Abstract
Currently carotid artery stenting (CAS) is a widely used technique for the treatment
of carotid artery stenosis. However, some patients with restenosis following CAS have
been reported, resulting in potential clinical problems. The purpose of this study
was to investigate the hemodynamic changes before and after CAS to find the factors
that may influence restenosis. Five patients (two with restenosis, three without restenosis)
were included in this study. The geometry and rheological conditions of the carotid
arteries were obtained from three-dimensional digital subtraction angiography and
ultrasound measurements. Computational fluid dynamics (CFD) modelling was performed
to calculate wall shear stress (WSS), wall shear stress gradient (WSSG) and internal
carotid artery (ICA) flow ratio. In addition, morphologic analysis was carried out.
CFD results indicated that the WSSG of the restenosis group was significantly larger
than that of the no-restenosis group. In the restenosis group, the WSS distribution
after CAS showed a significant variation at the ICA. The average ICA flow ratio of
the restenosis group was 43.5%, while in the no-restenosis group it was 68.6%. Furthermore,
there were similar significant differences between the two groups during morphology
analysis. CFD technology is useful for physicians in estimating haemodynamic changes
during ICA stenosis treatment. These parameters, including ICA flow ratio and WSS
distribution, may help to predict carotid restenosis. In future, CFD combined with
other medical techniques such as digital subtraction angiography, MRI and pathology
technologies will be available for the clinical estimation of ICA restenosis.
Keywords
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Article info
Publication history
Accepted:
March 30,
2013
Received:
March 4,
2013
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
