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The work is devoted to the construction and analysis of difference schemes for a system of hemodynamic equations obtained by averaging the hydrodynamic equations of a viscous incompressible fluid over the vessel cross-section. Models of blood as an ideal and as a viscous Newtonian fluid are considered. Difference schemes that approximate equations with second order on the spatial variable are proposed. The computational algorithms of the constructed schemes are based on the method of splitting on physical processes. According to this approach, at one time step, the model equations are considered separately and sequentially. The practical implementation of the proposed schemes at each time step leads to a sequential solution of two linear systems with tridiagonal matrices. It is demonstrated that the schemes are $\rho$-stable under minor restrictions on the time step in the case of sufficiently smooth solutions.

For the problem with a known analytical solution, it is demonstrated that the numerical solution has a second order convergence in a wide range of spatial grid step. The proposed schemes are compared with well-known explicit schemes, such as the Lax – Wendroff, Lax – Friedrichs and McCormack schemes in computational experiments on modeling blood flow in model vascular systems. It is demonstrated that the results obtained using the proposed schemes are close to the results obtained using other computational schemes, including schemes constructed by other approaches to spatial discretization. It is demonstrated that in the case of different spatial grids, the time of computation for the proposed schemes is significantly less than in the case of explicit schemes, despite the need to solve systems of linear equations at each step. The disadvantages of the schemes are the limitation on the time step in the case of discontinuous or strongly changing solutions and the need to use extrapolation of values at the boundary points of the vessels. In this regard, problems on the adaptation of splitting schemes for problems with discontinuous solutions and in cases of special types of conditions at the vessels ends are perspective for further research.

The mechanisms of hydrodynamical activation of blood coagulation system are investigated in stenosed vessels for a wide range of Reynolds number values (from 10 up to 500). It is assumed that the vessel wall permeability for procoagulant factors rapidly increases when wall shear stress exceeds specific threshold value. A number of patterns of blood coagulation processes development are described. The influence of blood flow topology changes on activation of blood coagulation is explored. It is established that not only blood flow decrease, but also its increase may promote activation of blood coagulation. It was found that dependence of thrombogenic danger of stenosis on vessel lumen blockage ratio is non-monotonic. The relevance of obtained theoretical results for clinical practice is discussed.

Numerical modeling of shear-induced platelet activation in haemodialysis arteriovenous fistulas was carried out in this work. The goal was to investigate the mechanisms of threshold shear-induced platelet activation in fistulas. For shear-induced platelet activation to take place, shear stress accumulated by platelets along corresponding trajectories in blood flow had to exceed a definite threshold value. The threshold value of cumulative shear stress was supposed to depend on the multimer size of von Willebrand factor macromolecules acting as hydrodynamic sensors for platelets. The effect of arteriovenous fistulas parameters, such as the anastomotic angle, blood flow rate, and the multimer size of von Willebrand factor macromolecules, on platelet activation risk was studied. Parametric diagrams have been constructed that make it possible to distinguish the areas of parameters corresponding to the presence or absence of shear-induced platelet activation. Scaling relations that approximate critical curves on parametric diagrams were obtained. Analysis showed that threshold fistula flow rate is higher for obtuse anastomotic angle than for sharp ones. This means that a fistula with obtuse angle can be used in wider flow rate range without risk of platelet activation. In addition, a study of different anastomosis configurations of arteriovenous fistulas showed that the configuration “end of vein to end of artery” is among the safest. For all the investigated anastomosis configurations, the critical curves on the parametric diagrams were monotonically decreasing functions of von Willebrand factor multimer size. It was shown that fistula flow rate should have a significant impact on the probability of thrombus formation initiation, while the direction of flow through the distal artery did not affect platelet activation. The obtained results allowed to determine the safest fistula configurations with respect to thrombus formation triggering. The authors believe that the results of the work may be of interest to doctors performing surgical operations for creation of arteriovenous fistulas for haemodialysis. In the final section of the work, possible clinical applications of the obtained results by means of mathematical modeling are discussed.

Hemostatic system serves the organism for urgent repairs of damaged blood vessel walls. Its main components – platelets, the smallest blood cells, – are constantly contained in blood and quickly adhere to the site of injury. Platelet migration across blood flow and their hit with the wall are governed by blood flow conditions and, in particular, by the physical presence of other blood cells – erythrocytes. In this review we consider the main regularities of this influence, available mathematical models of platelet migration across blood flow and adhesion based on "convection-diffusion" PDEs, and discuss recent advances in this field. Understanding of the mechanisms of these processes is necessary for building of adequate mathematical models of hemostatic system functioning in blood flow in normal and pathological conditions.

A numerical simulation of fluid flow in a blood pump was performed using the FlowVision software package. This test problem, provided by the Center for Devices and Radiological Health of the US. Food and Drug Administration, involved considering fluid flow according to several design modes. At the same time for each case of calculation a certain value of liquid flow rate and rotor speed was set. Necessary data for calculations in the form of exact geometry, flow conditions and fluid characteristics were provided to all research participants, who used different software packages for modeling. Numerical simulations were performed in FlowVision for six calculation modes with the Newtonian fluid and standard $k-\varepsilon$ turbulence model, in addition, the fifth mode with the $k-\omega$ SST turbulence model and with the Caro rheological fluid model were performed. In the first stage of the numerical simulation, the convergence over the mesh was investigated, on the basis of which a final mesh with a number of cells of the order of 6 million was chosen. Due to the large number of cells, in order to accelerate the study, part of the calculations was performed on the Lomonosov-2 cluster. As a result of numerical simulation, we obtained and analyzed values of pressure difference between inlet and outlet of the pump, velocity between rotor blades and in the area of diffuser, and also, we carried out visualization of velocity distribution in certain cross-sections. For all design modes there was compared the pressure difference received numerically with the experimental data, and for the fifth calculation mode there was also compared with the experiment by speed distribution between rotor blades and in the area of diffuser. Data analysis has shown good correlation of calculation results in FlowVision with experimental results and numerical simulation in other software packages. The results obtained in FlowVision for solving the US FDA test suggest that FlowVision software package can be used for solving a wide range of hemodynamic problems.

The possibility of numerical 3D simulation of thrombi formation is considered.

The developed up to now detailed mathematical models describing formation of thrombi and clots include a great number of equations. Being implemented in a CFD code, the detailed mathematical models require essential computer resources for simulation of the thrombi growth in a blood flow. A reasonable alternative way is using reduced mathematical models. Two models based on the reduced mathematical model for the thrombin generation are described in the given paper.

The first model describes growth of a thrombus in a great vessel (artery). The artery flows are essentially unsteady. They are characterized by pulse waves. The blood velocity here is high compared to that in the vein tree. The reduced model for the thrombin generation and the thrombus growth in an artery is relatively simple. The processes accompanying the thrombin generation in arteries are well described by the zero-order approximation.

A vein flow is characterized lower velocity value, lower gradients, and lower shear stresses. In order to simulate the thrombin generation in veins, a more complex system of equations has to be solved. The model must allow for all the non-linear terms in the right-hand sides of the equations.

The simulation is carried out in the industrial software FlowVision.

The performed numerical investigations have shown the suitability of the reduced models for simulation of thrombin generation and thrombus growth. The calculations demonstrate formation of the recirculation zone behind a thrombus. The concentration of thrombin and the mass fraction of activated platelets are maximum here. Formation of such a zone causes slow growth of the thrombus downstream. At the upwind part of the thrombus, the concentration of activated platelets is low, and the upstream thrombus growth is negligible.

When the blood flow variation during a hart cycle is taken into account, the thrombus growth proceeds substantially slower compared to the results obtained under the assumption of constant (averaged over a hard cycle) conditions. Thrombin and activated platelets produced during diastole are quickly carried away by the blood flow during systole. Account of non-Newtonian rheology of blood noticeably affects the results.

Most biomechanical tasks of interest to clinicians can be solved only using personalized mathematical models. Such models allow to formalize and relate key pathophysiological processes, basing on clinically available data evaluate non-measurable parameters that are important for the diagnosis of diseases, predict the result of a therapeutic or surgical intervention. The use of models in clinical practice imposes additional restrictions: clinicians require model validation on clinical cases, the speed and automation of the entire calculated technological chain, from processing input data to obtaining a result. Limitations on the simulation time, determined by the time of making a medical decision (of the order of several minutes), imply the use of reduction methods that correctly describe the processes under study within the framework of reduced models or machine learning tools.

Personalization of models requires patient-oriented parameters, personalized geometry of a computational domain and generation of a computational mesh. Model parameters are estimated by direct measurements, or methods of solving inverse problems, or methods of machine learning. The requirement of personalization imposes severe restrictions on the number of fitted parameters that can be measured under standard clinical conditions. In addition to parameters, the model operates with boundary conditions that must take into account the patient’s characteristics. Methods for setting personalized boundary conditions significantly depend on the clinical setting of the problem and clinical data. Building a personalized computational domain through segmentation of medical images and generation of the computational grid, as a rule, takes a lot of time and effort due to manual or semi-automatic operations. Development of automated methods for setting personalized boundary conditions and segmentation of medical images with the subsequent construction of a computational grid is the key to the widespread use of mathematical modeling in clinical practice.

The aim of this work is to review our solutions for personalization of mathematical models within the framework of three tasks of clinical cardiology: virtual assessment of hemodynamic significance of coronary artery stenosis, calculation of global blood flow after hemodynamic correction of complex heart defects, calculating characteristics of coaptation of reconstructed aortic valve.

Methods for modeling blood flow and its rheological properties are reviewed. Blood is considered as a particle suspencion. The methods are boundary integral equation method (BIEM), lattice Boltzmann (LBM), finite elements on dynamic mesh, dissipative particle dynamics (DPD) and agent based modeling. The analysis of these methods’ applications on high-performance systems with various architectures is presented.