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Abstract
Cardiovascular disease is the primary cause of morbidity and mortality in the western world. Complex hemodynamics play a
critical role in the development of atherosclerosis and the processes of aging, as well as many other disease processes. Biouid
mechanics play a major role in the cardiovascular system and it is important to understand the forces and movement of blood cells
and whole blood as well as the interaction between blood cells and the vessel wall. Fundamental uid mechanical, which are
important for the understanding of the blood ow in the cardiovascular circulatory system of the human body aspects are presented.
Measurement techniques for model studies such as LDA, ultrasound, and MRI studies will be discussed. Viscosity and ow
behavior changes specically the creation of vortices and ow disturbances can be used to show how medication can inuence ow
behavior. Experiments have shown that hemodynamics may have a strong inuence on the creation of aneurysms and varicose
veins. Other factors such as vessel wall structure are also important. In preliminary studies, it has been demonstrated that geometry
and elasticity of vessel walls help determine ow behavior. High velocity uctuations indicate ow disturbances that should be
avoided. Health care practitioners must understand uid dynamic factors such as ow rate ratio, pressure and velocity gradients,
and ow behavior, velocity distribution, shear stress on the wall and on blood cells. These mechanical factors are largely responsible
for the deposit of blood cells and lipids, a leading cause of atherosclerosis. The interaction between blood cells and of the cells with
the vessel, leads to the formation of plaques and agglomerations. These deposits are found predominantly at arterial bends and
bifurcations where blood ow is disturbed, where a secondary ow is created, and where ow separation regions are found.
Experiments on hemodynamic eects in elastic silicon rubber models of the cardiovascular system with ow wire, stents, or patches
for vessel surgery will be discussed. These studies can be important in improving diagnostics and therapeutic applications. r 2002
Published by Elsevier Science Ltd.
Keywords: Biouid mechanics; Hemodynamics; Flow visualization; Velocity measurements; LDFA and PIV measurements; Blood vessels; Elastic
models; Steady and pulsatile ow non-Newtonian ow behavior
1. Introduction
Biouid mechanics describe the kinematics and
dynamics of body uids in humans, animals and plants.
We distinguish between external ow around bodies as
in bird ight or the airow around bodies in air
conditioning situation, and internal ow through bodies
such as blood ow through blood vessels.
Hemodynamics deals with body uids in humans.
Classical hemodynamics deals with in vivo and in vitro
measurements of pressure, ow and resistance. Modern
biouid mechanics measures and analyzes local timedependent velocities and ow in blood vessels, the
respiratory system, the lymphatic system and the
*Fax: +49-89-1265-1502.
E-mail address: liepsch@rz.fh-muenchen.de (D. Liepsch).
0021-9290/02/$ - see front matter r 2002 Published by Elsevier Science Ltd.
PII: S 0 0 2 1 - 9 2 9 0 ( 0 1 ) 0 0 1 8 5 - 3
416
Fig. 2. Viscosity versus shear rate for a human blood sample at 371C
compared with the test uid at 211C.
417
Fig. 3. Pressure and velocity curve versus time in the common carotid artery model.
418
3. Model uids
To simulate the ow characteristics of blood, a blood
analog was developed which has a refraction index
identical to that of the model wall. The uid consists of
51% by weight aqueous Dimethylsulfoxide into which
various polyacrylamides are added (0.0035% Separan
AP-302 and 0.0025% AP-45, Dow Chemical). The
rheological behavior of this uid is nearly identical to
that of blood with a hematocrit of 46%. Fig. 2 (top)
compares the viscosity over the shear rate of the model
uid at 211C with the values for human blood, with
hematocrits of 46% and 42% at 371C. Fig. 2 (middle
and bottom) compares the viscous Z0 and elastic Z00
component (complex viscosity) over the frequency for
the same uids with a maximum deformation of 101 in a
rotating viscosimeter CV 100/RV 100 from Haake. The
viscosity of the model uid and the blood samples were
measured at the respective temperatures with this
viscosimeter. The density of the mixture was equal to
1050 kg/m3 of that of blood.
The representative viscosity, the representative shear
rate and the corresponding ow volume for various
Reynolds numbers were calculated using the measured
viscosity curve and shear gradient.
external carotid arteries. In addition to ow visualization techniques with dyes and a birefringent solution
with a photoelasticity apparatus, the velocity distribution was measured with a 3-D LDA system (Liepsch
et al., 1998). These measurements were also compared
with ultrasound catheter measurements (Liepsch et al.,
1995). Further details are described in Liepsch et al.
(1998). The ow, pressure and velocity curve used for
the experiments is shown in Fig. 3. The average
Reynolds number over a pulse cycle in all models
without stenosis was Re 250: In the stenosed models,
the Reynolds number decreased to Re 180 under
identical experimental conditions. Large velocity uctuations with vortices were found in the stenosed model.
These high frequency velocity uctuations can lead to a
hammer eect at the wall, causing damage over time.
This might be one cause of aneurysm development.
Fig. 4 shows the velocity distribution at several crosssections at steady ow for the non-Newtonian blood
4. Applications
4.1. Carotid artery models
The geometry and inuence of the bifurcation angle
(27491) between the internal and external carotid
arteries has been studied extensively (Liepsch et al.,
1998). It is important to remember that these two
branches do not normally lie in one plane. The spatial
situation is important and must be considered. The
bifurcation angle inuences ow separation. With larger
bifurcation angles, the ow separation regions extend
slightly. However, these dierences in the ow behavior
are small compared with the ow changes in carotid
arteries that have a stenosis in either the internal or
external artery, which causes ow rate ratio changes.
Pulsatile ow was studied in elastic silicon-rubber
carotid artery models using a non-Newtonian, bloodlike uid under physiological conditions. The experimental setup of the circulatory simulator and the
preparation of the models is described in Liepsch
(1989). Models included replicas of healthy human
carotid arteries with varying bifurcation angles, a model
with a 90% internal carotid artery (ICA) stenosis and a
model with 80% stenoses in both the internal and
419
Fig. 5. Velocity distribution at dierent phases of the pulse cycle for a healthy carotid artery model. The ow in the CCA was Re 250: The
measured plane is 15 mm proximal to the bifurcation.
420
Fig. 6. Velocity distribution at dierent phases of the pulse cycle for a healthy carotid artery model same as in Fig. 5 however the measured plane is
at the apex 0 mm in the ICA.
421
422
423
Fig. 9. Velocity component in the axial (a), vertical (b) and horizontal (c) direction for dierent phase ot of the pulse cycle 10 mm distal to the
bifurcation in the ICA. The ow was Re 250 in the CCA.
424
Fig. 9 (Continued )
425
Fig. 9 (Continued )
426
Fig. 9 (Continued )
427
Fig. 9 (Continued )
7. Arteriovenous stulas
Several arteriovenous stula models with lengths of
0.5, 1.0 and 2.0 cm were prepared for distal bypass
operation. The elastic silicon rubber models were
prepared from original polytetrauorethylene (PTFE)
grafts of 6 mm diameter. High velocity uctuations and
vortices were found in small stula models. The 2 cm
common ostium stula resulted in a smooth ow pattern
(Maurer et al., 1992, Veith, 1992). Laser vibrometer
studies in the arteriovenous stulas of the carotid artery
428
Fig. 9 (Continued )
429
9. Ultrasound catheters
Tests have been conducted in stenosed models to
determine whether the insertion of an ultrasound
catheter may provide the physicians with false information or with information that may be incorrectly
interpreted. Ultrasound catheters are used to measure
the blood velocity in vivo in the coronary or femoral
artery. Previous experiments with older catheter designs
showed dierences of >50% of the velocity (Liepsch
et al., 1995). Newer catheters are smaller in diameter
(0.34 mm). A smaller design improves the accuracy of
the signal, however the inuence of the catheter can still
Fig. 10. Same as Fig. 9ac, for a 90% stenosis in the ICA. The ow dropped to ReE180 and the ow rate ratio ICA to ECA 5644%.
430
Fig. 10 (Continued )
431
Fig. 10 (Continued )
11. Conclusions
Velocity distribution and the hemodynamic forces
acting on the vessel wall and blood cells are very
important. Normally under physiological ow conditions, the ow is neither fully developed laminar ow
nor turbulent ow. It can be described as laminar ow
with periodically returning vortices. These vortices are
432
D. Liepsch / Journal of Biomechanics 35 (2002) 415435
Fig. 11. Axial velocity components, a comparison of a healthy carotid artery model with a wide and a small patch plastic for the ICA.
433
Fig. 13. Velocity distribution 5 mm distal to the apex in the ICA for
three stents compared with a healthy ICA model.
434
Acknowledgements
Some of the studies were made possible by the
support of the Deutsche Forschungsgemeinschaft under
contract Li 256/1-42. Thanks are due to the many
doctoral candidates who helped with the experiments.
Thanks also to Joyce McLean for discussions and
editorial support.
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