Hemodynamics of the superficial femoral artery: clinical case study

The superficial femoral artery, in contrast to the deep femoral artery, is most often affected by atherosclerosis with the formation of hemodynamically significant stenoses or occlusions, which leads to ischemia of the lower limb. The latest Russian and European guidelines for peripheral arterial disease currently recommend an endovascular strategy (angioplasty and stenting) for all lesions shorter than 25 cm. The study of the hemodynamics of the superficial femoral artery is complicated by the fact that it is subject to severe deformation (compression, stretching, torsion) during physiological movements in the hip and knee joints. In this regard, a very urgent task is the numerical modeling of hemodynamics before and after angioplasty and stenting of the affected artery to assess the redistribution of blood flow in the great vessels of the lower limb. The work performed a numerical study of the hemodynamics of the arteries of the lower extremities under normal conditions, with occlusion, and with installed virtual stents of various porosities for a specific patient. It has been established that, depending on the chosen stent, the volume of blood flow through the superficial femoral artery can vary up to 15 %, and in general, the redistribution of blood flow can reach up to 50 % compared to a healthy limb. For stents with a porosity index of 0.1-0.2, the shear stresses in the stent area are up to 5 times higher than for stents for which this value is 0.8, although the maximum WSS over the entire configuration remains comparable, which indicates possible significantly different stent endothelialization scenarios. A deeper understanding of these processes will make it possible to determine the choice of treatment tactics and the type of implanted device, which can ultimately improve the immediate and long-term results of surgical treatment, as well as improve the patient’s rehabilitation status.