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Biomechanical Systems: Techniques & Applications, Vol. IV, Biofluid Methods in Vascular & Pulmonary Systems
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Cornelius T. Leondes
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Approximately one-quarter million United States citizens each year undergo either carotid endarterec-tomy for stroke prevention or lower extremity bypass to regain the ability to walk. These arterial reconstructions, as well as others, involve complex flows in branching blood vessels. Both early and late operative failures are due in part to the non-uniform hemodynamics, or disturbed flow related to the reconstruction geometry and its particular flow input waveform.
Optimization of the arterial reconstruction of carotid endarterectomies and anastomotic bypass grafts to minimize blood flow disturbances may be crucial in significantly reducing the probability and degree of early postoperative thrombosis and restenosis due to myointimal proliferation and recurrent atherosclerosis. These adverse events can lead to stroke or limb loss and associated disability or mortality.
Patient-derived risk factors that influence clinical outcomes of vascular surgical procedures can be favorably modified or controlled, but this lies outside the scope of this review. We have analyzed the effects of geometry and input waveform on disturbed flow in these two arterial systems and have completed work on the theoretical optimization of the branching blood vessel geometries. The methodology has been established, and an extended analysis of computationally derived junction geometries employing available graft material for clinical testing is being initiated.
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