Is flow in the common carotid artery fully developed?

The assumption of fully developed or axisymmetric velocity profiles in the common carotid artery (CCA) underlies the straightforward estimation of CCA blood flow rates or wall shear stresses (WSS) from limited velocity data, such as spectral peak velocities acquired using Doppler ultrasound. Using an automated velocity profile classifier developed for this study, we characterized the shape of the CCA velocity profile from cine phase contrast magnetic resonance images acquired as part of an Atherosclerosis Risk in Communities (ARIC) ancillary study, here focusing on 45 participants imaged twice as part of a repeatability protocol. When averaged over the cardiac cycle, roughly 60% of the velocity profiles were classified as skewed, with over half of these exhibiting the crescent shape characteristic of strong Dean-type flow in a curved tube. During early diastole, roughly 80% of the velocity profiles were skewed. In most cases the degree and orientation of skewing were reproduced in the repeat scan, indicating the persistence of these flow features. Fully developed flow thus appears to be the exception rather than the rule in the nominally straight CCA. Implications of this for flow rate and WSS estimation, and perhaps the development and progression of carotid atherosclerosis, warrant further investigation.