Key result
A finite element model of endarterectomy and polytetrafluoroethylene patching demonstrated diffuse low wall shear stress, high cyclic strain, and high effective stress in the repaired carotid.
Why the study?
What are the hemodynamic effects of carotid artery endarterectomy and polytetrafluoroethylene patching in a finite element model?
What are the hemodynamic effects of carotid artery endarterectomy and polytetrafluoroethylene patching in a finite element model?
Endarterectomy and PTFE patching produce considerable hemodynamic abnormalities, demonstrating the utility of advanced mechanical modeling to evaluate and optimize carotid revascularization approaches.
Modeled hemodynamic abnormalities after CEA with PTFE patch may promote restenosis; hypothesis-generating for patch optimization in prospective studies.
INTRODUCTION: The hemodynamic effects of carotid artery patching are not well known. Our objective was to develop a fluid-solid finite element model of the endarterectomized and patched carotid artery. METHODS: Hyperelastic materials parameters were determined from studies of 8 cadaveric carotids. Blood flow characteristics were based on intraoperative data from a patient undergoing endarterectomy. Wall shear stress, cyclic strain and effective stress were computed as hemodynamic parameters with known association with endothelial injury, neointimal hyperplasia and atherogenesis. RESULTS: Low wall shear stress, high cyclic strain and high effective stress were identified diffusely in the carotid bulb, at the margins around the patch and in the flow divider. CONCLUSION: Endarterectomy and polytetrafluoroethylene patching produce considerable abnormalities in the hemodynamics of the repaired carotid. Advanced mechanical modeling can be used to evaluate different carotid revascularization approaches to obtain optimized biomechanical and hemodynamic results for the care of patients with carotid bifurcation disease.
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Kamenskiy et al. (2009) studied Carotid bifurcation disease (n=9). Finite element modeling of endarterectomy and polytetrafluoroethylene patching was evaluated on Wall shear stress, cyclic strain and effective stress. A finite element model of endarterectomy and polytetrafluoroethylene patching demonstrated diffuse low wall shear stress, high cyclic strain, and high effective stress in the repaired carotid.
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