The hemodynamic effects of in-tandem carotid artery stenosis: implications for carotid endarterectomy.

OBJECTIVES: It remains controversial whether patients with severe disease of the internal carotid artery and a coexisting stenotic lesion downstream would benefit from a carotid endarterectomy (CEA) of the proximal lesion. The aim of this study was to simulate the hemodynamic and wall shear effects of in-tandem internal carotid artery stenosis using a computational fluid dynamic (CFD) idealized model to give insight into the possible consequences of CEA on these lesions. METHODS: A CFD model of steady viscous flow in a rigid tube with two asymmetric stenoses was introduced to simulate blood flow in arteries with multiple constrictions. The effect of varying the distance between the two stenoses, and the severity of the upstream stenosis on the pressure and wall shear stress (WSS) distributions on the second plaque, was investigated. The influence of the relative positions of the two stenoses was also assessed. RESULTS: The distance between the plaques was found to have minimal influence on the overall hemodynamic effect except for the presence of a zone of low WSS (range -20 to 30 dyne/cm2) adjacent to both lesions when the two stenoses were sufficiently close (<4 times the arterial diameter). The upstream stenosis was protective if it was larger than the downstream stenosis. The relative positions of the stenoses were found to influence the WSS but not the pressure distribution. CONCLUSIONS: The geometry and positions of the lesions need to be considered when considering the hemodynamic effects of an in-tandem stenosis. Low WSS is thought to cause endothelial dysfunction and initiate atheroma formation. The fact that there was a flow recirculation zone with low WSS in between the two stenoses may demonstrate how two closely positioned plaques may merge into one larger lesion. Decision making for CEA may need to take into account the hemodynamic situation when an in-tandem stenosis is found. CFD may aid in the risk stratification of patients with this problem.

Multi-dimensional conditional moment closure modelling applied to a heavy-duty common-rail diesel engine

A multi-dimensional combustion code implementing the Conditional Moment Closure turbulent combustion model interfaced with a well-established RANS two- phase flow field solver has been employed to study a broad range of operating conditions for a heavy duty direct-injection common-rail Diesel engine. These conditions include different loads (25%, 50%, 75% and full load) and engine speeds (1250 and 1830 RPM) and, with respect to the fuel path, different injection timings and rail pressures. A total of nine cases have been simulated. Excellent agreement with experimental data has been found for the pressure traces and the heat release rates, without adjusting any model constants. The chemical mechanism used contains a detailed NOx sub-mechanism. The predicted emissions agree reasonably well with the experimental data considering the range of operating points and given no adjustments of any rate constants have been employed. In an effort to identify CPU cost reduction potential, various dimensionality reduction strategies have been assessed. Furthermore, the sensitivity of the predictions with respect to resolution in particular relating to the CMC grid has been investigated. Overall, the results suggest that the presented modelling strategy has considerable predictive capability concerning Diesel engine combustion without requiring model constant calibration based on experimental data. This is true particularly for the heat release rates predictions and, to a lesser extent, for NOx emissions where further progress is still necessary. © 2009 SAE International.