Computational Fluid Dynamics of Carotid Arteries After Carotid Endarterectomy or Carotid Artery Stenting Based on Postoperative Patient-Specific Computed Tomography Angiography and Ultrasound Flow Data

Hayase, Hitoshi; Tokunaga, Koji; Nakayama, Tsuneyoshi; Sugiu, Kenji; Nishida, Akihiko; Arimitsu, Seiji; Hishikawa, Tomohito; Ono, Shigeki; Ohta, Makoto; Date, Isao

doi:10.1227/neu.0b013e318208f1a0

Cited by 22 publications

(10 citation statements)

References 40 publications

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“…The authors showed a significantly lower strain after C-CEA, which is highly consistent with the WSS pattern of our C-CEA model. Hayase et al 25 compared postoperative hemodynamics after carotid artery stenting (CAS) with those after C-CEA with patch-angioplasty by use of CFD. Similar to the present study the authors showed an increased low and turbulent flow at the carotid bulb after C-CEA that may cause thrombogenesis and recurrent atheromatous plaques.…”

Section: Discussionmentioning

confidence: 99%

“…20,21 In recent years, computational fluid dynamics (CFD) have become an accepted technique for investigating flow alterations in anatomical correct models in carotid artery disease and assessment of rheological conditions comparing different operative techniques. [22][23][24][25][26][27][28][29] To the best of our knowledge, there has yet not been a CFD comparison between the postoperative morphologic and flow conditions in patients after C-CEA versus E-CEA.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study

et al. 2014

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“…Numerical simulation was performed by a Finite Volume solver, CFD-ACE (ESI-Group, France) by solving the transport equations -the Naviér-Stokes equations. Blood was treated as an incompressible and Newtonian fluid with a density of 1050kg/m 3 and a dynamic viscosity of 0.0035 Pa·s [14]. The average Reynolds number in these models varies between 649 to 793; thus, a laminar model of the flow was applied during the computation [15].…”

Section: Methodsmentioning

confidence: 99%

“…Several mechanical parameters such as wall shear stress (WSS) have been reported to present close relationships to the establishment of plaque and restenosis [4,8,9]. Some of the studies correlated preand post-operative hemodynamic parameters [10,11]; however, very few of them compared the operated vessel to the contralateral, untreated carotid artery [12]. In fact, the left and right carotid arteries together with the vertebral arteries function systematically to supply blood to the brain and other facial organs.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamics analyses in treated and untreated carotid arteries of the same patient: A preliminary study based on three patient cases

Mei

Müller–Eschner

et al. 2015

BME

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Abstract. Carotid atherosclerotic disease is highly related to cerebrovascular events. Carotid endarterectomy is the common operation method to treat this disease. In this study, hemodynamics analyses are performed on the carotid arteries in three patients, whose right carotid artery had been treated by carotid endarterectomy and the left carotid artery remained untreated. Flow and loading conditions are compared between these treated and untreated carotid arteries and evaluation of the operative results is discussed. Patient-specific models are reconstructed from MDCT data. Intraoperative ultrasound flow measurements are performed on the treated carotid arteries and the obtained data are used as the boundary conditions of the models and the validations of the computational results. Finite volume method is employed to solve the transport equations and the flow and loading conditions of the models are reported. The results indicate that: (i) in two of the three patients, the internal-to-external flow rate ratio in the untreated carotid artery is larger than that in the treated one, and the average overall flow split ratio by summing up the data of both the left and right carotid arteries is about 2.15; (ii) in the carotid bulb, high wall shear stress occurs at the bifurcation near the external carotid artery in all of the cases without hard plaques; (iii) the operated arteries present low time-averaged wall shear stress at the carotid bulb, especially for the treated arteries with patch technique, indicating the possibility of the recurrence of stenosis; (iv) high temporal gradient of wall shear stress (>35 Pa/s) is shown in the narrowing regions along the vessels; and (v) in the carotid arteries without serious stenosis, the maximum velocity magnitude during mid-diastole is 32~37% of that at systolic peak, however, in the carotid artery with 50% stenosis by hard plaques, this value is nearly doubled (64%). The computational work quantifies flow and loading distributions in the S299treated and untreated carotid arteries of the same patient, contributing to evaluation of the operative results and indicating the recurrent sites of potential atheromatous plaques.

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“…CFD is being increasingly employed to understand carotid stenosis and its biological properties according to geometric risks,33-36) or via virtual prototyping to recommend the best design for surgical reconstruction during a carotid endarterectomy,37) and conjunctional research magnetic resonance images 37-42). Furthermore, CFD is being used to better understand blood flow through an aneurysm in the abdominal artery, and the development and progression of aortic dissection 43-47).…”

Section: Applications In the Cardiovascular Systemmentioning

confidence: 99%

Computational Fluid Dynamics in Cardiovascular Disease

Lee

2011

Korean Circ J

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Computational fluid dynamics (CFD) is a mechanical engineering field for analyzing fluid flow, heat transfer, and associated phenomena, using computer-based simulation. CFD is a widely adopted methodology for solving complex problems in many modern engineering fields. The merit of CFD is developing new and improved devices and system designs, and optimization is conducted on existing equipment through computational simulations, resulting in enhanced efficiency and lower operating costs. However, in the biomedical field, CFD is still emerging. The main reason why CFD in the biomedical field has lagged behind is the tremendous complexity of human body fluid behavior. Recently, CFD biomedical research is more accessible, because high performance hardware and software are easily available with advances in computer science. All CFD processes contain three main components to provide useful information, such as pre-processing, solving mathematical equations, and post-processing. Initial accurate geometric modeling and boundary conditions are essential to achieve adequate results. Medical imaging, such as ultrasound imaging, computed tomography, and magnetic resonance imaging can be used for modeling, and Doppler ultrasound, pressure wire, and non-invasive pressure measurements are used for flow velocity and pressure as a boundary condition. Many simulations and clinical results have been used to study congenital heart disease, heart failure, ventricle function, aortic disease, and carotid and intra-cranial cerebrovascular diseases. With decreasing hardware costs and rapid computing times, researchers and medical scientists may increasingly use this reliable CFD tool to deliver accurate results. A realistic, multidisciplinary approach is essential to accomplish these tasks. Indefinite collaborations between mechanical engineers and clinical and medical scientists are essential. CFD may be an important methodology to understand the pathophysiology of the development and progression of disease and for establishing and creating treatment modalities in the cardiovascular field.

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Computational Fluid Dynamics of Carotid Arteries After Carotid Endarterectomy or Carotid Artery Stenting Based on Postoperative Patient-Specific Computed Tomography Angiography and Ultrasound Flow Data

Abstract: CFD of postoperative carotid arteries disclosed the differences in streamlines and WSS between CAS and patch CEA. CFD may allow us to obtain adequate rheological conditions conducive to achieving the best clinical results.

Cited by 22 publications

References 40 publications

Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study

Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study

Hemodynamics analyses in treated and untreated carotid arteries of the same patient: A preliminary study based on three patient cases

Computational Fluid Dynamics in Cardiovascular Disease

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