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Updated: Jan 27, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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Flow Patterns in Carotid Webs: A Patient-Based Computational Fluid Dynamics Study.

K C J Compagne1,2, K Dilba1,3, E J Postema3

  • 1From the Departments of Radiology and Nuclear Medicine (K.C.J.C., K.D., A.C.G.M.v.E., A.v.d.L.).

AJNR. American Journal of Neuroradiology
|March 16, 2019
PubMed
Summary
This summary is machine-generated.

Carotid webs cause abnormal blood flow patterns, increasing stroke risk. Computational fluid dynamics reveal disturbed flow and higher shear stress, suggesting a mechanism for thrombus formation and recurrent ischemic stroke.

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Area of Science:

  • Vascular Neurology
  • Biomedical Engineering
  • Cardiovascular Research

Background:

  • Carotid webs are increasingly recognized as a cause of recurrent ischemic stroke, particularly in patients lacking other cardiovascular risk factors.
  • Altered hemodynamic flow patterns near carotid webs may contribute to thrombus formation.

Purpose of the Study:

  • To evaluate the hemodynamic flow patterns associated with carotid webs using computational fluid dynamics (CFD).
  • To investigate the relationship between carotid web morphology and disturbed blood flow characteristics.

Main Methods:

  • Utilized CFD models based on CT angiography lumen segmentations from patients with carotid webs (from the MR CLEAN trial).
  • Assessed hemodynamic parameters including recirculation zone area, wall shear stress (WSS), and oscillatory shear index (OSI).
  • Compared CFD-derived parameters between the carotid web and the contralateral carotid bifurcation.

Main Results:

  • Significantly larger recirculation zones were observed distal to carotid webs compared to contralateral bifurcations (63 vs 43 mm²).
  • Higher transverse WSS and OSI were found in recirculation zones of carotid webs.
  • Time-averaged WSS was significantly higher at the minimal lumen area of the carotid web compared to the contralateral side (0.58 vs 0.45 Pa).

Conclusions:

  • Carotid webs are associated with significantly disturbed flow, characterized by increased recirculation zones and elevated regional WSS metrics.
  • These hemodynamic alterations suggest that carotid webs may promote thrombus formation.
  • The disturbed flow patterns associated with carotid webs likely contribute to the increased risk of acute ischemic stroke.