Near-wall blood flow and wall shear stress (WSS) regulate major forms of cardiovascular disease, yet they are challenging to quantify with high fidelity. Patient-specific computational and experimental measurement of WSS suffers from uncertainty, low resolution, and noise issues. Physics-informed neural networks (PINNs) provide a flexible deep learning framework to integrate mathematical equations governing blood flow with measurement data. By leveraging knowledge about the governing equations (herein, Navier–Stokes), PINN overcomes the large data requirement in deep learning. In this study, it was shown how PINN could be used to improve WSS quantification in diseased arterial flows. Specifically, blood flow problems where the inlet and outlet boundary conditions were not known were solved by assimilating very few measurement points. Uncertainty in boundary conditions is a common feature in patient-specific computational fluid dynamics models. It was shown that PINN could use sparse velocity measurements away from the wall to quantify WSS with very high accuracy even without full knowledge of the boundary conditions. Examples in idealized stenosis and aneurysm models were considered demonstrating how partial knowledge about the flow physics could be combined with partial measurements to obtain accurate near-wall blood flow data. The proposed hybrid data-driven and physics-based deep learning framework has high potential in transforming high-fidelity near-wall hemodynamics modeling in cardiovascular disease.

Stimulated by a recent controversy regarding pressure drops predicted in a giant aneurysm with a proximal stenosis, the present study sought to assess variability in the prediction of pressures and flow by a wide variety of research groups. In phase I, lumen geometry, flow rates, and fluid properties were specified, leaving each research group to choose their solver, discretization, and solution strategies. Variability was assessed by having each group interpolate their results onto a standardized mesh and centerline. For phase II, a physical model of the geometry was constructed, from which pressure and flow rates were measured. Groups repeated their simulations using a geometry reconstructed from a micro-computed tomography (CT) scan of the physical model with the measured flow rates and fluid properties. Phase I results from 25 groups demonstrated remarkable consistency in the pressure patterns, with the majority predicting peak systolic pressure drops within 8% of each other. Aneurysm sac flow patterns were more variable with only a few groups reporting peak systolic flow instabilities owing to their use of high temporal resolutions. Variability for phase II was comparable, and the median predicted pressure drops were within a few millimeters of mercury of the measured values but only after accounting for submillimeter errors in the reconstruction of the life-sized flow model from micro-CT. In summary, pressure can be predicted with consistency by CFD across a wide range of solvers and solution strategies, but this may not hold true for specific flow patterns or derived quantities. Future challenges are needed and should focus on hemodynamic quantities thought to be of clinical interest.

Patient-specific computational fluid dynamics (CFD) is a promising tool that provides highly resolved haemodynamics information. The choice of blood rheology is an assumption in CFD models that has been subject to extensive debate. Blood is known to exhibit shear-thinning behaviour, and non-Newtonian modelling has been recommended for aneurysmal flows. Current non-Newtonian models ignore rouleaux formation, which is the key player in blood's shear-thinning behaviour. Experimental data suggest that red blood cell aggregation and rouleaux formation require notable red blood cell residence-time (RT) in a low shear rate regime. This study proposes a novel hybrid Newtonian and non-Newtonian rheology model where the shear-thinning behaviour is activated in high RT regions based on experimental data. Image-based abdominal aortic and cerebral aneurysm models are considered and highly resolved CFD simulations are performed using a minimally dissipative solver. Lagrangian particle tracking is used to define a backward particle RT measure and detect stagnant regions with increased rouleaux formation likelihood. Our novel RT-based non-Newtonian model shows a significant reduction in shear-thinning effects and provides haemodynamic results qualitatively identical and quantitatively close to the Newtonian model. Our results have important implications in patient-specific CFD modelling and suggest that non-Newtonian models should be revisited in large artery flows.