Pattern

Streamline & Velocity

• The fully developed flow starting at the inlet is

maintained, with linear streamline.

• The wall shear stress doesn’t change either,

WSS Contour staying at approximately at 2Pa.

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Results – Model II Streamline & Velocity

inlet outlet • In the aspect of mainstream, streamline and

velocity was not affected. (figure 1)
↑ figure 1 : Velocity & Streamline

• Streamline waves upwards near the pattern,

and recirculation occurred inside the pattern.
(figure 2)

↑ figure 2 : Velocity & Streamline near pattern

• Looking at the velocity vector inside the
pattern, we could confirm the recirculation.
↑ figure 3 : velocity vector inside pattern

(figure 3)
Velocity
0 m/s 0.25 m/s 0.5 m/s

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Results – Model II WSS Contour

• Low wall shear stress was formed in the

patterns. (figure 1)

• As it is the low wall shear stress we

↑ figure 1 : WSS Contour (0.4 ~ 4Pa) / ↓figure 2 : WSS Contour (0.1 ~ 2Pa) want to discuss, we changed the
contour range to 0.1 ~ 2Pa and checked
again.

• Increasing low wss was obsersved as it

gets deeper inside the pattern. (figure 2)

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Results – Model III Streamline & Velocity
↓ figure 3 : velocity vector in the ends of the pattern

inlet outlet

↑ figure 1 : Velocity & Streamline

• In the aspect of mainstream, streamline and velocity was

not affected. (figure 1)

• The streamline from mainstream goes through the middle

part of the pattern, and recirculation is formed in the both
↑ figure 2 : Velocity & Streamline near pattern and inside pattern
ends of the pattern. (figure 2)

• Looking at the velocity vector inside the pattern, we could

confirm the recirculation in both ends. (figure 3)
Velocity
0 m/s 0.25 m/s 0.5 m/s

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Results – Model III WSS Contour

• Low wall shear stress in formed in

the patterns. (figure 1)

• Looking at the side view, the ends of

pattern has thicker low wss region
than midst of pattern. (figure 2-1)

↑ figure 1 : WSS Contour (0.4 ~ 4Pa) / ↓figure 2 : WSS Contour (0.1 ~ 2Pa)

• Looking at the top view, the wss of

: Side view of pattern both ends has lower value than that
(figure 2-1) of middle. (figure 2-2)

: Top view of pattern

(figure 2-2) • Looking at the front view, there is
lower wss in the deeper region of
pattern. (figure 2-4)
: isometric view of pattern : Front view of pattern
(figure 2-3) (figure 2-4)

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Conclusion Artificial Blood Vessel w/ Pattern

Conclusion :

• Artificial blood vessels made from synthetic non-degradable polymers may have higher possibility
of restenosis due to the recirculation and formation of low wall shear stress region caused by flow
disturbance from pattern.

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Reference Artificial Blood Vessel w/ Pattern

1) Johnson WC, Lee KK. A comparative evaluation of polytetrafluoroethylene, umbilical vein, and saphenous vein bypass grafts for femoral-popliteal above-knee
revascularization: a prospective randomized Department of Veterans Affairs cooperative study. J Vasc Surg 2000;32(2):268–277. [PubMed: 10917986]

2) Trubel W, Schima H, Moritz A et al, Compliance mismatch and formation of distal anastomotic intimal hyperplasia in extremely stiffened and lumen-adapted
venous grafts. Eur J Vasc Endovasc Surg 1995; 10:415-423.

3) J. Lu, M.P. Rao, N.C. MacDonald, D. Khang, T.J. Webster, Improved endothelial cell adhesion and proliferation on patterned titanium surfaces with rationally
designed, micrometer to nanometer features, Acta Biomater. 4 (2008) 192– 201.

4) Reynolds MM, Hrabie JA, Oh BK, et al. Nitric oxide releasing polyurethanes with covalently linked diazeniumdiolated secondary amines. Biomacromolecules
2006;7(3):987–994. [PubMed: 16529441]

5) Kohler TR, Kirkman TR, Kraiss LW, Zierler BK, Clowes AW, Increased blood flow inhibits neointimal hyperplasia in endothelialized vascular grafts. Circ Res 1991;
69: 1557-1565.

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 Thanks to BFE lab
Link: BFE Lab Website

Thank You

@Kunwoo Lee

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