A Computational Fluid Dynamics Study on Patient-Specific Bifurcated Carotid Artery

Hegde, Abhimanyu H.; Bhat, Shreyaskumar R.; Rakesh, L; K, Dr Prakashini

doi:10.30919/es8d691

Cited by 3 publications

References 18 publications

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Hemodynamic analysis of carotid endarterectomy

et al. 2023

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Atherosclerotic stenosis of the carotid artery may lead to cerebral infarction, stroke and other serious consequences, and it is usually treated clinically with carotid endarterectomy. By comparing the pre- and postoperative flow fields, it can be shown that the operation improves hemodynamic parameters such as the velocity, wall shear stress and wall pressure of the local flow field of the carotid artery. However, previous studies have rarely considered the difference between postoperative and healthy carotid flow fields, and thus the cause of any postoperative restenosis may remain hidden. Therefore, this study constructed preoperative, postoperative and (hypothetically) healthy carotid artery models based on the real vascular structure data of a patient and applied numerical simulations verified by physical models to compare hemodynamic parameters such as flow rate, flow state, and wall shear. The results showed that after the operation, the maximum carotid blood flow velocity decreased from 2.8 m/s to 1.02 m/s, the maximum wall shear stress decreased from 190 Pa to approximately 75 Pa, the wall pressure of the carotid inlet recovered from 3000 Pa to 400 Pa, and the vortex in the distal ICA disappeared. In addition, this study also found a vortex and low-level wall shear stress of approximately 5 Pa remained in the carotid bifurcation after the operation, which also lacked spiral flow, unlike the healthy model. Therefore, due to the morphological differences between the postoperative and healthy carotid artery, adverse hemodynamic factors and a potential risk of postoperative restenosis will remain after the procedure.

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Hemodynamic analysis of carotid endarterectomy

et al. 2023

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Effect of heart rate on the hemodynamics in healthy and stenosed carotid arteries

et al. 2023

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Stenosis in the internal carotid arteries is a serious cardiovascular condition. It is well-reported that low and oscillatory wall shear stress enhances the risk of stenosis progression. However, the effects of increased heart rates in highly stenosed arteries are not well explored. A detailed understanding of the flow features and stress distribution in stenosed carotid arteries at different heart rates may help clinicians to prescribe better exercise schedules for patients. In this study, we probe the effects of elevated heart rates on the hemodynamics in healthy and stenosed carotid arterial geometries using an immersed boundary method-based computational framework. Our results reveal that a strong recirculation, secondary velocity, and oscillatory shear index (OSI) zone develop inside a severely stenosed carotid artery at normal heart rate. Higher heart rates may potentially improve arterial health by reducing OSI only for the healthy and mild stenosis carotid arteries. However, the increased heart rates worsen the arterial health of severely stenosed arteries by onsetting flow instabilities, enhancing the spread and severity of the recirculation zone and the magnitude of the secondary velocity, the pressure drops across the stenosis, and the spread of high OSI (≥0.2) zone downstream. Furthermore, in the case of severe stenosis, the wall shear stress at the stenosis throat rises significantly, which can contribute to plaque rupture and thrombus development. Here, we report in detail the behavior of stress levels and pressure fluctuations in the carotid artery model at different stenosis levels for normal and elevated heart rates.

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