Analysis of restenosis after carotid artery stenting: Preliminary results using computational fluid dynamics based on three-dimensional angiography

被引:11
作者
Uemiya, Nahoko [1 ,2 ]
Lee, Chang-Joon [1 ]
Ishihara, Shoichiro [2 ]
Yamane, Fumitaka [2 ]
Zhang, Yu [1 ]
Qian, Yi [1 ]
机构
[1] Macquarie Univ, Australian Sch Adv Med, Sydney, NSW 2109, Australia
[2] Saitama Med Univ, Int Med Ctr, Dept Endovasc Neurosurg, Saitama, Japan
关键词
Carotid artery stenting; Computational fluid dynamics; Restenosis; Wall shear stress; Wall shear stress gradient; WALL SHEAR-STRESS; BIFURCATION; ENDARTERECTOMY; DISTRIBUTIONS; EXPOSURE; GEOMETRY;
D O I
10.1016/j.jocn.2013.03.042
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Currently carotid artery stenting (CAS) is a widely used technique for the treatment of carotid artery stenosis. However, some patients with restenosis following CAS have been reported, resulting in potential clinical problems. The purpose of this study was to investigate the hemodynamic changes before and after CAS to find the factors that may influence restenosis. Five patients (two with restenosis, three without restenosis) were included in this study. The geometry and rheological conditions of the carotid arteries were obtained from three-dimensional digital subtraction angiography and ultrasound measurements. Computational fluid dynamics (CFD) modelling was performed to calculate wall shear stress (WSS), wall shear stress gradient (WSSG) and internal carotid artery (ICA) flow ratio. In addition, morphologic analysis was carried out. CFD results indicated that the WSSG of the restenosis group was significantly larger than that of the no-restenosis group. In the restenosis group, the WSS distribution after CAS showed a significant variation at the ICA. The average ICA flow ratio of the restenosis group was 43.5%, while in the no-restenosis group it was 68.6%. Furthermore, there were similar significant differences between the two groups during morphology analysis. CFD technology is useful for physicians in estimating haemodynamic changes during ICA stenosis treatment. These parameters, including ICA flow ratio and WSS distribution, may help to predict carotid restenosis. In future, CFD combined with other medical techniques such as digital subtraction angiography, MRI and pathology technologies will be available for the clinical estimation of ICA restenosis. (C) 2013 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1582 / 1587
页数:6
相关论文
共 26 条
  • [1] [Anonymous], 2012, PERSPECTIVES MED, DOI DOI 10.1016/J.PERMED.2012.02.051
  • [2] Analysis of complex flow and the relationship between blood pressure, wall shear stress, and intima-media thickness in the human carotid artery
    Augst, A. D.
    Ariff, B.
    Thom, S. A. G. McG
    Xu, X. Y.
    Hughes, A. D.
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 2007, 293 (02): : H1031 - H1037
  • [4] Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics
    Birchall, D
    Zaman, A
    Hacker, J
    Davies, G
    Mendelow, D
    [J]. EUROPEAN RADIOLOGY, 2006, 16 (05) : 1074 - 1083
  • [5] Carotid Artery Stenting Versus Carotid Endarterectomy A Comprehensive Meta-Analysis of Short-Term and Long-Term Outcomes
    Economopoulos, Konstantinos P.
    Sergentanis, Theodoros N.
    Tsivgoulis, Georgios
    Mariolis, Anargiros D.
    Stefanadis, Christodoulos
    [J]. STROKE, 2011, 42 (03) : 687 - 692
  • [6] Reproducibility study of magnetic resonance image-based computational fluid dynamics prediction of carotid bifurcation flow
    Glor, FP
    Long, Q
    Hughes, AD
    Augst, AD
    Ariff, B
    Thom, SAM
    Verdonck, PR
    Xu, XY
    [J]. ANNALS OF BIOMEDICAL ENGINEERING, 2003, 31 (02) : 142 - 151
  • [7] CFD analysis in an anatomically realistic coronary artery model based on non-invasive 3D imaging:: comparison of magnetic resonance imaging with computed tomography
    Goubergrits, Leonid
    Kertzscher, Ulrich
    Schoeneberg, Bastian
    Wellnhofer, Ernst
    Petz, Christoph
    Hege, Hans-Christian
    [J]. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2008, 24 (04) : 411 - 421
  • [8] Overview of the 2011 Food and Drug Administration Circulatory System Devices Panel Meeting on the ACCULINK and ACCUNET Carotid Artery Stent System
    Gray, William A.
    Simonton, Charles A.
    Verta, Patrick
    [J]. CIRCULATION, 2012, 125 (18) : 2256 - U223
  • [9] Kleinstreuer C, 2001, CRIT REV BIOMED ENG, V29, P1, DOI 10.1615/CritRevBiomedEng.v29.i1.10
  • [10] PULSATILE FLOW AND ATHEROSCLEROSIS IN THE HUMAN CAROTID BIFURCATION - POSITIVE CORRELATION BETWEEN PLAQUE LOCATION AND LOW AND OSCILLATING SHEAR-STRESS
    KU, DN
    GIDDENS, DP
    ZARINS, CK
    GLAGOV, S
    [J]. ARTERIOSCLEROSIS, 1985, 5 (03): : 293 - 302