The purpose of this paper is to demonstrate the importance of a compliant wall approach in modeling of non‐Newtonian and non‐physiological blood flows. A case study of a stenosed and symptomatic carotid bifurcation was considered to show the influence of the wall‐resilience assumption on the flow parameters obtained with numerical simulations. Patient‐specific data concerning the geometry and flow conditions were collected and used to carry out two‐way coupled fluid structure interaction simulations of the pulsatile blood flow through carotid artery. The wall compliance was considered separately as related to the wall‐elasticity and as associated with the reaction of the loose connective tissue surrounding the carotid bifurcation. The obtained hemodynamic parameters were compared to those which were found in rigid‐wall simulations. The difference between the results obtained for rigid‐wall and compliant‐wall approaches for the peak‐systolic area‐averaged wall shear stress achieved 35%, whereas the difference between the time‐averaged local vorticity and shear strain reached, respectively, 42% and 43%. The influence of the highly resilient wall on the monitored hemodynamic parameters was significant even if time‐averaged values are compared, which suggests that these metrics are considerably overestimated if the wall compliance is not considered. Moreover, the findings show that the mechanical response of the loose connective tissue cannot be neglected in blood flow simulations. Additionally, this study indicates that stiffening of the arterial wall due to atherosclerosis significantly rises hemodynamic parameters. This explains the therapeutic benefits of surgical removal of plaque lesions formed in the carotid bifurcation (endarterectomy).

Giant intracerebral aneurysms (GIA) comprise up to 5 % of all intracranial aneurysms. The indirect surgical strategy, which leaves the GIA untouched but reverses the blood flow by performing a bypass in combination with proximal parent artery occlusion is a useful method to achieve spontaneous aneurysm occlusion. The goal of this study was to assess the utility of computational fluid dynamics (CFD) in preoperative GIA treatment planning. We hypothesise that CFD simulations will predict treatment results. A fluid-structure interaction (FSI) CFD investigation was performed for the entire arterial brain circulation. The analyses were performed in three patient-specific CT angiogram models. The first served as the reference geometry with a C6 internal carotid artery (ICA) GIA, the second a proximal parent artery occlusion (PAO) and virtual bypass to the frontal M2 branch of the middle cerebral artery (MCA), and the third a proximal PAO in combination with a temporal M2 branch bypass. The volume of “old blood”, flow residence time (FRT), dynamic viscosity and haemodynamic changes were also analysed. The “old blood” within the aneurysm in the bypass models reached 41 % after 20 cardiac cycles while in the reference model it was fully washed out. In Bypass 2 “old blood” was also observed in the main trunk of the MCA after 20 cardiac cycles. Extrapolation of the results yielded a duration of 4 years required to replace the “old blood” inside the aneurysm after bypass revascularization. In both bypass models a 7-fold increase in mean blood viscosity in the aneurysm region was noted. Bypass revascularization combined with proximal PAO favours thrombosis. Areas prone to thrombus formation, and subsequently the treatment outcomes, were accurately identified in the preoperative model. Virtual surgical operations can give a remarkable insight into haemodynamics that could support operative decision-making.

Results obtained with computational fluid dynamics (CFD) rely on assumptions made during a pre-processing stage, including a mathematical description of a fluid rheology. Up to this date there is no clear answer to several aspects, mainly related to the question of whether and under what conditions blood can be simplified to a Newtonian fluid during CFD analyses. Different research groups present contradictory results, leaving the question unanswered. Therefore, the objective of this research was to perform steady-state and pulsatile blood flow simulations using eight different rheological models in geometries of varying complexity. A qualitative comparison of shear- and viscosity-related parameters showed no meaningful discrepancies, but a quantitative analysis revealed significant differences, especially in the magnitudes of wall shear stress (WSS) and its gradient (WSSG). We suggest that for the large arteries blood should be modelled as a non-Newtonian fluid, whereas for the cerebral vasculature the assumption of blood as a simple Newtonian fluid can be treated as a valid simplification.

The primary objective of this research can be divided into two separate aspects. The first one was to verify whether own software can be treated as a viable source of data for the Computer Aided Design (CAD) modelling and Computational Fluid Dynamics CFD analysis. The second aspect was to analyze the influence of the Ventricle Assist Device (VAD) outflow cannula positioning on the blood flow distribution in the brain-supplying arteries. Patient-specific model was reconstructed basing on the DICOM image sets obtained with the angiographic Computed Tomography. The reconstruction process was performed in the custom-created software, whereas the outflow cannulas were added in the SolidWorks software. Volumetric meshes were generated in the Ansys Mesher module. The transient boundary conditions enabled simulating several full cardiac cycles. Performed investigations focused mainly on volume flow rate, shear stress and velocity distribution. It was proven that custom-created software enhances the processes of the anatomical objects reconstruction. Developed geometrical files are compatible with CAD and CFD software – they can be easily manipulated and modified. Concerning the numerical simulations, several cases with varied positioning of the VAD outflow cannula were analyzed. Obtained results revealed that the location of the VAD outflow cannula has a slight impact on the blood flow distribution among the brain supplying arteries.

MeMoS (Medical Model Sketcher), a software package that provides data required to reconstruct 3D medical models, basing on DICOM and RAW image sets, is presented. The uttermost objective of the software creation was to reduce a time needed to perform laborious data extraction process from medical images (necessary for the model reconstruction), without the need of purchasing expensive licenses for already existing programs. Obtained data can be used in any CAD software to recreate the spatial object. Generated 3D models of vascular systems can be used in numerical simulations so as to investigate the physical phenomena occurring in the circulatory system. Additionally, MeMoS is capable of creating datasets for texture analysis - that can be directly fed to the input of texture analysis software. Several results of the possible program output along with preliminary validation of implemented algorithms are outlined as well.