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Purpose. Atherosclerosis is a diseased condition of blood vessel. It causes partial blockage in lumen of vessel and affects hemodynamic of localized flowing blood. Complex geometries like region of bifurcation also affects hemodynamic to a larger extent. Complexity further increases in presence of stenoses at region of bifurcation. Such morphological change in vessel largely affects parent as well as corresponding sister and daughter vessels. In this paper, complexity in hemodynamic of blood in pair of carotid arteries (left and right carotid arteries) is evaluated in presence of stenoses at basilar segment of right artery in three-dimensional domain using reconstructed tomographic images of patient. Methods. Transient information of blood flow is obtained using four-dimensional phase-contrast MRI technique. Haematocrit component of blood at diseased condition is considered using Power Law and Quemada model. Numerical techniques are used to solve pressure-coupled governing equations of flowing blood. Results. Dysfunctions of endothelial cells near the wall are characterised by evaluating shear stress markers. Wall shear stress and its gradient based and harmonic based descriptors are calculated over complete geometry during one cardiac cycle. Conclusion. Internal branch of left carotid artery and external branch of right carotid artery are found prone to secondary stenoses in presence of primary stenoses at basilar segment of right carotid artery. [ABSTRACT FROM AUTHOR]

Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context. Methods. A comprehensive search of literature employing electronic as well as manual sources and screening 2783 papers published between Jan 1980 and Oct 2015 was conducted to collect, identify, and analyze relevant information through peer-reviewed research articles, systematic reviews, and other published works. The cardiovascular events, including accelerated atherosclerotic cardiovascular disease (ASCVD), stroke, heart failure, myocardial infarction, myocardial ischemia, and stress induced myocardial dysfunction, leading to death were considered relevant. Results. A total of 23 published articles met the inclusion criteria and were included for in-depth review and analysis to finalize a comprehensive systematic review article. All the studies showed a significant association between the blood pressure and cardiovascular disease events in hemodialysis patients. Conclusions. Both intradialytic hypertension/hypotension episodes are major risk factors for cardiovascular mortality with a high percentage of probable causality; however, clinicians are faced with a dilemma on how to evaluate blood pressure and treat this condition. [ABSTRACT FROM AUTHOR]

This paper presents an ultrasound simulation model for pulsatile blood flow, modulated by the motion of a stenosed vessel wall. It aims at generating more realistic ultrasonic signals to provide an environment for evaluating ultrasound signal processing and imaging and a framework for investigating the behaviors of blood flow field modulated by wall motion. This model takes into account fluid-structure interaction, blood pulsatility, stenosis of the vessel, and arterial wall movement caused by surrounding tissue’s motion. The axial and radial velocity distributions of blood and the displacement of vessel wall are calculated by solving coupled Navier-Stokes and wall equations. With these obtained values, we made several different phantoms by treating blood and the vessel wall as a group of point scatterers. Then, ultrasound echoed signals from oscillating wall and blood in the axisymmetric stenotic-carotid arteries were computed by ultrasound simulation software, Field II. The results show better consistency with corresponding theoretical values and clinical data and reflect the influence of wall movement on the flow field. It can serve as an effective tool not only for investigating the behavior of blood flow field modulated by wall motion but also for quantitative or qualitative evaluation of new ultrasound imaging technology and estimation method of blood velocity. [ABSTRACT FROM AUTHOR]