Hemodynamic simulation for plantar arteries by anatomical structure based mathematical model

Diabetic foot is a kind of common complications in diabetic patients, manifesting as ischemic lesions in plantar tissue. The plantar tissue ischemia can be estimated by the perfusion of plantar blood flow. Currently, it lacks effective methods to monitor and assess plantar blood flow perfusion in practice and detailed information is not available. This study intends to address this problem from the view of mathematical modelling. It aims to provide quantitative approach to investigate the risk of ischemia in diabetic foot by simulating the hemodynamic status along the plantar vascular network. A simplified topological structure map of the main plantar arteries was established considering the anatomical structure and physical data of each vessel. Aided by bond graph technology, a Poiseuille’s law based hemodynamic model of the plantar vessels was constructed. The model simulated the blood flow distribution in the feet of healthy individuals and diabetic patients. Compared with healthy individuals, diabetic patients show increased plantar blood pressure and decreased blood supply. The reduction in blood flow on the lateral side of the foot is greater than on the medial side in diabetic patients. The study marks the first application of vascular modeling in the plantar region, providing a quantitative method for investigating foot hemodynamics in diabetic patients and offering new potential for assessing the progression of diabetic foot and the risk of tissue ulceration.