Sensitivity Analysis of a Model of Lower Limb Haemodynamics

Post-thrombotic syndrome (PTS) has variable clinical presentation with significant treatment costs and gaps in the evidence-base to support clinical decision making. The contribution of variations in venous anatomy to the risk of complications following treatment has yet to be characterized in detail. We report the development of a steady-state, OD model of venous anatomy of the lower limb and assessments of local sensitivity (10% radius variation) and global sensitivity (50% radius variation) of the resulting flows to variability in venous anatomy. An analysis of orthogonal sensitivity was also performed. Local sensitivity analysis was repeated with four degrees of thrombosis in the left common iliac vein. The largest normalised sensitivities were observed in locations associated with the venous return. Both local and global approaches provided similar ranking of input parameters responsible for the variation of flow in a vessel where thrombosis is typically observed. When a thrombus was included in the model increase in absolute sensitivity was observed in the leg affected by the thrombosis. These results can be used to inform model reduction strategies and to target clinical data collection.