title: The influence of flow, vessel diameter, and non-newtonian blood viscosity on the wall shear stress in a carotid bifurcation model for unsteady flow.
abstract: OBJECTIVE
  The atherosclerotic process in arteries is correlated with the local wall shear stress (WSS). Plaque development particularly occurs in regions with recirculation (ie, where the WSS oscillates). We investigated the effects of non-Newtonian blood viscosity, variations in flow rate, and vessel diameter on wall phenomena in a carotid bifurcation model.
  
  
  METHODS
  The flow through a model of a carotid artery bifurcation was simulated by means of the finite element method. The whole-blood viscosity is a function of shear rate, and was modeled by the Carreau-Yasuda (CY) model. Flow rate and vessel morphology were assessed with magnetic resonance imaging. Flow rate, blood viscosity, and hematocrit levels (Hct) were measured in 49 healthy volunteers. We propose an adaptation of the CY model so that differences in Hct can be incorporated; furthermore, plasma viscosity was varied in the CY model.
  
  
  RESULTS
  The data from our model indicate that flow increases have a larger effect on the WSS than predicted with a simple paraboloid model. Hct had more influence on the WSS when the plasma viscosity was low. Low plasma viscosity was associated with a low WSS, which implies a contradiction, because both high WSS and low plasma viscosity are thought to be indicators for a healthy system. Maximum WSS oscillations were found at the edges of the recirculation region.
  
  
  CONCLUSIONS
  Flow and diameter changes have significant influence on wall shear stress values; the same is true for the viscosity, but to a lesser extent.
authors.affiliation: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Frieke M A
authors.initials: FM
authors.lastname: Box
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van der Geest
authors.forename: Marcel C M
authors.initials: MC
authors.lastname: Rutten
authors.forename: Johan H C
authors.initials: JH
authors.lastname: Reiber
mesh_terms: D000328:Adult; D000368:Aged; D001809:Blood Viscosity / Q000502:physiology*; D002339:Carotid Arteries / Q000033:anatomy & histology* / Q000502:physiology; D017536:Carotid Artery, Common / Q000033:anatomy & histology / Q000502:physiology; D002342:Carotid Artery, External / Q000033:anatomy & histology / Q000502:physiology; D002343:Carotid Artery, Internal / Q000033:anatomy & histology / Q000502:physiology; D003198:Computer Simulation; D005260:Female; D020342:Finite Element Analysis; D006400:Hematocrit; D018056:Hemorheology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008955:Models, Cardiovascular; D010949:Plasma / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D013314:Stress, Mechanical; D013599:Systole / Q000502:physiology