2024-03-28T17:39:09Zhttps://www.tdx.cat/oai/requestoai:www.tdx.cat:10803/4049402017-08-30T06:29:14Zcom_10803_183col_10803_328728
nam a 5i 4500
Carótidas
enGrid
vmtk
ParaView
Doppler
OpenFOAM
Womersley
Fluidodinámica computacional
Software libre
Ictus
Stroke
Carotid arteries
Mejora del diagnóstico y de la hemodinámica en la revascularización carotídea : aplicación de la dinámica de fluidos computacional mediante el OpenFOAM® y otras herramientas de libre distribución
[Barcelona] :
Universitat Politècnica de Catalunya,
2017
Accés lliure
http://hdl.handle.net/10803/404940
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Arias Araluce, Fausto Arturo,
autor
1 recurs en línia (285 pàgines)
Tesi
Doctorat
Universitat Politècnica de Catalunya. Departament d'Enginyeria Civil i Ambiental
2017
Universitat Politècnica de Catalunya. Departament d'Enginyeria Civil i Ambiental
Tesis i dissertacions electròniques
Rivera Amores, Juanjo,
supervisor acadèmic
TDX
Stroke is a major cause of death and disability in Spain and in the Western world. It is often caused by an accumulation of atherosclerotic plaques on the walls of carotid arteries. Carotid revascularization may be the solution chosen by the specialist. This choice depends directly on the symptoms, the diagnosis and the potential benefits vs. costs of performing surgery.
Hemodynamics plays a crucial role in all decision making. The conventional methods for analyzing hemodynamics are Doppler ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA). These methods may be enriched with the numerical simulation of blood flow in the area of interest, using techniques of computational fluid dynamics (CFD). The result of the simulations can be used to improve diagnosis and to propose hemodynamic improvement during surgery or treatment. It can also provide conclusions on the progress of the patient. However, it is currently very difficult to perform these simulations and reach valid conclusions. This difficulty is due to the state of the technique and to the lack of scientific consensus in regard to clinical aspects, data gathering and processing, reproduction of geometries, construction of models, and execution of the simulations, among other aspects. Furthermore, obtaining results and drawing conclusions from them requires a high degree of specialization and the use of software that is often expensive.
The present thesis uses numerical simulation to replicate the blood flow in the carotid arteries. It uses the results to guide the diagnosis and prognosis of patient progress. It develops a methodology for the creation of numeric models using data provided by CTA and Doppler ultrasound, both of which are used in routine clinical practice.
From the images contained in the files with DICOM format resulting from the CTA, the geometries of carotid arteries of patients are reproduced. The data provided by the ultrasound velocities are used to obtain velocity curves in the inputs, outputs and areas of interest within the carotid artery. Models of carotid arteries are also built with CAD tools.
OpenFOAM®; is used for model meshing, solving the equations that govern the fluid movement and obtaining the relevant hemodynamic variables such as carotid wall shear stress. The Womersley boundary condition for velocities, which is the most suitable one for simulating pulse flows in carotid arteries, is implemented in this software environment.
In cases of moderate stenosis, a diagnosis by a specialist is added. A comparison between a pre- and postoperative situation was made in order to take it into account for any proposals of hemodynamic improvement. The pre-processing, processing and post-processing were performed almost entirely with open source tools such as vmtk, enGrid, ParaView and OpenFOAM®.
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