Boundary Condition Options for Carotid Bifurcation Analysis, Using Doppler Velocity Measurements

Abstract

The Common Carotid Artery plays a vital role in supplying the brain, and its bifurcation is susceptible to vascular diseases. It is often analyzed using computational fluid dynamics (CFD) simulations, but it is challenging to prescribe boundary conditions that approach patient-specific flow conditions. We examined six boundary condition (BC) groups to determine the most accurate flow conditions aligning with available measured data. We conducted CFD simulations on a stenotic carotid bifurcation, using patient-specific Doppler ultrasound sonography velocity measurements at the inlet and both outlets. Three BC methods used defined inlet flow rate and either constant pressure (Basic), Windkessel model, or constant flow ratio (Murray) at the outlets. Three other methods were defined with flow rates at two boundaries and constant pressure at the third one. Defining two boundary flow rates shows the closest results to physiologically valid data. However, the difficult Doppler measurements on the outlet branches can inaccurately amplify velocity amplitudes and may detect a false flow direction. Therefore, cross-sectional corrections were implemented to fit the outlet and inlet flow rates, while keeping the measured velocity histories.
Our results show that the Murray and Basic methods, while easily available, exclude carotid-specific flow conditions by disregarding downstream flow resistances. We conclude that a Windkessel-method can produce the most accurate results without forcing outflow conditions. However, usually unavailable measurements are necessary for its application. Simulations with outlet-defined volume flow can also produce physiologically valid solutions but require the application of cross-sectional geometry correction.