Key result
Patient-based computational fluid dynamic analysis of carotid stenosis demonstrated a complex haemodynamic environment, with maximum wall shear stress reaching 360 Pa in the stenosed artery compared to 83 Pa in a healthy artery.
Observational (n=5)
No
Absolute Event Rate: 360% vs 83%
Patient-specific computational fluid dynamics modeling of carotid artery stenosis reveals complex hemodynamic changes, including significant pressure drops and high wall shear stress, which may contribute to endothelial damage and stenosis pathophysiology.
Patient-specific CFD may elucidate carotid stenosis hemodynamics; pilot data leaves open its clinical role pending validation.
Haemodynamic physical parameters play a role in determining endothelial cell phenotype and influence vascular remodelling. Accurate measurement of total pressure, velocity magnitude, and wall shear stress is vital for studies on the pathogenesis of atherosclerosis. This paper investigated a lesion-based computational fluid dynamic (CFD-Fluent) pilot analysis to understand the complex haemodynamic changes prevailing in patients with high-grade carotid artery stenosis (CS) 90%. All subjects were examined with colour-flow Doppler, power Doppler, and digital subtraction angiography to enable visualization of carotid stenosis and plaque surface morphology, and used to generate computational meshes. Two models were devised: the first without any stenosis and the second with an 82% grade of stenosis localized in the external carotid artery. The distribution of the principal parameters can be obtained by computational fluid dynamics (CFD-Fluent) using patient-specific geometries and flow analytical measurements. The total pressure distribution ranged between 16,000 and 8,000 Pa in the case of normal carotid artery and 16,000 and 5,500 Pa in the case of the stenosed artery. The velocity registered a peak in the stenosis region of 5 m/s. The mean wall shear stress within the stenosis region was 360 Pa. In conclusion, patient-based CFD-Fluent analysis of CS predicts a complex haemodynamic environment with large spatial haemodynamic parameter variations that occur very rapidly over short distances. Our results improve estimates of the flow changes and forces at the vessel wall in CS and the link between haemodynamic changes and stenosis pathophysiology.
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V. Filardi (2013) conducted an observational in Carotid artery stenosis (n=5). Carotid artery stenosis vs. Normal carotid artery was evaluated on Maximum wall shear stress (WSS). Patient-based computational fluid dynamic analysis of carotid stenosis demonstrated a complex haemodynamic environment, with maximum wall shear stress reaching 360 Pa in the stenosed artery compared to 83 Pa in a healthy artery.
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