Elucidating the hemodynamic impact of residual stenosis post-carotid artery stenting: A numerical study.

Autor: Zhang X; School of Mechanical Engineering, Jiangsu University of Technology, Changzhou, Jiangsu, China.; Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China., Fan Z; School of Mechanical Engineering, Jiangsu University of Technology, Changzhou, Jiangsu, China., Zhao P; Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China., Ye X; School of Mechanical Engineering, Jiangsu University of Technology, Changzhou, Jiangsu, China., Deng X; Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China., Guidoin R; Department of Surgery, Universit´e Laval and Division of Regenerative Medicine, CHU de Qu´ebec Research Centre, Québec City, Quebec, Canada., Liu M; Department of Vascular Surgery, Beijing Friendship Hospital, Beijing Center for Vascular Surgery, Capital Medical University, Beijing, China.
Jazyk: angličtina
Zdroj: Medical physics [Med Phys] 2024 Dec; Vol. 51 (12), pp. 9303-9317. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1002/mp.17386
Abstrakt: Background: Residual stenosis (RS) and hemodynamics demonstrate a significant correlation with postoperative in-stent restenosis/thrombosis following carotid artery stenting (CAS).
Purpose: This study endeavors to elucidate the potential associations between RS and adverse postoperative hemodynamic factors.
Methods: This study utilized 46 patient-specific carotid artery models post-stenting, which were categorized into two groups based on the presence of RS: the normal group (N, n = 23) and the RS group (RS, n = 23). A comparative analysis was conducted to evaluate the discrepancies in geometry and adverse hemodynamic parameters, alongside investigating the potential correlation between hemodynamic and geometric parameters.
Results: The results reveal that a higher reflux flow volume is discernible in the RS group during low-velocity phases of the cardiac cycle, concomitant with an augmented extent of areas exposed to oscillatory shear stress and extended particle residence time. Moreover, the adverse hemodynamic parameters exhibit a positive correlation with the degree of stent expansion, stent length in the common carotid artery (CCA), and the distal slope of the RS.
Conclusion: The distal slope and tortuosity of RS significantly influence the development of adverse hemodynamic conditions post-stenting, exacerbating the hemodynamic environment near the stenosis. Interestingly, while an extended stent length in the internal carotid artery (ICA) region improves hemodynamics by reducing flow disturbance, a longer stent in the CCA significantly worsens these conditions. Hence, it is prudent to analyze the characteristics of the local lesion regions to optimize the strategy for stent implantation.
(© 2024 American Association of Physicists in Medicine.)
Databáze: MEDLINE
Externí odkaz: