Med Biol Eng Comput - Modeling hemodynamics in an unoccluded and partially occluded inferior vena cava under rest and exercise conditions.

Tópicos

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Resumo

Pulmonary embolism is the third leading cause of death in hospitalized patients in the US. Vena cava filters are medical devices inserted into the inferior vena cava (IVC) and are designed to trap thrombi before they reach the lungs. Once trapped in a filter, however, thrombi disturb otherwise natural flow patterns, which may be clinically significant. The goal of this work is to use computational modeling to study the hemodynamics of an unoccluded and partially occluded IVC under rest and exercise conditions. A realistic, three-dimensional model of the IVC, iliac, and renal veins represents the vessel geometry and spherical clots represent thombi trapped by several conical filter designs. Inflow rates correspond to rest and exercise conditions, and a transitional turbulence model captures transitional flow features, if they are present. The flow equations are discretized and solved using a second-order finite-volume method. No significant regions of transitional flow are observed. Nonetheless, the volume of stagnant and recirculating flow increases with partial occlusion and exercise. For the partially occluded vessel, large wall shear stresses are observed on the IVC and on the model thrombus, especially under exercise conditions. These large wall shear stresses may have mixed clinical implications: thrombotic-like behavior may initiate on the vessel wall, which is undesirable; and thrombolysis may be accelerated, which is desirable.

Resumo Limpo

pulmonari embol third lead caus death hospit patient us vena cava filter medic devic insert inferior vena cava ivc design trap thrombi reach lung trap filter howev thrombi disturb otherwis natur flow pattern may clinic signific goal work use comput model studi hemodynam unocclud partial occlud ivc rest exercis condit realist threedimension model ivc iliac renal vein repres vessel geometri spheric clot repres thombi trap sever conic filter design inflow rate correspond rest exercis condit transit turbul model captur transit flow featur present flow equat discret solv use secondord finitevolum method signific region transit flow observ nonetheless volum stagnant recircul flow increas partial occlus exercis partial occlud vessel larg wall shear stress observ ivc model thrombus especi exercis condit larg wall shear stress may mix clinic implic thromboticlik behavior may initi vessel wall undesir thrombolysi may acceler desir

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