Flow patterns in the human carotid artery bifurcation.

Motomiya, Mineo; Karino, Takeshi

doi:10.1161/01.str.15.1.50

Cited by 225 publications

(96 citation statements)

References 24 publications

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“…High axial velocities near the flow divider and areas of flow separation and reversal on the side of the bulb opposite to this divider were also observed under conditions of steady flow in rigid models1 2 and studies on undistensible vessels in vitro. 4 In this situation, however, the region of separation is fixed and a well-defined stable secondary flow structure can be observed.…”

Section: Discussionmentioning

confidence: 99%

Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages.

Reneman¹,

Merode²,

Hick³

et al. 1985

Circulation

149

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Velocity patterns in and distensibility of the carotid artery bulb were studied in younger (20 to 30 years; n -1 1) and older (50 to 60 years; n 9) volunteers without detectable lesions of the cervical carotid arteries by means of a high-resolution, multigate, pulsed Doppler system coupled to a B mode imager. In the bulb the axial velocities were highest on the side of the flow divider, while regions of flow separation and recirculation were observed on the side opposite to this divider. Flow separation and recirculation were less pronounced and less common in the older subjects. Flow separation was not continuously present throughout the cardiac cycle. The distensibility of the carotid arteries was significantly diminished in older subjects, especially in the bulb. The velocity patterns in the carotid artery bulb of younger subjects corroborate the patterns observed in models. The diminished flow separation and recirculation in the older subjects might result from alterations in distensibility at the transition from common to internal carotid artery with increasing age. Circulation 71, No. 3, 500-509, 1985. IN A RECENT STUDY relating data derived from autopsy specimens to flow patterns and shear stresses as assessed in model bifurcation, . ' 2Zarins et al.3 showed that in the carotid artery bulb, maximal intimal thickening and atherosclerotic plaque formation occurred in regions of flow separation and reduced shear stress. These regions were located on the side opposite to the flow divider. Regions with predominantly axial and unidirectional flow velocities and high shear stresses, located on the side of the flow divider, were relatively devoid of these wall changes. A zone of recirculation in the carotid artery bulb opposite to the flow divider was also observed in studies performed on excised human carotid artery bifurcations.4 In these investigations flow patterns were studied under conditions of steady flow, while undistensible materials and Newtonian fluids were used, conditions quite different from the situation in vivo. Although preliminary studies in models indicate that the flow patterns in the carotid artery bulb are similar under steady and pulsaFrom the

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Section: Discussionmentioning

confidence: 99%

Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages.

Reneman¹,

Merode²,

Hick³

et al. 1985

Circulation

149

View full text Add to dashboard Cite

show abstract

“…Researchers have proposed various geometric risk factors for the incidence of atherosclerotic plaques, e.g., increased bifurcation angle and enhanced differences in area ratios including the flare, proximal curvature, and tortuosity of ICA. Computational fluid dynamics (CFD) simulations have been carried out to calculate various atherogenic hemodynamic parameters, i.e., low wall shear stress (WSS) and high oscillatory shear index (OSI), at carotid artery bifurcation (14,18,19,21,22,29). These morphometric and hemodynamic studies suggested the presence of atherosclerotic plaques near the sinus region of carotid artery bifurcation because of low WSS and high OSI.…”

mentioning

confidence: 99%

Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations

Huang

Yin

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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“…This results in an increased tendency to thrombosis and increase in leukocyte adhesion, smooth muscle proliferation and endothelial apoptosis. 15,16) Considering the fact that the RCA is also exposed to this type of mechanical affect, especially in its crux, and low shear stress may trigger or accelerate the atherosclerotic involvement here, bifurcation between right posterior descending artery and right posterolateral artery is more likely to be targeted to the atherosclerotic process than proximal segments of the RCA. Therefore, flow runoff of the venous bypass grafts anastomosed proximally to the crux may be at risk for occlusion in long-term.…”

Section: Discussionmentioning

confidence: 99%

Should Right Coronary Bypass Grafts Be Anastomosed Proximal or Distal to the Crux? A Comparison of Graft Patencies

Aksüt

Köksal

Kocamaz

et al. 2012

Ann Thorac Cardiovasc Surg

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Aim: Late occlusion of bypass grafts is one of the main issues associated with long-term survival after coronary artery bypass grafting (CABG) surgery. Left coronary system is generally revascularized using arterial conduits, whereas saphenous venous grafts are used for right coronary system. We investigated the prognostic factors that are related to the patency and risk of occlusion of saphenous venous grafts used for revascularization of diseased right coronary arteries. Patients and Method: 92 patients who underwent CABG operation including a right coronary artery (RCA) bypass using saphenous venous graft (SVG) between January 2003 and July 2010 were evaluated retrospectively. Mean time of follow up was 66.9 ± 27.2 months (range 104-13 months). Grafts patencies were investigated using coronary angiography, and associated risk factors for mortality and morbidity were determined during the mid-term and long-term follow up. During the data collection phase, a significant association was noticed between patency of right coronary bypass grafts and site of distal anastomoses on RCA. Thus, patients were divided into two groups, according to the site of anastomosis. Right coronary anastomoses were performed either proximal (Group A, n = 44) or distal (Group B, n = 46) to the crux of the RCA (PDA). Results: Patency rates were similar in-group A (50% occluded and 50% patent) whereas patency rates were significantly higher in-group B (occluded 16.7%, patent 83.3%, p = 0.001). Mean age was significantly higher in-group A compared to Group B (p <0.05); however, there was no statistically significant difference between the two groups with regard to risk factors associated with cardiovascular disease (p >0.05). Also, mean diameter of the target vessel was significantly higher in-group A (p <0.01). Conclusion: Based on the results of our study we suggest that even though an appropriate segment for anastomosis is available proximal to the crux of the RCA, right posterior descending artery (PDA) should be preferred for revascularization when RCA is the target vessel in CABG.

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Flow patterns in the human carotid artery bifurcation.

Cited by 225 publications

References 24 publications

Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages.

Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages.

Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations

Should Right Coronary Bypass Grafts Be Anastomosed Proximal or Distal to the Crux? A Comparison of Graft Patencies

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