Changes in Carotid Artery Flow Velocities after Stent Implantation: A Fluid Dynamics Study with Laser Doppler Anemometry

Greil, O.; Pflugbeil, G.; Weigand, Klaus; Weiß, Wolfgang; Liepsch, D.; Maurer, P.; Berger, Hermann

doi:10.1177/152660280301000217

Cited by 22 publications

(17 citation statements)

References 11 publications

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“…A larger risk area is found in case of treatment‐C as compared with treatment‐O. This can be ascribed to the higher number of struts and the smaller cell size of the closed‐cell design stent and matches with the observation of Greil et al who, based on the analysis of a silicon carotid artery model using Laser Doppler Anemometry, reported that larger cell stents may lower the flow disturbance in the bifurcation. Besides the primary role played by the stent cell size, vessel straightening may also contribute.…”

Section: Discussionsupporting

confidence: 82%

“…A straightened vessel loses 3D geometrical features such as bending and twisting and, consequently, reduces 3D fluid dynamics features such as helical flow in the bulk, which is supposed to improve the arterial hemodynamics . As an extreme case, vessel straightening may be responsible for stenosis formation distal to the stent after the procedure .…”

Section: Discussionmentioning

confidence: 99%

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A Computational Study of the Hemodynamic Impact of Open- Versus Closed-Cell Stent Design in Carotid Artery Stenting

et al. 2013

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The aim of this study is to analyze the shape and flow changes of a patient-specific carotid artery after carotid artery stenting (CAS) performed using an open-cell (stent-O) or a closed-cell (stent-C) stent design. First, a stent reconstructed from micro-computed tomography (microCT) is virtually implanted in a left carotid artery reconstructed from CT angiography. Second, an objective analysis of the stent-to-vessel apposition is used to quantify the lumen cross-sectional area and the incomplete stent apposition (ISA). Third, the carotid artery lumen is virtually perfused in order to quantify its resistance to flow and its exposure to atherogenic or thrombogenic hemodynamic conditions. After CAS, the minimum cross-sectional area of the internal carotid artery (ICA) (external carotid artery [ECA]) changes by +54% (-12%) with stent-O and +78% (-17%) with stent-C; the resistance to flow of the ICA (ECA) changes by -21% (+13%) with stent-O and -26% (+18%) with stent-C. Both stent designs suffer from ISA but the malapposed stent area is larger with stent-O than stent-C (29.5 vs. 14.8 mm(2) ). The untreated vessel is not exposed to atherogenic flow conditions whereas an area of 67.6 mm(2) (104.9) occurs with stent-O (stent-C). The area of the stent surface exposed to thrombogenic risk is 5.42 mm(2) (7.7) with stent-O (stent-C). The computer simulations of stenting in a patient's carotid artery reveal a trade-off between cross-sectional size and flow resistance of the ICA (enlarged and circularized) and the ECA (narrowed and ovalized). Such a trade-off, together with malapposition, atherogenic risk, and thrombogenic risk is stent-design dependent.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

A Computational Study of the Hemodynamic Impact of Open- Versus Closed-Cell Stent Design in Carotid Artery Stenting

et al. 2013

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“…Stent migration is one of the major factors affecting the clinical efficiency of carotid stenosis stent angioplasty, which is more common when using the whole-weaving type of stent (Greil et al, 2003). Reports have indicated that the laser-carved stent only needed the first 2 to 3 stages for releasing, after which the stent could firmly anchor to the walls of blood vessels, and generally did not show situations of moving forward or backward (Alvarez et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Clinical effects and safety review of self-expanding stent surgery for extracranial carotid artery stenosis treatment

Zhu¹,

Fang²,

Wang³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. This study aimed to investigate the clinical effects and safety review of self-expanding stent surgery in the treatment of extracranial carotid artery stenosis. Seventy-eight patients with carotid artery stenosis were applied with the self-expanding stent for endovascular interventional therapy. Eighty-one stents were implanted into 80 blood vessels of the 78 patients, in which protective umbrellas were used in 56 cases, and the success rate of stent implantation was 100%. The stenosis degree decreased from the preoperative (86.72 ± 9.5%) to the postoperative (13.43 ± 5.62%) stage, and the blood peak velocity of the stenosed vessels decreased from 189.58 ± 13.5 to 83.73 ± 5.61 cm/s. Transient blood pressure and heart rate decreases occurred in 21 cases, continuously low blood pressure and heart rate decreasing occurred in 29 cases, and acute occlusion of the ipsilateral middle cerebral artery occurred in 1 case, which was resolved through thrombolysis and thrombus breaking in time. Overperfusion symptoms were observed in 13 cases, although without serious complications such as cerebral hemorrhage. The follow-up period continued for 6-32 months, and ultrasonography revealed that Evaluation of self-expanding stent surgery 77 cases had no stent-restenosis, while 1 case had restenosis. The application of self-expanding stents had good clinical effects, with fewer complications and higher safety for the treatment of extracranial carotid artery stenosis.

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“…10 Furthermore, in vitro models have demonstrated abnormal ECA flow dynamics when the stent is extended across the ECA orifice. 11 Thus, we sought to determine whether patients undergoing CAS had any change in ECA patency and any resultant symptoms.…”

Section: ¤ ¤mentioning

confidence: 99%

Differential Effects of Carotid Artery Stenting versus Carotid Endarterectomy on External Carotid Artery Patency

et al. 2007

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Changes in Carotid Artery Flow Velocities after Stent Implantation: A Fluid Dynamics Study with Laser Doppler Anemometry

Cited by 22 publications

References 11 publications

A Computational Study of the Hemodynamic Impact of Open- Versus Closed-Cell Stent Design in Carotid Artery Stenting

A Computational Study of the Hemodynamic Impact of Open- Versus Closed-Cell Stent Design in Carotid Artery Stenting

Clinical effects and safety review of self-expanding stent surgery for extracranial carotid artery stenosis treatment

Differential Effects of Carotid Artery Stenting versus Carotid Endarterectomy on External Carotid Artery Patency

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