High-Frequency Fluctuations in Post-stenotic Patient Specific Carotid Stenosis Fluid Dynamics: A Computational Fluid Dynamics Strategy Study

PurposeScreening of asymptomatic carotid stenoses is performed by auscultation of the carotid bruit, but the sensitivity is poor. Instead, it has been suggested to detect carotid bruit as neck's skin vibrations. We here take a first step towards a computational fluid dynamics proof-of-concept study, and investigate the robustness of our numerical approach for capturing high-frequent fluctuations in the post-stenotic flow. The aim was to find an ideal solution strategy from a pragmatic point of view, balancing accuracy with computational cost comparing an under-resolved direct numerical simulation (DNS) approach vs. three common large eddy simulation (LES) models (static/dynamic Smagorinsky and Sigma).MethodWe found a reference solution by performing a spatial and temporal refinement study of a stenosed carotid bifurcation with constant flow rate. The reference solution dwas compared against LES for both a constant and pulsatile flow.ResultsOnly the Sigma and Dynamic Smagorinsky models were able to replicate the flow field of the reference solution for a pulsatile simulation, however the computational cost of the Sigma model was lower. However, none of the sub-grid scale models were able to replicate the high-frequent flow in the peak-systolic constant flow rate simulations, which had a higher mean Reynolds number.ConclusionsThe Sigma model was the best combination between accuracy and cost for simulating the pulsatile post-stenotic flow field, whereas for the constant flow rate, the under-resolved DNS approach was better. These results can be used as a reference for future studies investigating high-frequent flow features.