Review of the Development of Haemodynamic Modelling Techniques to Capture Flow Behaviour in Arteries Affected by Aneurysm, Atherosclerosis and Stenting.

Cardiovascular diseases (CVDs) are the leading cause of death in the developed world. CVD can include atherosclerosis, aneurysm, dissection or occlusion of the main arteries. Many CVDs are caused by unhealthy haemodynamics. Some CVDs can be treated with the implantation of stents and stent grafts. Many investigations have sought to understand the effects stents and stent grafts have on arteries and the haemodynamic changes post-treatment. Many studies on stent haemodynamics have been carried out using Computational Fluid Dynamics (CFD), and have yielded significant insight into the effect of stent mesh design on near wall blood flow and improving haemodynamics. Particle Image Velocimetry (PIV) has also been used to capture behaviour of fluids that mimic physiological haemodynamics. However, PIV studies have largely been restricted to unstented models or intra-aneurysmal flow rather than peri or distal stent flow behaviours. PIV has been used both as a standalone measurement method and as a comparison to validate the CFD studies. This article reviews the successes and limitations of several experimental methods used to investigate the haemodynamic effects of stents. The review includes an overview of physiology and relevant mechanics of arteries as well as consideration of boundary conditions and the working fluids used to simulate blood for each modelling method along with the benefits and limitations introduced.