Abstract
Transluminal attenuation gradient (TAG) is expected as a noninvasive assessment of the functional significance of a stenosis, and has reported relatively high diagnostic performance. TAG measures the gradient of intraluminal radiological attenuation from the ostium at the first pass of the injected contrast agent; therefore, replacement of fluid by jet flow from a stenosis with gradually increasing contrast agent concentration should be investigated. We performed a phantom experiment and ALE fluid-structure interaction finite element simulation on pulsatile flow through a bifurcated flexible tube system with a stenosis. Experiment and simulation showed good agreement with temporal change of flow rate, pressure, and radius under 1 Hz square pulsatile flow. We varied Young modulus and rate of stenosis with 1 Hz sinusoidal input. Young modulus had little effect on the distribution of total flow, but a changed flow rate waveform and faster maximal velocity in the stenosis was observed with a smaller Young modulus. Then we simulated convection of particle tracers generated at the inlet, imitating a gradual increase in contrast agent with 80% and 95% stenosis. With 80% stenosis, axially symmetric flow resulted in reproductive tracer distributions; however, with 95% stenosis, the direction of jet flow from the stenosis and of subsequent helical flow varied every beat, suggesting this variation might lower sensitivity of TAG.
