Computational fluid dynamic characterization of carotid bifurcation stenosis in patient-based geometries.
Abstract
Hemodynamic forces play a role in determining endothelial cell (EC) phenotype and influence vascular remodeling. We present a lesion-based computational fluid dynamic (CFD) pilot analysis to understand the complex spatial and temporal hemodynamic changes that prevail in patients with high-grade carotid artery stenosis (CS). High-resolution three-dimensional (3D) rotational angiography datasets were acquired in eight patients, and used to generate computational meshes. CFD analysis was carried out implementing realistic shear-dependent viscosity for blood. The mean wall shear stress (WSS) within the stenosis region was 107 ± 73 dyn/cm(2) rapidly followed by direction reversal and lower oscillating values in the recirculation zone at a mean of 19 ± 14 dyn/cm(2). WSS vectors exhibited complex dynamic directional and amplitude oscillations not seen in healthy segments, along with time-dependent convergence and divergence strips during the cardiac cycle. The spatial gradient of WSS revealed an elevated average magnitude at the throat of the stenosis of 1425 ± 1012 dyn/cm(3). In conclusion, patient-based CFD analysis of CS predicts a complex hemodynamic environment with large spatial WSS variations that occur very rapidly over short ...Continue Reading
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