Extended Eversion Carotid Endarterectomy: Computation of Hemodynamics

被引:0
作者
Istvanic, Tomislav [1 ]
Vrselja, Zvonimir [2 ,3 ]
Brkic, Hrvoje [4 ]
Radic, Radivoje [3 ]
Leksan, Igor [3 ]
Curic, Goran [5 ]
机构
[1] Univ Hosp Osijek, Surg Clin, Dept Vasc Surg, Osijek, Croatia
[2] Univ Hosp Osijek, Dept Radiol, Osijek, Croatia
[3] Univ Osijek, Fac Med, Dept Anat & Neurosci, Osijek 31000, Croatia
[4] Univ Osijek, Fac Med, Dept Biophys Med Stat & Med Informat, Osijek 31000, Croatia
[5] Univ Osijek, Fac Med, Dept Med Chem Biochem & Clin Chem, Osijek 31000, Croatia
关键词
BLOOD-FLOW; SHEAR-STRESS; THROMBUS FORMATION; STENOSIS; ATHEROSCLEROSIS; ANGIOPLASTY; RESTENOSIS; TRIAL; IMAGE; WALL;
D O I
10.1016/j.avsg.2015.05.034
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Stroke prevention includes surgery for significant stenosis of internal carotid artery (ICA). Consensus on a standard approach lacks and one alternative approach is eversion carotid endarterectomy (eCEA). To overcome disadvantages of eCEA, we developed extended-eversion carotid endarterectomy (exeCEA). Aiming to investigate hemodynamics after different surgical approaches, we created computational fluid dynamics (CFD) models of exeCEA and eCEA with included progressing lumen narrowing, representation of artery restenosis at the incision line. Methods: Blood flow velocities, volume flow rates, and wall shear stress (WSS) were established in carotid arteries from models of eCEA and exeCEA with included increasing groove (1, 1.5, 2, and 2.5 mm) at the "incision line'', under input pressure of 120 and 150 mm Hg. Results: For the corresponding restenosis grade, models of exeCEA had a larger orifice toward ICA, lower blood flow velocities and higher volume flow rates in ICA, with lower volume flow rates in external carotid artery. WSS values in ICA of exeCEA models were lower than in eCEA models, later reaching the thrombotic range. Conclusions: CFD showed better hemodynamic properties in exeCEA models, indicating presented approach might be better at preserving brain perfusion.
引用
收藏
页码:1598 / 1605
页数:8
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