Research Article

Hemodynamic and fluid flow analysis of a cerebral aneurysm: a CFD

simulation
Ahmed G. Rahma1 · Talaat Abdelhamid1

Received: 30 June 2022 / Accepted: 3 January 2023

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023  OPEN

Abstract
In this study, we investigate the hemodynamics parameters and their impact on the aneurysm rupture. The simulations
are performed on an ideal (benchmark) and realistic model for the intracranial aneurysm that appears at the anterior
communicating artery. The realistic geometry was reconstructed from patient-specific cerebral arteries. The computa-
tional fluid dynamics simulations are utilized to investigate the hemodynamic parameters such as flow recirculation,
wall shear stress, and wall pressure. The boundary conditions are measured from the patient using ultrasonography. The
solution of the governing equations is obtained by using the ANSYS-FLUENT 19.2 package. The CFD results indicate that
the flow recirculation appears in the aneurysms zone. The effect of the flow recirculation on the bulge hemodynamics
wall parameters is discussed to identify the rupture zone.

Highlights • The flow-wall interaction due to the flow recirculation

produce uneven variation in the wall shear stress (WSS),
• The presence of the aneurysms in the patient’s vascular
which help to investigate the region of the rupture.
system leads presence of a flow vortex inside the bulge.
• The wall pressure and the wall shear stress have a quali-
The flow recirculation occurs due to separation at the
tative similarity in their behavior.
rear edge of the aneurysm.

Keywords Hemodynamics · Intracranial aneurysms · Computational fluid dynamics · Flow recirculation · Wall shear
stress

1 Introduction stress (WSS) [7–9]. These simulations are done using two
different branches complementing each other. These two
Hemodynamic analysis of the vascular systems of the branches are based on the used computational domain
patients introduced a significant value to understand and (Model) [10, 11], the benchmarks (simplifies models)
diagnose its diseases [1, 2] such as stenosis [3], aneurysms [12–14] and the realistic models (based on a patient-spe-
[4] (such as fusiform [5], saccular, false and dissection types cific vascular system) [15–17]. Cebral et al. evaluated the
[6]), and angiosclerosis. The computational fluid dynam- realistic flow passes reconstructed from Digital Subtrac-
ics (CFD) simulations for the hemodynamic analysis are tion Angiography (DSA) to present the blood flow struc-
used to investigate various parameters such as the flow ture in an intracranial aneurysm (saccular aneurysm type).
structure, recirculation flow, wall pressure, and wall shear The DSA obtained from 15 patient’s cerebral arteries with

* Talaat Abdelhamid, [email protected] | 1Physics and Mathematical Engineering Department, Faculty

of Electronic Engineering, Menoufiya University, Menouf 32952, Egypt.

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15 cerebral aneurysms. Their obtained results show a simi- for the WSS and the wall pressure. The patient under an
larity with the DSA and the CFD reaches 78% [18]. Xiang exercise state has a high blood flow velocity which leads
et al. investigated the hemodynamics role in the rupture to an increase in the recirculation flow, wall pressure, and
of the intracranial aneurysms. The results show that the the WSS within the aneurysm [29]. Islami et al. performed
CFD simulation models are accurate to predict the intrac- a CFD study of the blood flow inside a simplified model of
ranial aneurysm risk assessment in case of availability of treated cerebral aneurysms with flow diverter stents (FDS).
actual database [19]. Bauer et al. investigated the WSS of The numerical simulations were done on a simplified mod-
an aneurysm (Fusiform aneurysms type) using two dif- els of the carotid artery (one with FDS and one without).
ferent flow regimes. The flow regimens implemented the The simulations are conducted at Re = 500, with specific
pulsatile flow regime and the transitional regime. Besides mass 1050 kg.m−3. The blood described as incompressible
the CFD, the experimental work was done using magnetic Newtonian fluid with viscosity model (Carreau model).
resonance velocimetry (MRV) and laser Doppler veloci- The results show enhancement for the flow patterns in
metry (LDV). The results of the CFD and the LDV show an the case with the FDS, which lead to expedite occlusion
excellent similarity. The WSS temporal and spatial distribu- of the cerebral aneurysm. Enhancement the flow patterns
tion is highly affected by the vortex formation, where the lead to reduce the flow recirculation, wall pressure, and
maximum value of the WSS is located at the zone where the WSS [30]. Souza et al. conducted a numerical study on
the vortex is initialized. A laminar flow is shown at the an intracranial aneurysms model to investigate the blood
undilated zone and transitional zone (laminar-turbulent) flow and structure beside other parameters such as the
at the aneurysm [20]. wall’s mechanical behavior. These parameters have the
Investigation the effect of the blood flow parameters main influence on the aneurysm’s rupture. The CFD simu-
such as the flow recirculation, wall pressure, and WSS on lations were done for the same model with four different
the hemodynamics of the vascular diseases is an important Re values (1, 100, 500, and 1000). The problem is imple-
issue [21]. Iimuro et al. conducted a numerical simulation mented using the commercial software Fluent, Ansys 2020
for the portal venous system aneurysms that appears in R2. The results of the investigations show that the flow
75-years woman patient. The simulations were performed recirculation at the aneurysms appears with increasing the
using ANSYS FLUENT package software. The simulations Re value. Furthermore, the WSS, displacement, and strain
are conducted at blood flow rate 1000 mL/min. The results have a maximum value at the highest Re [31].
show presence of recirculation flow (turbulences) inside In this paper, numerical simulations were performed
the aneurysms, and the WSS increased at the wall of the for the intracranial aneurysms (IA) at anterior communi-
aneurysms. The presence of these parameters could lead cating artery. The remainder of the paper is organized as
to creating thrombosis or rupture of the aneurysms [22]. follows: In Sect. 2, the problem description, and the sys-
The intracranial aneurysms (IA) are dilations (bulge) in tem of incompressible Navier–Stokes equations with a
the intracranial arteries vessel due to the blood vessel wall fully implicit finite element discretization are presented.
weakness. These cases appears in range of 0.5–6% for the Furthermore, the validation with the literature review is
population worldwide [23–25]. The rupture of the intrac- presented. The CFD studies were done using the commer-
ranial aneurysms (IA) happen for approximately 0.25% of cial package Ansys Fluent 19.2 to investigate the blood
these IAs. About 60% of these rupture cases could face flow parameters such as the WSS, wall pressure, and flow
death [26, 27]. Shishir et al. investigated the blood flow recirculation in Sect. 3. Moreover, the simulation is con-
dynamics in a human arterial with a saccular aneurysm at ducted on a simplified geometry (benchmark) of the IA,
the bend. The CFD simulations were done for simplified then the simulations upgraded to consider an actual brain
models with different aneurysm diameters varying from aneurysm at the anterior communicating artery recon-
5 to 8 mm. The simulations are conducted at Re = 110— structed from the MRI. Some concluding remarks are given
850, specific mass = 1008 kg.m−3, blood flow rate 3.6 mL/s, in Sect. 4.
velocity value = 0.2365 m/s, and viscosity of 0.0035 N/m2s2.
The problem implemented using the Ansys CFD Fluent.
The obtained results from the CFD study show that the 2 Numerical methods
recirculation flow (vortex) that appears in the aneurysm
zone is affected by the size of the aneurysm [28]. Usmani 2.1 Problem description
and Patel conducted a numerical simulation of a healthy
and a patient’s cerebral artery with a saccular aneurysm. The CFD simulations in this work are consist of two differ-
The simulation is done under exercise and rest states. The ent segments complement each other, as shown in the
results show that the interaction of recirculated flow with Fig. 1. The segment one is an investigation for the flow
the wall of the aneurysm presents abnormal distribution

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Build a simplified geometry of the intracranial

aneurysms (IA) (benchmark).
Segment one

Segment two

MRI of a patient with brain aneurysm at

Meshing using ICEM CFD 19.2 software.
anterior communicating artery

The boundary
Build a model for the aneurysm from the MRI Conduct a CFD simulation on the benchmark conditions Use a boundary conditions from the
using SimVascular software. using Ansys fluent 19.2 software. literature review.

Validation and ensure

the correctness of the
methodology adopted

Conduct a CFD simulation on the realistic Obtain the results

Post processing for the CFD data using
Meshing using ICEM CFD 19.2 software. model of the aneurysm using Ansys fluent 19.2
Tecplot 360 and OriginPro 8.5 softwares.
software.

The boundary conditions

Measure the blood flow velocity profile at the

inlet and the pressure profile at the outlet by
ultrasonography.

Fig. 1  Flow chart for CFD simulations of the blood flow in the brain aneurysm at anterior communicating artery

parameters of a simplified model of the IA (benchmark). MRI using SimVascular software. The boundary conditions
The model is reconstructed and studied at boundary con- used for the simulation such as the velocity profile at the
ditions based on the data from the literature [31]. In the inlet and the pressure profile at the outlet are obtained by
segment two, an evaluation for the same parameters for ultrasonography. The computational studies for both seg-
a realistic model of an actual brain aneurysm at anterior ments are conducted to present the blood hemodynamics
communicating artery. The model reconstructed from the with similar CFD model adjustments, with changing the

(c) A

Flow

(d) (b) A

10

(a)
(mm)
5

0
0 10 20 30 40 50
(mm)

Fig. 2  a Schematic of the computational domain (the intracranial aneurysms (IA) benchmark model), b The computational mesh of the con-
sidered model, c Zoomed in view of the intracranial aneurysms mesh, and (D) Section A-A, Side view

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velocity inlet, pressure outlet profile, and the geometry of Table 2  Numerical values for 𝜇∞(Pa.s) 𝜇0 n 𝜆 (s)
the computational domain. the Carreau model
1.0 0.436 0.36 3.3
2.2 Governing equations and physical model

Steady-state three-dimensional CFD computations 𝜇 = H(t)(𝜇∞ + (𝜇0 − 𝜇∞ )[1 + 𝛾 2 𝜆2 ]

n−1
2 ) (5)
were performed for the considered geometry shown in
Figs. 2a, 8. Differential equations governing the blood where H(t) is the temperature dependence, known as the
flow are given as in [32, 33]. The blood motion was gov- Arrhenius law.
erned by Navier–Stokes equations in the laminar flow ( ) ( )
condition as: H(t) = exp[𝛼
1
−
1
] (6)
T − T0 T𝛼 − T0
Δ(𝜌u) = 0 (1)
where 𝛼 is the ratio of the activation energy to the ther-
𝜕p modynamic constant and T𝛼 is a reference temperature for
Δ(𝜌uu) = − + Δ(𝜇∇u) (2) which H(t) = 1. The T0 is the temperature shift, is set to 0 by
𝜕x
default, and corresponds to the lowest temperature that is
𝜕p thermodynamically acceptable. The λ is the time constant.
Δ(𝜌uv) = − + Δ(𝜇∇v) (3) In the current work, the simulations done in the two
𝜕y
segments using the commercial package Ansys Fluent 19.2
software [33] to solve the governing differential equations
𝜕p in the three-dimensional computational domain. The Re
Δ(𝜌uw) = − + Δ(𝜇∇w) (4)
𝜕z used is less than 2300, which means that the flow is lami-
where u, v, w are the blood flow velocities in x, y, z coordi- nar. Second-order upwind schemes are used for all conser-
nates, respectively. The blood flow 𝜌 is the blood specific vation equations. The pressure–velocity coupling used a
mass while pressure defined as P . It is assumed that blood coupled scheme, and the pressure is calculated with the
can be described as incompressible non-Newtonian fluid second-order scheme. That coupling scheme solves the
with viscosity model (Carreau model) and specific mass 𝜌 momentum and pressure-based continuity equations
of 1063 kg/m3. The wall of the blood vessels supposed to together. The pseudo transient for fluid and solid zones are
be rigid with no slipping ratio as shown in Tables 1 and 2 0.7 and 1.0, respectively. The pseudo transient scheme is
for the blood properties and Carreau model [31, 34]. It is used to accomplish strong convergence which is favorable
noted that the Carreau fluid model treats the Newtonian for the complicated flow of the blood.
fluid (blood flow in the present case). This means, at low
shear rate the Carreau fluid model behaves as a Newtonian 2.3 Mesh
fluid model and at high shear rate behaves as a power law
fluid. So, it is recommended for the blood artery simulation A grid independence study is performed to ensure the
for accurate prediction [35]. It is noted that shear-thinning computational results and the generated mesh is shown
and wall shear stress with resistive impedance and their in Figs. 2b, c, d, and 8e. For the segment one, 522,323 tet-
growth are successfully captured by using the Carreau rahedral mesh used for grinding the IA benchmark. For the
fluid model. These assumptions account for the rigid wall segment two, 722,724 tetrahedral mesh used for grinding
model prescribed in the present simulation. The Carreau the realistic aneurysm model. The size and number of ele-
flow model equations can be found as follows [33]. ments used obtained from CFD study at the literature [10].
For all meshes at the segment one and two, the mesh was
refined and y+ is approximate 1.

Table 1  Blood flow properties used for the intracranial aneurysms

(IA) benchmark model Table 3  The pressure drop Reference Pin − Pout
Properties Value (Unit) across the intracranial
aneurysms benchmark model, Souza et al. 726.120 (Pa)
Specific mass 1063 (Kg.m−3) in comparison of the published (2022) [31]
results
Entrance velocity 888 (mm/s) Present 749.802 (Pa)
Outlet pressure (Gauge) 0 (Pa Gauge) Error (%) 3.15

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Fig. 3  The distribution wall pressure for the intracranial aneurysms (IA) benchmark model at inlet velocity flowrate = 888 mm/s, for a the
published results in [31], and b present work

2.4 Validation 3.1.1 The pressure distribution

The results obtained from the CFD simulation validated In Figs. 3 and 4, the value of the wall pressure decreased in
the literature results [31]. In Table 3, the pressure drop the direction of the blood flow except for the aneurysms
across the IA benchmark model in the present work zone. The value of the wall pressure at the beginning
shows a 3.261% error by comparing it with the literature of that zone remain constant due to the present of the
[31]. Moreover, Fig. 3 shows visual aid for the validation recirculation flow inside the aneurysms. The flow starts to
of the results, which report the wall pressure contours reverse at the rear edge region of the aneurysms as result
of the present and the literature studies. This validation of the flow-wall interaction at that zone. The interaction
grantee that the present CFD simulations are capable to with the edge and the surrounding wall lead to increase
evaluate the hemodynamics, especially for the aneurysm. the wall pressure value.
The relative error between the obtained pressure differ-
ence and that of the literature Souza et al. [31], is given by 3.1.2 The flow structures
|749.802−726.120|
726.120
∗ 100 = 3.15%.
The blood flow velocity have a significant impact on the
presence of the recirculation flow, which by increasing the
3 Results and discussions velocity the presence of flow recirculation will be noted
[29, 31]. In Fig. 5, two types of flow regimes appeared.
3.1 Segment one, Results for the simplified IA The laminar flow regime appeared close to the inlet and
(benchmark) model the outlet of the vessel, and the recirculation flow (vor-
tex formation) appeared close and inside the bulge. The
In this part, a comprehensive investigation for the blood recirculation flow in the aneurysms zone presented due to
flow parameters such as the wall pressure, recirculation using high flow velocity (888 mm/s). The flow recirculation
flow, and the WSS within IA model are presented. presented due to separation at the aneurysms rear edge.

1000

800
)
Wall pressure (Present) (

600

400

200

Pressure ( )
0
0 10 20 30 40 50
(a) (mm) (b)

Fig. 4  Wall pressure magnitude profile a along x axis and b xy section of pressure contour

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Fig. 5  3D velocity streamlines for the intracranial aneurysms (IA) benchmark model, which show the recirculation of the flow at aneurysms

1.4

1.2 Velocity ( )

1.0
)

0.8
Velocity (

0.6

0.4

0.2

0.0
0.0000 0.0029 0.0058 0.0087 0.0116

(a) (m) (b)

Fig. 6  a Absolute velocity profiles at three different regions for the intracranial aneurysms (IA) benchmark model b Three cutting planes cor-
responding to the curves in (a), respectively

In Fig. 6, three absolute velocity profiles with y axis at wall pressure distribution shown in Figs. 3 and 4. The value
three cutting. The three cutting in the x direction show the of the WSS decreased in the flow direction except for the
velocity magnitude contour at different positions (inlet, bulge zone. The value of the WSS at the beginning of the
outlet, and the aneurysms). The velocity profile at the inlet aneurysms zone remain constant due to the presence of the
and the outlet shows a symmetric distribution around the recirculation flow. The value of the WSS increases at the out-
center of the cylinder y axis. The flow profile at the inlet has let of the bulge due to the flow interaction and separation
a developing velocity profile, and that ensure the method- at the rear edge.
ology adopted, which the flow inlet have a plug velocity
boundary condition. The velocity profile at the outlet has a 3.2 Segment two, results for the realistic model
fully developed velocity profile. The present of the saccular of an actual brain aneurysm at anterior
aneurysm leads to change in the velocity profile symmetry. communicating artery
The right side of the aneurysm velocity profile shows that
the velocity value decreased comparing to the velocity at In this part, a CFD simulation are done on a realistic model
the center of the cylinder. The absolute value of the velocity of an actual brain aneurysm at anterior communicating
magnitude increased at the y axis range of (6 mm—9 mm), artery reconstructed from the MRI of patient specific artery
which indicate to the core of the vortex formation. as shown in Fig. 8. The computational domain recon-
structed using the SimVascular software as discussed in
3.1.3 The wall shear stress (WSS) the methodology. The size of the aneurysm is 9.91 mm,
6.62 mm, and 8.082 mm in yz , xy , and xz planes, respec-
The wall shear stress around the bulge was investigated in tively. The change of the cross section from the main ves-
Fig. 7. The behavior of the WSS is qualitatively similar for the sel branch to the aneurysm have a significant increasing

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60

50 WSS ( )

40

30
)
WSS (

20

10

-10
0 10 20 30 40 50

(a) (mm) (b)

Fig. 7  a Wall shear stress (WSS) magnitude profile b Wall shear stress (WSS) magnitude distribution along the intracranial aneurysms (IA)
benchmark model, respectively

(b)

(a)

(c)

(d) (e)

Fig. 8  a The computational domain, b, c side view of the computational domain at yz , xy planes, respectively, d Zoomed in view for the
brain aneurysm at anterior communicating artery, and (e) a magnified view of the computational mesh

which approximately 200% in the yz plane, as shown in used at the segment one. The boundary conditions of
Fig. 9. the simulation based on measured values of the blood
Furthermore, at segment two the inlet velocity and flow velocity profile at the inlet and the pressure profile
the outlet pressure profiles are different than the ones at the outlet by ultrasonography as shown in Figs. 10 and

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Line 1 ( plane)

6.62 mm Line 2 ( plane)

9.91 mm
Line 3 ( plane)

(xy plane) (yz plane)

8.082 mm

4.96 mm

(xz plane)

(a) (b)

Fig. 9  a The size of the aneurysm in the planes (yz, xy, and xz), 3D geometry, and b the size of the inlet vessel

0.09 0.09
)

0.08 0.08
(

0.07 0.07
Inlet velocity

Inlet velocity

0.06 0.06 (Measured)

(Computed)
0.05 0.05
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 0.0 0.2 0.4 0.6 0.8 1.0
Time ( ) Time ( )
(a) (b)

Fig. 10  The velocity profiles imposed on the anterior communicating artery inlets

11. The blood flow parameters investigated in that part to present the flow separation. At the separation region,
is the same ones discussed in the segment one. the value of the wall pressure and the WSS achieve the
highest values in that zone.
3.2.1 The flow structure In Fig. 13, two cuts in the bulge show the velocity mag-
nitude contour at aneurysm zone at yz and xz planes,
The aneurysm at anterior communicating artery leaded respectively. At yz plane, the maximum velocity appears
to present the recirculation flow (vortex formation) at the inlet and decreases gradually in the z direction
which affect a lot on the WSS, wall pressure, and outlet except for the zone of the vortex formation. In Fig. 13c,
flow regimes. In Fig. 12, away from the aneurysm, the the velocity distribution vector shows the interaction of
flow at the inlet and the outlet of the main artery have the flow with the bulge wall, which leads to reverse flow
a laminar flow, which presented in Fig. 5 at the segment responsible for the vortex formation at the z direction. At
one. The flow interaction with the wall of the bulge leads xz plane, the maximum value of the velocity magnitude

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112
14450

)
(Measured)
104

)
13600 (Computed)

(
96 12750
(

Outlet pressure
Outlet pressure

88 11900

11050
80
10200
72
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 0.0 0.2 0.4 0.6 0.8 1.0
Time ( ) Time ( )

(a) (b)

Fig. 11  The pressure profiles imposed on the anterior communicating artery outlets in a mmHg and b Pa

Fig. 12  a The velocity streamlines for the anterior communicating artery b Zoomed in view for the aneurysm

at the core of the flow inlet and decrease gradually in the understand the aneurysm rupture. In Figs. 14 and 15,
z direction except for the value next to the wall in the x the values of wall parameters affected by the blood flow
direction. The value of the velocity is high next to the wall regimes. The value of the WSS and the wall pressure
in the right part of the x direction compared to the velocity decreased gradually in the blood flow pass except for the
in the same level of x direction due to the present of the aneurysm zone, which presented in the simplified model
recirculation flow next to the flow-wall interaction zone, at segment one (Figs. 4 and 7). In Figs. 14b and c, the WSS
as shown in Figs. 13b and d. is much higher near the bulge zone inlet comparing to the
outlet zone. The WSS increases at the outlet edges due to
3.2.2 Hemodynamics wall parameters the flow interaction with the edges. The variation of WSS
help to expect the location of the aneurysm ruptured. The
The investigation of the wall parameters such as the investigations state that the rupture would occurs at low
WSS and the wall pressure have a significant value to wall shear stress region [36].

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Fig. 13  Contours of the velocity distribution at a yz-plane and b xz-plane. Cross section views of velocity distribution vector at c yz plane
and d xz plane, respectively

Furthermore, the change in the cross-section of the two geometrical models (ideal and realistic geometry) and
blood vessel has a significant impact on the WSS. The Newtonian model with viscosity model (Carreau model).
aneurysm is not only blood vessel disease that appears The approach of using a simplified (benchmark) geometry
due to the change in the cross-section area. The presence of the aneurysm helped to understand the hemodynam-
of stenosis influences the WSS values, where the presence ics inside the complex geometry of the realistic model.
of the stenosis increases the value of the WSS at the ste- It is observed that, the presence of the aneurysms in the
nosis zone, Fig. 14d. After the contraction zone, the WSS patient’s vascular system lead to recirculation flow inside
values were reduced with increasing the cross-section area the bulge. The flow-wall interaction due to the flow recir-
of the blood vessel [34, 37]. culation produce uneven variation in the wall shear stress,
which help to investigate the region of the rupture. The
obtained results investigate that the wall pressure and the
4  Conclusion WSS achieve the highest values at the flow-wall interaction
zone. The wall pressure and the WSS behaviors are qualita-
In this paper, the CFD simulations are conducted to inves- tively similar. The presence of stenosis increases the WSS
tigate the hemodynamics of the flow for a patient with a at the contraction zone.
brain aneurysm at anterior communicating artery using

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Fig. 14  a The wall shear stress distribution along the patient’s blood vessels. zoom in view of (b) the area near the aneurysm inlet, c the area
near the aneurysm outlet, and d the area near the stenosis

Fig. 15  The pressure distribu-

tion along the patient’s blood
vessels

Acknowledgements This work was partially supported by the Sci- Conceptualization, methodology, draft revision, commenting,
ence and Technology Development Fund (STDF) of Egypt, project Supervision.
No: 39385.
Funding Open access funding provided by The Science, Technol-
Authors’ contributions AGR: Conceptualization, methodology, ogy & Innovation Funding Authority (STDF) in cooperation with The
data curation, model building, simulation, validation, visualiza- Egyptian Knowledge Bank (EKB).
tion, figure preparation, draft preparation, and draft revision. TA:

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Data availability The data that support the findings of this study are problems in human artery with stenosis. J Comput Phys. https://​
available from the corresponding author upon reasonable request. doi.​org/​10.​1016/j.​jcp.​2019.​108926
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Declarations shear stress in coronary surgery: computational fluid dynamics
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Conflict of interest The authors declare that they have no conflict of
doi.​org/​10.​1093/​cvr/​cvq210
interest.
12. Lin KY, Shih TC, Chou SH, Chen ZY, Hsu CH, Ho CY (2016) Com-
putational fluid dynamics with application of different theoreti-
Open Access This article is licensed under a Creative Commons Attri- cal flow models for the evaluation of coronary artery stenosis
bution 4.0 International License, which permits use, sharing, adap- on CT angiography: comparison with invasive fractional flow
tation, distribution and reproduction in any medium or format, as reserve. Biomed Phy Eng Exp 2:1–11. https://​doi.​org/​10.​1088/​
long as you give appropriate credit to the original author(s) and the 2057-​1976/2/​6/​065011
source, provide a link to the Creative Commons licence, and indicate 13. Shanmugavelayudam SK, Rubenstein DA, Yin W (2010) Effect of
if changes were made. The images or other third party material in this geometrical assumptions on numerical modeling of coronary
article are included in the article’s Creative Commons licence, unless blood flow under normal and disease conditions. J Biomech Eng
indicated otherwise in a credit line to the material. If material is not 132:61004. https://​doi.​org/​10.​1115/1.​40010​33
included in the article’s Creative Commons licence and your intended 14. Katritsis D, Kaiktsis L, Chaniotis A, Pantos J, Efstathopoulos EP,
use is not permitted by statutory regulation or exceeds the permitted Marmarelis V (2007) Wall shear stress: theoretical considera-
use, you will need to obtain permission directly from the copyright tions and methods of measurement. Prog Cardiovasc Dis United
holder. To view a copy of this licence, visit http://​creat​iveco​mmons.​ States 49:307–329. https://​doi.​org/​10.​1016/j.​pcad.​2006.​11.​001
org/​licen​ses/​by/4.​0/. 15. Murayama Y, Fujimura S, Suzuki T, Takao H (2019) Computational
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