Localization of Atherosclerosis in Arterial Junctions Concentration Distribution of Low Density Lipoproteins at the Luminal Surface in Regions of Disturbed Flow

To investigate the role of fluid mechanical factors in atherogenesis and anastomotic intimal hyperplasia, the effect of blood flow on the transfer of low density lipoproteins from flowing blood to the luminal surface was studied theoretically using a two dimensional T-junction model. The flow fields in the junction were obtained by solving the Navier-Stokes equations numerically and the concentration distribution of low density lipoproteins at the luminal surface was determined using a finite difference analysis. The transfer of low density lipoproteins from flowing blood to the surface of the vessel wall was greatly enhanced in the two regions of disturbed flow, one in the main vessel, the other in the subsidiary vessel. The highest concentration of low density lipoproteins on the inner surface of the vessel wall was predicted to occur in the areas of the reattachment points. The slower the recirculation flow, the higher the lipid accumulation at the luminal surface in the disturbed flow regions and the wider the highly concentrated low density lipoprotein area. In summary, the authors' mathematical model predicts that locally disturbed blood flows at arterial bifurcations and surgically created junctions provide favorable conditions for the accumulation of atherogenic substances at the luminal surface, thus increasing the potential for lipid infiltration into the vessel wall.