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研究生：	蘇峻民 Su, Chun-Min
論文名稱：	三維動脈繞道流場之計算研究 Three-Dimensional Flow Computations for Arterial Bypass
指導教授：	李定智 Lee, Denz
學位類別：	博士 Doctor
系所名稱：	工學院 - 航空太空工程學系 Department of Aeronautics & Astronautics
論文出版年：	2005
畢業學年度：	93
語文別：	英文
論文頁數：	171
中文關鍵詞：	動脈繞道、吻合術、內膜增生、血液動力學、壁面剪應力、數值模擬
外文關鍵詞：	hemodynamics, intimal hyperplasia, arterial bypass, anastomosis, wall shear stress, numerical simulation
相關次數：	點閱：94 下載：4
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　　臨床上在治療阻塞性的主動脈病變時，動脈繞道手術是目前普遍應用且有效的方法之一。然而，其長短期的成功率一直無法有效地提高，短期上由於血栓形成，長期上則肇因內膜增生，以致最後必須再重複接受手術治療。在這由管壁內膜增厚導致繞道手術失敗的過程中，血液動力學因子已廣被接受為扮演重要的角色。本研究的目的，在於發展一套實用且可靠的計算工具以用來探討與動脈繞道相關的血液動力學環境，並期能據以提供較佳治療方式的參考。

　　在數值模擬的方法中，利用邊界契合座標系統及區域式格點法來處理複雜幾何外形。採用協變速度作為動量方程式的相依變數及非交錯式的格點配置，並以動量內插法求得控容面上的速度。程式並引入以MPI做為資料傳輸協定的個人電腦叢集平行運算，以減少計算所需的時間。

　　研究中所廣泛探討的外形為一完整的動脈繞道系統，包含部份或完全阻塞的主管，以及彎曲的繞道管。在初步的穩態流場探討中，進行了一系列的參數測試，包括雷諾數、吻接角度、阻塞位置，以及近端分流比率；各參數皆顯示出對流場獨特的影響。文中並闡述了繞道管的曲率以及插接處之兜帽外形對流場的作用。

　　本文接下來進一步考慮動脈繞道的三維特徵。首先藉由在繞道管的兩吻接處間引進一扭轉角度，對非平面的幾何特性進行系統性的探討，並發現在螺旋狀的繞道管中引致的轉動慣量明顯地改變了末端插接處下游的流場。其次則針對部分阻塞的動脈，透過考慮包括軸對稱與非對稱的動脈狹窄型態，闡明了主管面積縮減比例、栓塞結構的非對稱性及其在主管中相對於繞道管的位置關係等因素對流場的影響。本研究最後採用股骨動脈處之脈動波形及一經修改而使波峰較為和緩的變異波形，模擬動脈繞道的脈動流場。計算結果揭露了流場動態的本質及複雜的結構，並顯示出低且震盪之剪應力與內膜增生間可能的關連性。此外，比較結果亦指出若脈動波形呈現出高度震盪的特性，相應的穩態流場觀察對提供血液動力學的瞭解有其侷限性。

　Graft-bypass surgery is at present a routine and effective revascularization procedure for occlusive arterial diseases. However, the long-term success of vascular grafts is often limited by the progression of intimal hyperplasia. Hemodynamics has now been widely accepted to play an important role in this pathological proliferation and subsequent graft failure. In hopes of providing insights towards better treatments, this thesis presents a practical and reliable computational tool to investigate the hemodynamic environment associated with arterial bypasses.

　The numerical simulation techniques involve a boundary-fitted coordinate system and the zonal grid approach to deal with complex geometries. The covariant velocity components were selected as the dependent variable for the momentum equations, while the non-staggered grid arrangement together with a momentum interpolation scheme in obtaining cell-face velocities were employed. A PC cluster based parallel computing using MPI (message passing interface) for message-passing was embedded to reduce the time required for computations.

　Flow in a complete arterial bypass system, which consists of a stenosed/occluded host artery and a curved bypass graft, was comprehensively studied. Parameters involved in the preliminary steady flow investigation include the inlet Reynolds number, anastomotic angle, occlusion site and proximal outflow division, while the distinct effect of each was elucidated. The influences of the bypass curvature and graft hood were also addressed.

　Further three-dimensional features of the arterial bypass were then considered. The out-of-plane characteristics were examined systematically by introducing a twist angle on the bypass tube between the two anastomotic junctions. The rotational inertia established in the helical graft was found to markedly affect the downstream flow filed. Another geometric aspect of the bypass system elaborated was the morphology of the stenosis in a partially obstructed artery. By considering both axisymmetric and asymmetric stenoses, the effects of area reduced in the host artery, stenosis asymmetry and the locality of an asymmetric stenosis with respect to the bypass graft on the flow field were demonstrated. Finally, the pulsatile flow fields in an arterial bypass were illustrated using a femoral artery flow waveform as well as its modification. Results revealed the dynamic nature and complicated structures of pulsatile flow fields, and suggested a possible correlation between low and oscillating shear and the development of intimal hyperplasia. Moreover, comparison indicated that steady flow observations have limited capability in providing insights if the pulsatile waveform is highly oscillatory.

CONTENTS

ABSTRACT............................................................................................................i

ACKNOWLEDGMENTS IN CHINESE................................................................iii

EXTENDED CHINESE ABSTRACT....................................................................iv

CONTENTS.........................................................................................................xii

LIST OF TABLES................................................................................................xv

LIST OF FIGURES.............................................................................................xvi

NOMENCLATURE............................................................................................xxi

CHAPTER Ⅰ 
  INTRODUCTION..................................................................................................1
1.1 Background.....................................................................................................1
1.2 Review of Previous Works..............................................................................5
1.3 Specific Topics and Contributions.................................................................10
1.4 Organization..................................................................................................11

CHAPTER Ⅱ 
GOVERNGING EQUATIONS AND NUMERICAL METHODS.........................12
2.1 Governing Equations.....................................................................................13
2.2 Coordinate Transformations...........................................................................14
2.3 Numerical Formulations.................................................................................17
2.3.1 Finite Volume Discretization.......................................................................17
2.3.2 Discretized Momentum Equations with Covariant Velocity Components....20
2.3.3 The Momentum Interpolation Scheme.........................................................21
2.3.4 The Solution Algorithm...............................................................................25
1. The First Pressure Correction Equation.............................................................26
2. The Second Pressure Correction Equation........................................................27
3. Solution Algorithm...........................................................................................28

CHAPTER Ⅲ 
GRIDDING TECHNIQUES AND COMPUTATION PROCEDURES...................30
3.1 Zonal Grid Approach.....................................................................................30
3.1.1 Continuous (Aligned) Grid Lines................................................................31
3.1.2 Overlapped Grid Technique........................................................................31
3.2 Grid Generation of Arterial Bypass................................................................32
3.3 Interface Treatments of Arterial Bypass.........................................................34
3.3.1 The Proximal Bifurcation............................................................................34
3.3.2 The Distal Anastomosis..............................................................................36
3.3.3 The Stenosis...............................................................................................36
1. The Validation.................................................................................................37
2. The Grid Overlapping......................................................................................38
3.4 Parallel Computing Using MPI.......................................................................40
3.5 The Overall Computation Procedure..............................................................42

CHAPTER Ⅳ 
HEMODYNAMICS IN AN ARTERIAL BYPASS: 
PRELIMINARY STEADY FLOW RESULTS.......................................................43
4.1 Code Validation.............................................................................................43
4.1.1 Flow in a Stenosed Artery...........................................................................44
4.1.2 Flow in a Distal End-to-Side Anastomosis..................................................45
4.2 Planar Bypass of Fully Occluded Artery........................................................47
4.2.1 Baseline Model...........................................................................................49
1. Distal End-to-Side Anastomosis vs. Complete Arterial Bypass........................52
2. The Influence of the Graft Hood......................................................................53
4.2.2 Effects of Flow Rate....................................................................................55
4.2.3 Effects of Anastomotic Angle.....................................................................56
4.2.4 Effects of Occlusion Site.............................................................................58
4.2.5 Effects of Proximal Outflow Division.........................................................58
4.2.6 Summary....................................................................................................59

CHAPTER Ⅴ 
HEMODYNAMICS IN AN ARTERIAL BYPASS: 
NON-PLANARITY, ASYMMETRY AND UNSTEADINESS..............................61
5.1 Non-Planar Bypass of Fully Occluded Artery................................................61
5.1.1 Physical Problem........................................................................................62
5.1.2 Velocity Pattern..........................................................................................63
5.1.3 Wall Shear Stress Distribution.....................................................................66
5.2 Bypass of Partially Occluded Artery..............................................................67
5.2.1 Physical Problem........................................................................................68
5.2.2 Velocity Pattern..........................................................................................69
5.2.3 Wall Shear Stress Distribution.....................................................................72
5.2.4 Bypass Ratio and Pressure Drop.................................................................74
5.3 Pulsatile Flow in an Arterial Bypass...............................................................75
5.3.1 Physical Problem.........................................................................................75
5.3.2 Velocity Pattern...........................................................................................76
5.3.3 Wall Shear Stress Distribution......................................................................78
5.3.4 Effects of Waveform Modification...............................................................80
5.4 Summary........................................................................................................82

CHAPTER Ⅵ 
CONCLUDING REMARKS.................................................................................85
6.1 Summary of Thesis.........................................................................................85
6.2 Recommendations for Future Work................................................................88

APPENDIX 
MODEL CONSTRUCTION FOR NON-PLANAR BYPASS.................................90

REFERENCES......................................................................................................92

TABLES.............................................................................................................101

FIGURES...........................................................................................................105

PUBLICATION LIST.........................................................................................170

VITA..................................................................................................................171
                                    

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