Flows in Stenotic Vessels

• Published in: Annual review of fluid mechanics Vol. 32; no. 1; pp. 347 - 382
• Main Authors: Berger, S. A, Jou, L-D
• Format: Journal Article
• Language: English
• Published: Palo Alto, CA 94303-0139 Annual Reviews 01.01.2000; 4139 El Camino Way, P.O. Box 10139 Annual Reviews, Inc; USA
• Subjects: atherogenesis; atherosclerosis; Biological and medical sciences; Biomechanics. Biorheology; blood flow; Blood vessels; Buoyancy; Capillary flow; Exact sciences and technology; Flow measurement; Flows in ducts, channels, nozzles, and conduits; Fluid dynamics; Fundamental and applied biological sciences. Psychology; Fundamental areas of phenomenology (including applications); Haemodynamics, pneumodynamics; Mathematical models; Physics; Shear stress; Steady flow; stenotic vessel flows; Tissues, organs and organisms biophysics; Unsteady flow; Carotid bifurcation; Pipe flow; Pressure distribution; Stenosis; Cardiovascular disease; Review; Velocity distribution; Arterial disease; Vascular disease; Atherosclerosis; Medical imagery; Hemodynamics; Stream line; Branching pipe; Secondary flow; Curvature
• ISSN: 0066-4189; 1545-4479
• DOI: 10.1146/annurev.fluid.32.1.347

The relationship between flow in the arteries, particularly the wall shear stresses, and the sites where atherosclerosis develops has motivated much of the research on arterial flow in recent decades. It is now well accepted that it is sites where shear stresses are low, or change rapidly in time or space, that are most vulnerable. These conditions are likely to prevail at places where the vessel is curved; bifurcates; has a junction, a side branch, or other sudden change in flow geometry; and when the flow is unsteady. These flows, often but not always involving flow separation or secondary motions, are also the most difficult ones in fluid mechanics to analyze or compute. In this article we review the modeling studies and experiments on steady and unsteady, two-and three-dimensional flows in arteries, and in arterial geometries most relevant in the context of atherosclerosis. These include studies of normal vessels-to identify, on the basis of the fluid mechanics, lesion foci-and stenotic vessels, to model and measure flow in vessels after the lesions have evolved into plaques sufficiently large to significantly modify the flow. We also discuss recent work that elucidates many of the pathways by which mechanical forces, primarily the wall shear stresses, are transduced to effect changes in the arterial wall at the cellular, subcellular, and genetic level.