L.

Morris
Centre for Applied Biomedical Engineering Research, Dept. Mechanical & Aeronautical Eng. and Material and Surface Science Institute, University of Limerick, Castletroy, Limerick, Ireland

P. Delassus
Dept. Mechanical & Industrial Eng., Galway & Mayo Institute of Technology, Galway, Ireland

A. Callanan M. Walsh
Centre for Applied Biomedical Engineering Research, Dept. Mechanical & Aeronautical Eng. and Material and Surface Science Institute, University of Limerick, Castletroy, Limerick, Ireland

3-D Numerical Simulation of Blood Flow Through Models of the Human Aorta
A Spiral Computerized Tomography (CT) scan of the aorta were obtained from a single subject and three model variations were examined. Computational uid dynamics modeling of all three models showed variations in the velocity contours along the aortic arch with differences in the boundary layer growth and recirculation regions. Further downstream, all three models showed very similar velocity proles during maximum velocity with differences occurring in the decelerating part of the pulse. Flow patterns obtained from transient 3-D computational uid dynamics are inuenced by different reconstruction methods and the pulsatility of the ow. Caution is required when analyzing models based on CT scans. DOI: 10.1115/1.1992521 Keywords: Computational Fluid Dynamics, Aorta, Blood Flow, Reconstruction Methods, Imaging

F. Wallis P. Grace
MidWestern Regional Hospital, Dooradoyle, Limerick, Ireland

T. McGloughlin
Fax: 353 61 202944 e-mail: Tim.Mcgloughlin@ul.ie Centre for Applied Biomedical Engineering Research, Dept. Mechanical & Aeronautical Eng. and Material and Surface Science Institute, University of Limerick, Castletroy, Limerick, Ireland

Introduction

There have been numerous studies carried out on curved vessels to establish the inuence of vessel curvature, Reynolds number, Dean number and Womersley number on the ow patterns 17 . Blood ow through the aorta is one of the most complex ow situations found in the cardiovascular system. This is mainly due to the strong curvature effects, irregular geometry, tapering and branching. Because of the irregularities found in the vascular system such as curvature, branching and bifurcations, these are sites for atherosclerotic lesions 8,9 . Previous numerical studies have shown a dependence on vessel geometries 10,11 . Papaharilaou et al. 10 showed that out of plane curvature models of the coronary arteries create a bulk rotation of the velocity prole that produces a Dean type ow. Also Myers et al. 11 found Dean like secondary ow features in the right coronary artery were extremely sensitive to the local curvature effects. Different reconstruction methods can thus alter the ow patterns considerably as was found numerically by Berthier et al. 12 , who modelled the
Contributed by the Bioengineering Division for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received by the Bioengineering Division August 27, 2003; revision received May 4, 2005. Associate Editor: James Moore.

effects of different reconstruction methods for the coronary arteries. Also, Naruse et al. 13 found experimentally that large curvature induces a signicant enhancement of the secondary ow velocity effects and a greater axial ow reversal along the aortic arch. Recent studies indicate the development of early lesions are due to low and/or oscillatory wall shear stress as well as elevated wall shear stress gradients, both spatial and temporal 1416 . Shearing of blood across the lumen can damage red blood cells 17 . This shearing is further amplied due to the strong curvature effects, out of plane curvature and branching. Recirculations and eddies can contribute to enhanced deposition of blood particulates along the arterial wall. Thrombus formation is commonly found in the aortic arch and thoracic aorta 1824 . Thus wall shear stress can be an indicator of thrombus development due to the effects of the local curvature. Previous numerical models of the human aorta, which included the aortic arch, based on CT or MRI scans have included various model simplications. Such simplications included approximating the cross sections as circles Shahcheragi et al., 2002 , applying a constant diameter throughout the model Mori and Yamaguchi, 2002 . This current study is a numerical evaluation of unsteady and steady blood ow through different reconstruction OCTOBER 2005, Vol. 127 / 767

Journal of Biomechanical Engineering

Copyright 2005 by ASME

Fig. 1 a 2 D contour smoothing based on nonparametric smoothing methods. b Axial smoothing of the centroids in x direction.

methods of a human aortic arch and descending aorta obtained from spiral CT scans. The purpose of this study was to assess how the inclusion of model simplications inuenced the ow regime.

Methods

2.1 3-D Geometrical Reconstruction. The generation of the 3-D Aorta model was obtained from a series of slices that were acquired in vivo using CT spiral imaging scanning Department of Radiology, Mid-Western Regional Hospital, Limerick, Ireland . The 3-D Aorta model was based on a male subject aged over 70 years suffering from an Abdominal Aortic Aneurysm. A DICOM Digital Imaging and Communications in Medicine format le was created. A spiral acquisition was performed with a slice thickness or distance between the slices of 4mm, table movement of 12 mm/ sec. A total of 135 slices from the tip of the aortic arch to the Iliac arteries were generated. A eld of view of 422 422 mm2 and a 512 512 matrix resulted in a pixel size of 0.8242 mm. Scion Imager Beta Release Beta 4.0.2, Scion Corporation, Frederick, Md was used to analyse each of the CT scans. The Sobel edge detection operator was applied to each slice to detect the edges of the arterial boundary. The coordinates of the arterial boundary were exported as an ASCII le. Nonparametric smoothing methods were applied to the boundary data. Edge effects were minimized by converting the boundary data from the Cartesian co-ordinate system to the Polar coordinate system and smoothing the data over two cycles. The results for one cycle were obtained from to 3 . Figure 1 a shows a nonparametric curve t to the data based on the Nadaraya-Watson type estimator with a bandwidth of 0.025 and a 15 harmonic Fourier series estimator with a taper based on the Rogosinski kernel 2527 . There was less than 2% difference in the square of the residues between the two methods. The Fourier series estimator was chosen since its rst and second derivate were smoother with no step changes. To verify the accuracy of the segmentation and smoothing method applied, a cylindrical silicone model with known diameter was scanned in the spiral CT scanner. The average variation in radius around this model was less than 2%. A bifurcated idealized abdominal aortic aneurysm phantom model was also scanned by the spiral CT scanner and this was used to check the accuracy of the surface generation. This idealized aortic aneurysm model was replicated by a two-part silicon rubber Elastosil RT 601 A&B, Wacker-Chemie GmbH . The lost wax process was used to create this model. This was where a wax model created by a CNC machined cavity was positioned inside another CNC machined aluminium model with a larger cavity than the wax model. Silicone was then injected into the mould by a syringe and left to cure in an oven for a period of 24 hours as reported by OBrien et al. 28 . There was a 5 to 10% difference in the Gaussian surface curvature for the known idealized model and the generated model based on the segmentation method described below for model 2 768 / Vol. 127, OCTOBER 2005

which included axial and area smoothing. The Gaussian surface curvature was calculated automatically by Pro/Engineer 2001 Parametric Technology Corporation . Fifty equally spaced data points based on the Fourier series estimator t were imported into a parametric solid modeller Pro/ Engineer 2001 Parametric Technology Corporation . A 3-D interpolating spline was tted through the points for each crosssectional slice. A swept blend was used to connect the spline curves into a solid model of the aorta. Three models were generated with the following variations, Model 1: A model based on the segmented CT scan slices with contour smoothing. The generation of this model created slices that were shifted laterally. This displacement of the slices created a rough outer surface as can be seen in Fig. 2 model 1 . CT slice lateral displacement from one level to the next was probably due to respiratory motion and tissue movement that occurs during the contraction of the myocardium and the time-dependent lateral deformation of the thoracic aorta. There was no patient movement, as this would have shown up as streaklike artefacts in the resulting image. The spiral CT scans were not cardiac gated and were thus affected by pulse pressure variation which causes a change in diameter from diastolic to systolic. Model 2: To reduce the errors caused by slice displacement and pulse pressure variation, axial and area smoothing was applied to each of the scanned slices. This was based on a method developed by Moore et al. 29,30 . The axial and area smoothing method applied was based on the following formula xnew,ynew = x,y xcen,ycen + xcen
smooth,ycen smooth

areasmooth area , 1

where the cen refers to the centroid location. The result of cen-

Fig. 2 Aortic arch reconstructions. Model 1: CT scan model with no axial or area smoothing. Model 2: Axial and area smoothed model. Model 3: All cross sections are assumed circular with axial and area smoothing.

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Fig. 3 Inputted ascending aorta velocity pulse with its corresponding 10 harmonic Fourier series

Fig. 4 a Pave mesh across inlet. b Swept Cooper scheme throughout volume. Lower mesh density is shown to ease visualization.

troid smoothing and area smoothing were to modify the x,y coordinates. Figure 1 b shows the axial smoothing of ascending aorta in the x-direction based on the nonparametric 15 harmonic Fourier series estimator. This Fourier series t estimator was also applied to smooth the centroids of the aortic arch and descending aorta in the x and y directions as well as the cross-sectional areas. Figure 2 model 2 shows the smoothed aorta model. Model 3: All cross sections where assumed to be circular. The cross-sectional areas of the circular model were the same as model 1. Axial and area smoothing was also applied to this model. The aortic arch was generated by sweeping a circular cross-section at the entrance, in the middle and at the exit of the arch as can be seen in Fig. 2. The surface creation of the aortic arch created a different radius of curvature for all models. Due to axial smoothing there is a difference in the radius of curvature in the ascending and descending aorta for models 2 and 3 when compared to model 1. 2.2 Model Properties & Boundary Conditions. The blood was assumed to be incompressible, homogeneous and Newtonian uid, which is a valid assumption in larger arteries with a constant viscosity of 0.0035 Pas. The density of blood was taken to be 1050 kgm3 8,31 . The vessel walls were considered to be rigid and a no-slip condition was applied at the walls. A at or plug pulsatile velocity prole was applied at the aortic inlet. The assumption of a at velocity prole at the aortic inlet has been conrmed by various in vivo measurements using hot lm anemometry on different animal models distal to the aortic valve 8,3234 . A time dependant velocity prole was imposed by a Fourier series trigonometric t using 10 harmonics. The ow rates were obtained from Nichols and ORourke 31 for the ascending aorta and the input velocity based on this ow rate is shown in Fig. 3. The time average input velocity was 0.059 m / s with a maximum input velocity of 0.262 m / s occurring at 0.137 sec. The maximum acceleration and deceleration occurred at 0.078 sec and 0.379 sec respectively. The Reavg based on the average crosssectional area of the whole scan was 700. The corresponding Remax based on the average cross-sectional area of the whole scan was 3100. The Womersley number based on the average crosssectional area was 20. The average Velmax across the lumen was used to calculate both Reynolds and Dean number, Vellumen = areainlet / arealumenVelinlet. Flow in the aorta is mainly laminar. For pulsating ow, turbulence may occur for a Reynolds number much larger that expected for steady ow. This is due to the fact that an accelerating ow is more stable than steady ow 8,25 , also the decelerating ow is more unstable than steady ow. This can create bursts of turbulence during the decelerating phase 8 . Nerem et al. 35 found a critical Reynolds number for unsteady ow. This takes the form of Rec = constant , with the constant of proportionality ranging from 250 to 1000 35 . For this model, Rec ranges from 5000 to 20,000. The maximum Reynolds number for our model is below the threshold Rec. Based on this critical Reynolds number for unsteady ow, the ow is assumed to be Journal of Biomechanical Engineering

laminar. Time step independence was achieved at 2 milliseconds per step and pulse cycle independence was achieved at the third cycle. Computational Fluid Dynamics. The Navier-Strokes equations momentum and mass conservation governing the uid motion were solved by the Finite Volume CFD code Fluent 6.0 Inc., Lebanon, HH, USA . Discretisation of the equations at each control volume was achieved by the QUICK Quadratic Upwind Differencing Scheme , which uses a three-point upstream-weighted quadratic interpolation for the cell face values. This QUICK scheme is based on a weighted average of second-order upwind and central interpolations of the variable and is normally applied to quadrilateral and hexahedral meshes. The PISO Pressure Implicit with Splitting of Operators algorithm was used for the coupling of the pressure-velocity terms. The unsteady terms were solved by a fully implicit rst order scheme by applying the transient PISO algorithm with a time step of 2 milliseconds. A segregated algorithm was applied to solve all the equations. 2.4 Grid. The grid consisted of hexahedral cells for all three reconstructed geometries. Meshing was achieved by using the Gambit software Fluent Inc., Lebanon, NH, USA . A pave mesh was applied at the inlet. Each cross-section consisted of between 628 to 740 cells, 674 to 786 nodes. The Cooper algorithm was used to sweep the mesh along the 3-D vessel as shown in Fig. 4. The quality of the mesh was deemed to be satisfactory since the aspect ratio was below 6 for all the models. Mesh independence was reached at 170,000 to 190,000 cells for all models. Figures 5 a and 5 b shows the axial velocity at the aortic arch entrance and outlet. The uid ow can be well-resolved at lower mesh densities for velocity proles but in the case of higher order computed quantities such as wall shear stress an accurate velocity ow eld does not imply an accurate wall shear stress eld 36 . Figure 5 c shows the wall shear stress for the inner wall of the aorta for different mesh densities showing mesh independence.

Results and Discussion

3.1 Geometrical Factors. The main inuencing factor for the velocity proles through the three reconstructed models are the geometrical differences that are associated with each model. The three sections in these models are the ascending aorta, the aortic arch and the descending aorta. Dean number D is the ratio of the effective centrifugal inertial forces to the viscous forces. With increasing D, the effects of the centrifugal forces become stronger and increase the secondary velocities. Dean number is an analytical solution to fully developed ow in curved tubes and is given by a nondimensional parameter 37,38 OCTOBER 2005, Vol. 127 / 769

Fig. 5 Axial velocity plots for the maximum velocity and wall shear stress along the inner wall for different density meshes showing grid independence

D = Re

r , R

models, i.e., the model with the lowest radius of curvature has the highest Dean number. The radius of curvature for the central axis through the centroids was dened by R= 1 , 3

where Re is the Reynolds number, R is the radius of curvature of the arch and r is the radius of the lumen along the line of the radius of curvature. Dean number D can be used to assess the variation due to the radius of curvature effects along the aortic arch. For all three models the radius of curvature and diameter along the aortic arch varies with distance. Dean number can be used to analyze the different geometrical differences associated with each model and hence predict which model will create the greatest skewness, recirculation and secondary velocities. Referring to Eq. 2 , Dean number is inversely proportional to the radius of curvature and directly proportional to the radius of the lumen and Reynolds number. Figure 6 shows the inuencing factors associated with Dean number for the aortic arch in terms of the length ratio. The length ratio is the distance along the central axis of the arch and scaled nondimensionally from 0 to 1. With 0 representing the entrance into the aortic arch and 1 the exit out of the aortic arch. The nondimensional length along the central axis for each model was calculated by dividing a distance along the central axis by the total length of the central axis. The central axis was based on a curve through the centroids along the aortic arch. The centroids were found by two projected curves, which were generated one on top of the aortic arch surface and the other along the bottom of the aortic arch surface. Both curve were split up evenly into 20 points. 20 cut planes were then generated along the aortic arch through these points from the bottom curve to the top curve. From each generated plane along the aortic arch the centroid location and crosssectional area was obtained. The average radiuii r were calculated based on these cross-sectional areas. Since there were variations in the surface generation for each model throughout the aortic arch the central axis for each model was not coincident. Comparing Fig. 6 b with Fig. 6 d , it can be seen that the radius of curvature is a good predictor of the relative difference between the 770 / Vol. 127, OCTOBER 2005

where is the curvature and is dened in parametric terms t and is given by the following equation in parametric terms as t = T t / F t , where T t is the unit tangent vector of the curve and F t is the absolute magnitude of the rate of change of the parameterised curve F t . Pro Engineer 2001 Parametric Techology Corporation applies Eq. 3 to nd the radius of curvature for the parametric representation of the central axis through the centroids for each model. The curvature ratio r / R as given in Fig. 6 c is a better indicator of Dean number qualitatively. Dean number varies throughout the aortic arch due to both the varying radius of curvature and cross-sections across the lumen. The radius of curvature varies in all three planes and this complicated variation contributes to the direction of the ow throughout the aorta. The sharp increase in the radius of curvature as shown by the spikes in Fig. 6 b is the where the curvature tends to innity i.e. a straight line , this occurs for the human arch as the curvature along the arch varies from a low value sharp bends to a high value straight line and when the curvature changes direction. A high radius of curvature leads to a smaller Dean number. Dean number as given in Fig. 6 d was based on the resultant radius of curvature and this alone is sufcient in comparing which model will have the greatest skewing, recirculation and secondary velocities. The average curvature ratio r / R for the human aortic arch is around 0.312 5 . The curvature ratio varies for each of the reconstructed models with model 1 varying from 0.09 to a peak of 7, model 2 from 0.1 to 2.35 and model 3 from 0.01 to 0.65 see Fig. 6 c . Figure 6 c shows that model 1 has a greater variable in the radius/radius of curvature with more crests and troughs throughout most of the aortic arch tapering off after a length ratio Transactions of the ASME

Fig. 6 a Radius of Lumen along arch. b Radius of curvature. c Relationship between r / R. d Dean number.

of around 0.7 when compared to the other two models. When selecting regions of interest along the aortic arch it is not sufcient to compare the Dean number at that point as the ow prole depends on the history of the curvature ratio upstream of the selected region. Changes in the ow patterns caused by the curvature ratio further upstream will take effect somewhere downstream due to the inertia of the blood. Figure 6 d shows that model 1 has the largest Dean number at the entrance of the aortic arch at a length ratio of 0.3 to 0.7 and also at the exit of the aortic arch. Model 1 has an average Dean number which is 7% larger than model 2 and 17% larger than model 3. The history dependence of the curvature will affect the ow pattern further downstream. Other geometrical factors are the cross sectional differences throughout the models. The size and shape of the cross sections alone would cause skewness and recirculation of the ow regardless of the radius of curvature. Figure 7 shows the sections of interest that can describe the

ow throughout the models. These regions are the aortic arch entrance section 2 , mid way along the aortic arch section 3 , aortic arch exit section 4 , mid way along the descending aorta section 5 , where there was possible plaque buildup which was removed in model 3 due to the circular cross-section representation. Section 6 is the descending aorta outlet. 3.2 Velocity Proles. Figure 8 is a comparison of the axial velocity proles for each model, along each of the selected crosssections from the inner wall to outer wall as labelled in Fig. 4 a . Each section in Fig. 8 gives the axial velocity prole at the selected time steps of maximum velocity and maximum deceleration as given Fig. 3 Figure 9 is a comparison between a time averaged steady ow solution with its corresponding time average velocity for the accelerating and decelerating part of the pulse for model 2. The comparisons given in Figs. 8 and 9 will determine what is the greatest inuencing factor on the ow. Section 1: Inlet. A at or plug prole was inputted as the boundary condition for the inlet. Section 2: Aortic Arch Entrance. The ow begins as a at inlet prole at the inlet section 1 and travels up through the ascending aorta to the aortic arch entrance. Referring to Fig. 8 a for the maximum velocity part of the pulse, the axial ow is skewed towards the inner wall for all three models. This characteristic of ow was shown experimentally by Chandran 6 , Nerem et al. 26 , Falsetti et al., 27 , Seed and Wood 29 . For the maximum deceleration, the ow is still skewed towards the inner wall but is shifting towards the centre with slight recirculation at the inner wall and an increased boundary layer at the inner and outer walls. Figure 9 a shows the axial ow is skewed towards the inner wall for the steady ow solution with a similar boundary layer to decelerating part of the pulse. The steady part has its peak velocity value 5% greater than the accelerating portion and 44% lower OCTOBER 2005, Vol. 127 / 771

Fig. 7 The sections of interest that describes the ow throughout the models

Journal of Biomechanical Engineering

Fig. 8 The axial velocity proles for each model at the selected section from left to right as given in Fig. 4a. T1 is the time step for maximum acceleration. T2 is for maximum velocity. T3 is for maximum deceleration and T4 is for minimum velocity. The position of these time steps are given in Fig. 3.

than the decelerating part. Section 3: Aortic ArchMid Plane. The ow now has travelled half way along the aortic arch. The ow is skewed towards the inner wall for the maximum velocity with no recirculation. Yearwood and Chandran 4 Chandran 5 found experimentally that the ow is skewed towards the inner wall along the arch during the accelerating phase. During the maximum deceleration the boundary layer has grown from the entrance of the aortic arch with a recirculation and reverse ow at the inner wall for all three models. Figure 9 b shows that the ow is also skewed towards the inner wall for the time averaged steady ow solution and the corresponding acceleration phase, with similar velocity magnitudes decelerating phase. The deceleration phase is beginning to reverse its ow along the inner wall. Section 4: Aortic Arch Exit. The ow is now entering the ascending aorta. The boundary layer has grown at the inner wall for all models with the greatest boundary layer thickness occurring at the maximum deceleration. The ow is still skewed towards the inner wall shifting towards the outer wall during the pulse cycle due to the growing boundary layer. During the pulse cycle the recirculation regions grows at the inner wall for all models with the most recirculation occurring for model 1 & 2. Dean number for the model 1 & 2 was the greatest towards the exit of the aortic arch and this can explain the greater boundary layer thickness and recirculation when compared to model 3. Also there was a smoother geometrical surface along the aortic arch for model 3. These two factors may explain why there was no recirculation for model 3 during the maximum velocity. This ow proles that was found at the aortic arch exit was proven experimentally by Yearwood and Chandran 4, Chandran 5 Tortoli 772 / Vol. 127, OCTOBER 2005

et al. 7 . Figure 9 c shows the ow is skewed towards the outer wall for the steady ow solution with no recirculation unlike what happens during the decelerating part of the pulse. Section 5: Descending Aorta Mid-Way. This is a position along the descending aorta where there was possible plaque build-up on the bottom of the outer wall that was removed in model 3. Figure 8 g and 8 h shows that the axial ow proles are attening out for each model for the two time steps. The boundary layer has reduced at the inner wall for all models and has not quite developed to a constant boundary layer. Figure 9 d shows the ow is skewed towards the outer wall for the steady ow component while for the accelerating and decelerating part the pulse is attening out. Section 6: Descending Aorta Outlet. The axial velocity prole from left to right as given in Fig. 8 i and 8 j shows that the ow is attening out for all models for the maximum velocity. This attening of the ow prole further downstream of the aortic arch was found experimentally by Yearwood and Chandran 4 , Chandran 5 Tortoli et al. 7 , Nerem et al. 32 , Falsetti et al. 33 , Seed and Wood 34 . Model 1 shows skewness of the ow towards the inner wall during the maximum decelerating. This difference could be due to the unsmoothed nature of the centroids. The steady ow is in an M-shape prole as can be seen in Fig. 9 e , with similar velocity magnitudes to the decelerating part of the pulse. 3.3 Wall Shear Stress. Figures 10 a and 10 b shows the maximum wall shear stress along the outer and inner walls of all models during the maximum velocity. Thrombus formation is due to the rupture of a plaque or denuTransactions of the ASME

Fig. 9 Comparison between a time averaged steady ow solution with its corresponding time average velocity for the accelerating and decelerating part of the pulse for model 2

dation of the endothelium overlying a brous plaque which results in exposure of the highly thrombogenic subendothelium and lipid core. This thrombus formation is commonly found in the aortic arch and thoracic aorta 1824 , which leads to atheroembolic

stroke 8 . High wall shear stress and recirculation regions are believed to promote the development of these lesions 39 . Figure 10 shows that the maximum wall shear stress for all models occurs along the inner wall of the bend along the aortic arch length

Fig. 10

a Inner wall shear stress. b Outer wall shear stress.

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ratio from 0.2 to 0.4 , which can be seen as the spikes in Fig 10 a . These spikes occur due to the skewing and recirculating of the ow towards the inner wall that is developed along the aortic arch as was shown in Figs. 8 c and 8 e . The wall shear stress then shifts towards the outer wall as the ow progresses downstream into the descending aorta. The oscillations in wall shear stress are due to the surface roughess along the outer wall for models 1 and 2. Model 3 shows the least oscillatory variation in wall shear stress due to its smoother outer wall surface. This shift in wall shear stress from the inner to the outer wall was shown experimentally by Yearwood and Chandran 4 , Choi et al. 40 . This indicates the regions where plaque buildup will occur.

Acknowledgments
This study was supported by an Enterprise Ireland Strategic Research & Research Innovation Fund Grants.

Nomenclature:
D R Re Rec Reavg Remax Velmax r x y k Dean number radius of curvature Reynolds number critical Reynolds number for pulsatile ow average Reynolds number maximum Reynolds number maximum velocity radius of lumen x coordinate y coordinate curvature Womersley number

Conclusion

The main aim of this study was to see the effect of modifying the geometry and the effects due to the pulsatility of the ow would have on the ow characteristics. Modifying geometries obtained from CT scans is essential for the creation of low aspect ratio grids. In this study three models were simulated. Firstly model 1 was based on the CT scans with contour smoothing, secondly model 2 with axial and area smoothing and thirdly model 3 was a circular cross-sectional model. The results showed that all the models had similar characteristics for the general ow patterns. The axial velocity for all models was skewed towards the inner wall at the aortic arch entrance. The ow in the arch was skewed towards the inner wall during maximum velocity with an increased boundary layer and reversal of ow along the inner wall during maximum deceleration. At the aortic arch exit there was a signicant recirculation region at the inner wall with the ow skewed towards the inner wall. The ow in the descending aorta was relatively at during the maximum velocity with some recirculation and skewness of the ow during maximum deceleration. Comparing the time averaged velocity during the accelerating and decelerating phase with a steady ow computation showed that the steady ow results underestimated the recirculation and reversed ow patterns that occurred during the decelerating part of the pulse. The main inuencing factors associated with the three models are the geometrical differences associated with each model and the pulsatility of the ow. This is mainly due to the cross-sectional differences, and radius of curvature difference in the aortic arch. Entering the aortic arch the ow proles were nearly identical. Along the aortic arch and entering the descending aorta model 1 and model 2 had the greatest boundary layer growth, secondary velocities and recirculation regions. Midway along the descending aorta where there was a local discontinuity in the realistic model, all model were quite similar having the greatest the boundary layer at the inner wall. During the decelerating part of the pulse showed the greatest difference in the skewness and magnitude of velocity for all models along the descending aorta The maximum wall shear stress for all models occurs along the inner wall of the bend at the aortic arch entrance and shifts towards the outer wall as the ow progresses downstream. The WSS for all models are similar both quantitatively and qualitatively for all selected time steps. This gives an indication of where lesions are most likely to occur. In conclusion the main inuencing factor is the radius of curvature changes that occurred along the aortic arch and the pulsatility of the ow. Major differences in ow patterns were found along the aortic arch. Further downstream, all three models showed very similar velocity proles during the maximum velocity with differences in skewness during the maximum decelerating phase. The steady ow solution underestimates the recirculation and reverse ow regions. The occurrence of the greatest recirculation and reverse ow regions during the maximum deceleration is due to the fact that a decelerating uid is more unstable than an accelerating uid 8 . Care is needed when reconstructing arterial models from CT scans. 774 / Vol. 127, OCTOBER 2005

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