Hemodynamic alterations in portal hypertension: A CFD-based study with emphasis on helical flow characteristics

Li, Haonan; Fan, Zhenmin; Zhao, Na; Deng, Xiaoyan; Zhang, Zhixiang

doi:10.37190/abb/213616

Abstract

Purpose: Portal hypertension (PHT) leads to complications such as variceal bleeding, hepatic remodeling and thrombosis, driven by altered hemodynamics. This study aims to elucidate flow structure, shear stress and helicity changes under PHT, and their potential roles in promoting thrombosis and vascular remodeling.

Methods: A patient-specific portal venous system model was reconstructed from CT images. Computational fluid dynamics (CFD) simulations were conducted to evaluate flow velocity, wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT) and helicity.

Results: Compared to the healthy model, the PHT condition demonstrated reduced flow velocity, lower TAWSS and elevated RRT, particularly near bifurcations. Moreover, the strength and symmetry of helical flow were significantly impaired in PHT, especially at the main portal vein bifurcation – an area frequently associated with thrombosis.

Conclusions: This study highlights the role of hemodynamic disruption, particularly helicity loss, in the pathogenesis of PHT-related complications. CFD-based helicity analysis offers novel insight into biomechanical risk assessment and may inform future interventional strategies.

References

Augustin H.G., Koh G.Y., Organotypic vasculature: From descriptive heterogeneity to functional pathophysiology, Science, 2017.
Search in Google Scholar Back to article
Calo K., Capellini K., De Nisco G., Mazzi V., Gasparotti E., Gallo D. et al., Impact of wall displacements on the large-scale flow coherence in ascending aorta, J. Biomech., 2023, 111620.
Search in Google Scholar Back to article
Davignon J., Ganz P., Role of endothelial dysfunction in atherosclerosis, Circulation, 2004, III27–32.
Search in Google Scholar Back to article
De Franchis R., Baveno V.I.F., Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension, J. Hepatol., 2015, 743–752.
Search in Google Scholar Back to article
De Franchis R., Bosch J., Garcia-Tsao G., Reiberger T., Ripoll C., Baveno VII Faculty., Baveno VII – Renewing consensus in portal hypertension, J. Hepatol., 2022, 959–974.
Search in Google Scholar Back to article
De Nisco G., Hoogendoorn A., Chiastra C., Gallo D., Kok A.M., Morbiducci U., Wentzel J.J., The impact of helical flow on coronary atherosclerotic plaque development, Atherosclerosis, 2020, 39–46.
Search in Google Scholar Back to article
El Sherbiny W., Abdelrahman A., Diasty M., Shaltout S.W., Changes in Doppler parameters of portal pressure after interventional management of hepatocellular carcinoma, Abdom. Radiol. (NY), 2016, 1532–1538.
Search in Google Scholar Back to article
George S.M., Hemodynamic investigation of the liver using magnetic resonance imaging and computational fluid dynamics, Georgia Institute of Technology, 2008.
Search in Google Scholar Back to article
Hyodo R., Takehara Y., Mizuno T., Ichikawa K., Horiguchi R., Kawakatsu S. et al., Four-dimensional Flow MRI Assessment of Portal Hemodynamics and Hepatic Regeneration after Portal Vein Embolization, Radiology, 2023, e230709.
Search in Google Scholar Back to article
Li D., Wang J., Zeng W., Zeng X., Liu Z., Cao H. et al., The loss of helical flow in the thoracic aorta might be an identifying marker for the risk of acute type B aortic dissection, Comput. Methods Programs Biomed., 2023, 107331.
Search in Google Scholar Back to article
Li X., Wang X.K., Chen B., Pu Y.S., Li Z.F., Nie P., Su K., Computational hemodynamics of portal vein hypertension in hepatic cirrhosis patients, Biomed. Mater. Eng., 2015, S233–S243.
Search in Google Scholar Back to article
Lu J., Fan Z., Ye X., Deng X., Feng H., Liu M., Impact of lower limb movements on iliac vein stenting in iliac vein compression syndrome patients: insights from computational modeling, Acta Bioeng. Biomech., 2024, 23–35.
Search in Google Scholar Back to article
Mooradian D.L., Hutsell T.C., Keefer L.K., Nitric oxide (NO) donor molecules: effect of NO release rate on vascular smooth muscle cell proliferation in vitro, J. Cardiovasc. Pharmacol., 1995, 674–678.
Search in Google Scholar Back to article
Petkova S., Hossain A., Naser J., Palombo E., CFD modelling of blood flow in portal vein hypertension with and without thrombosis, Third International Conference on CFD in the Minerals and Process Industries CSIRO, Melbourne, Australia, 2003, 10–12.
Search in Google Scholar Back to article
Pinzani M., Rosselli M., Zuckermann M., Liver cirrhosis, Best Pract. Res. Clin. Gastroenterol., 2011, 281–290.
Search in Google Scholar Back to article
Prakash S., Bies J., Hassan M., Mares A., Didia S.C., Portal vein thrombosis in cirrhosis: A literature review, Front. Med. (Lausanne), 2023, 1134801.
Search in Google Scholar Back to article
Qian S., Ma T., Zhang N., Liu X., Zhao P., Li X. et al., Spatiotemporal transfer of nitric oxide in patient-specific atherosclerotic carotid artery bifurcations with MRI and computational fluid dynamics modeling, Comput. Biol. Med., 2020, 104015.
Search in Google Scholar Back to article
Qiu Y., Tai Y., Lei J., Zeng Y., Wu H., Li K., Modelling the liver region as porous media to noninvasively measure portal vein pressure gradient (PPG) with numerical methods, J. Biomech., 2023, 111660.
Search in Google Scholar Back to article
Ripoll C., Groszmann R., Garcia-Tsao G., Grace N., Burroughs A., Planas R. et al., Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis, Gastroenterology, 2007, 481–488.
Search in Google Scholar Back to article
Stonebridge P.A., Vermassen F., Dick J., Belch J.J., Houston G., Spiral laminar flow prosthetic bypass graft: medium-term results from a first-in-man structured registry study, Ann. Vasc. Surg., 2012, 1093–1099.
Search in Google Scholar Back to article
Van Steenkiste C., Trachet B., Casteleyn C., Van Loo D., Van Hoorebeke L., Segers P. et al., Vascular corrosion casting: analyzing wall shear stress in the portal vein and vascular abnormalities in portal hypertensive and cirrhotic rodents, Lab. Invest., 2010, 1558–1572.
Search in Google Scholar Back to article
Wang T., Yong Y., Ge X., Wang J., A computational modelbased study on the feasibility of predicting post-splenectomy thrombosis using hemodynamic metrics, Front. Bioeng. Biotechnol., 2023, 1276999.
Search in Google Scholar Back to article
Wang T., Zhou Z., Liang F., Influences of Anatomorphological Features of the Portal Venous System on Postsplenectomy Hemodynamic Characteristics in Patients With Portal Hypertension: A Computational Model-Based Study, Front. Physiol., 2021, 661030.
Search in Google Scholar Back to article
Wei W., Pu Y.S., Wang X.K., Jiang A., Zhou R., Li Y. et al., Wall shear stress in portal vein of cirrhotic patients with portal hypertension, World J. Gastroenterol., 2017, 3279–3286.
Search in Google Scholar Back to article
Wild N.C., Bulusu K.V., Plesniak M.W., Vortical Structures Promote Atheroprotective Wall Shear Stress Distributions in a Carotid Artery Bifurcation Model, Bioengineering (Basel), 2023.
Search in Google Scholar Back to article
Wu X., Xiao H., Ma L., The application of computational fluid dynamics in hepatic portal vein haemodynamics research: a narrative review, Quant. Imaging Med. Surg., 2025, 2605–2620.
Search in Google Scholar Back to article
Yan Y., Xiong Z., Wang X., Yang L., Zheng T., Luo X., A novel potential mechanism for the development of portal vein thrombosis in cirrhosis based on portal hemodynamics, Insights Imaging, 2022, 192.
Search in Google Scholar Back to article
Yao H., Wang Y., Relationship between hemodynamic parameters and portal venous pressure in cirrhosis patients with portal hypertension, Open Life Sci., 2020, 981–987.
Search in Google Scholar Back to article
Zarins C.K., Giddens D.P., Bharadvaj B.K., Sottiurai V.S., Mabon R.F., Glagov S., Carotid bifurcation atherosclerosis. Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress, Circ. Res., 1983, 502–514.
Search in Google Scholar Back to article
Zhang L., Duan Y.Y., Li J.M., Yin J.K., Hemodynamic features of Doppler ultrasonography in patients with portal hypertension: intraoperative direct measurement of portal pressure in the portal venous system, J. Ultrasound Med., 2007, 1689–1696.
Search in Google Scholar Back to article
Zhang X., Fan Z., Liu X., Liu M., Ye X., Deng X., Hemodynamic impact of snoring on carotid artery after stent implantation: the role of oscillation, Acta Bioeng. Biomech., 2023, 35–45.
Search in Google Scholar Back to article

Hemodynamic alterations in portal hypertension: A CFD-based study with emphasis on helical flow characteristics

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