The Computational Fluid Dynamic Simulations for Gangrene Disease in Diabetic Foot

  • Ali Amer Al-allaq Office Reconstruction and Projects/ Ministry of High Education and Scientific Research

Abstract

The diabetic foot is considered one of the long term diabetes complications caused by a defect in blood vessel and nerve system. This requires dealing with diabetic foot with professional medical care, so as to prevent its development in advanced stages which could end to gangrene and amputation of the foot. This study has been initiated through follow-up of twelve patients with diabetes and the presence various occlusions in lower limb artery. One patient from them was chosen for investigation, this patient has stenosis in popliteal artery and presence multiple stenosis in superficial femoral artery. This study based on analysis present case of patient and prediction for progress stenosis in superficial femoral artery till arrive semi total occlusion of the artery and interpret the occurrence of gangrene in the lower limb. The geometrical values of the artery and stenosis were acquired measured directly from the patient by using angiography device. The disease of gangrene and artery stenosis in diabetic foot has been investigated by using a simulation program (ANSYS Fluent CFD).  The results of study by using four models with (75%, 90%) stenosis from original artery diameter in the healthy patient case are presented and compared with present and healthy case (without stenosis). It has been appeared, with presence of multi stenosis in superficial femoral artery for diabetic foot, and by assuming the blood to be a Newtonian fluid, a significant increase in the blood velocity and wall shear stress in the area of stenosis compared with non stenosis region. The blood flow rate was decreased constrained as the degree of stenosis increased and vice versa. Peak blood velocity is about (0.88) m/sec for healthy artery, it reaches (2) m/sec for a 42.4% stenosis (current case).The maximum velocity values were (10.36, 49.31) m/sec for 75%, 90% stenosis respectively. The maximum wall shear stress at the stenosis region varies from (1094) pa in the 75% stenosis to (15916) pa in the 90% stenosis against a values of (6.36, 380.5) pa in the healthy artery, current case respectively.                                    

Downloads

Download data is not yet available.

References

Chiristos S. Mantzoros, “obesity and diabetes”, humana press, totowa, New Jersey, pp. (136,225), 2006.

Alexander A. Vitin, “gangrene – current concepts and management options”, in tech, pp.I, 2011.

Dafiewhare O.E., Agwu E., Ekanem P.,Ezeonwumelu J.O.C., Okoruwa G. and Shaban A., “a review of clinical manifestations of gangrene in western uganda”, intech,pp1-14,2013.

Randi s. Most, pomeroy s., “the epidemiology of lower extremity amputations in diabetic individuals”, diabetes care, vol. 6, no. 1, pp.87-91, 1983.

American Diabetes Association, “peripheral arterial disease in people with diabetes “, diabetes care, vol. 26, no. 12, pp.3333-3341 2003.

Erik W., Andries D. van der M., Marijke J. E. Kuijpers., Jean P. F., Albert van den B., Johan W. M. Heemskerka, “atherosclerotic geometries exacerbate pathological thrombus formation poststenosis in a von Willebrand factor-dependent manner”, Proceedings of the National Academy of Sciences (PNAS), ,vol. 110 , no. 4 pp. 1357–1362, 2013.

Heather A. Hall , Hisham S. Bassiouny, “ultrasound and carotid bifurcation atherosclerosis”, chapter 2, “ pathophysiology of carotid atherosclerosis”, springer-verlag london limited ,pp.27-39,2012.

American Diabetes Association, “preventive foot care in people with diabetes”, diabetes care, vol. 25, supplement 1, pp.s69-s70, 2002.

Piergiorgio C., Paola De R., Massimo L., “critical limb ischemia” chapter2, “clinical presentation of critical limb ischemia”, informa healthcare USA,pp.19, 2009.

Robert G. Frykberg, “an evidence-based approach to diabetic foot infections”, the american journal of surgery 186/5a, pp. 44s–54s, 2003.diabetes care, vol. 25, no. 8, pp.1444-1450, 2002.

Suguru O. , Yasuaki I. ,Kazuya F., Masaaki H., “lower limb amputation for diabetic foot”, Archives of Orthopaedic and Trauma Surgery, vol.121 , pp.186–190 , 2001.

Edward b. Jude, samson o. Oyibo, nicholas c., andrew j.m. Boulton, “peripheral arterial disease in diabetic and nondiabetic patients”, diabetes care, vol. 24, no.8, pp.1433-1437, 2001.

Paulo G., Thomas W., Sotirios T., “rapid progression of common femoral artery stenosis leading to development of ischemic foot ulcer following repeated ipsilateral arterial access”, catheterization and cardiovascular interventions :66,pp.487–490 ,2005.

Mingxiu Li, “numerical simulation of blood flow and vessel wall stresses in stenosed arteries”, doctor of philosophy thesis, the university of Edinburgh, 2006.

Luisa S., Catarina C., Carlos A., Rui C., “computational techniques and validation of blood flow simulation”, wseas transactions on biology and biomedicine, issue 4, vo. 8, pp.145-155,2011.

[16]. Sónia I.S. Pinto, E.D. Costa, J.B.L.M. Campos, J.M. Miranda, “study of blood flow in a bifurcation with a stenosis”, international conference on experimental mechanics, vol.15, pp.1-10, 2012.

Padukkage R. , Barber T. , “effect of non-axisymmetry in arterial stenoses”, 19th australasian fluid mechanics conference, Melbourne, Australia,2014.

Nabeel S. M., Ali A. A., “Numerical Study of the Effects of Aneurysm and Stenosis in the Left Coronary Artery on the Human Blood Stream” Engineering and Technology Journal, vol. 35, Part A, No. 1, pp.29-40, 2017.

Joseph D. Bronzino, “The Biomedical Engineering HandBook”, CRC Press LLC, pp. 1127-1274, 2000.

Carol E.H., Scott C., “essential operative techniques and anatomy” fourth edition, wolters kluwer , lippincott williams & wilkins, pp.725, 2014.

Kendra M. Merine, Anton N. Sidawy “diabetic foot lower extremity arterial disease and limb salvage” chapter 11, “anatomic distribution of atherosclerotic lesions as influenced by diabetes and other risk factors”, first edition, lippincott williams & wilkins, pp.130,2006.

Wilmer W. Nichols, Michael F O’Rourke, Charalambos Vlachopoulos, Arnold P Hoeks, Robert S Reneman, “mcdonalds blood flow in arteries theoretical, experimental and clinical principles”, sixth edition, Hodder Arnold, pp.17, 2011.

Tiffany C. , Richard F., “Mechanobiology handbook”, chapter two , “Fluid Mechanics”, CRC Press Taylor & Francis pp.24-30 ,2011.

Reva Arnez Curry, Betty Bates Tempkin, “sonography: introduction to normal structure and function”, “vascular technology”, Elsevier health sciences, fourth edition, pp. 623, 2015.

ANSYS FLUENT, Version 15, ANSYS Inc. 2014, "Fluent 15 Theory Guide", 2014.

[26]. Linda S. Costanzo, “Physiology”, 4th edition, Saunders Elsevier, pp.115-117, 2010.

Ratan, “Handbook of Human Physiology”, Circulatory System, Jaypee Brothers Publishers, pp.90-91, 2004.

Sandor Ianos Bernad, Romeo Susan-Resiga, Elena Bernad,Dan Gaita, Gheorghe I. Mihalas, Ioan Munteanu, “computerized study of the blood flow in arterial stenosis”, TMJ, Vol. 54, No. 2,pp.142-145, 2004.

S. A. Berger, L-D. Jou, “flows in stenotic vessels”, The Annual Review of Fluid Mechanics, 32, pp.347–382, 2000.

Richard E. Klabunde, “Cardiovascular Physiology Concepts”,2nd edition ,Published by Lippincott Williams & Wilkins,pp.27-28, 2011.

Sue E. Huether, Kathryn L. Mc Cance, “ pathophysiology The Biologic Basis for Disease in Adults and Children “ ,6th edition , mosby elsevier,pp.1055,2014.

Robert M. Winslow, “Blood Substitutes “, Elsevier Academic Press, pp.93, 2006.

Thomas J. Fogarty, Rodney A. White, “Peripheral Endovascular Interventions”, Springer Science & Business Media, pp.17, 2013.

Jeffrey I. Weitz, Chair; John Byrne, G. Patrick Clagett, Michael E. Farkouh, John M. Porter, David L. Sackett, D. Eugene Strandness Jr ,Lloyd M. Taylor , “Diagnosis and Treatment of Chronic Arterial Insufficiency of the Lower Extremities: A Critical Review”, Circulation, 94,pp.3026-3049, 1996.

Tanvir Bajwa, Paramjit Romi Chopra, Rick Coats, Dennis Gable, Paul Jones,Mark Mewissen, Amir Motarjeme, James Park, Ashish Pershad, Richard Saxon, Darren Schneider, Peter Soukas, “endovascular repair of the superficial femoral artery”, supplement to endovascular today,pp.1-23 , september 2008.

Published
2018-12-01
How to Cite
Al-allaq, A. (2018). The Computational Fluid Dynamic Simulations for Gangrene Disease in Diabetic Foot. Al-Khwarizmi Engineering Journal, 13(4), 111- 123. https://doi.org/10.22153/kej.2017.05.003