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Prediction of Hemodynamic-Related Hemolysis in Carotid Stenosis and Aiding in Treatment Planning and Risk
Krystian Jędrzejczak1, Wojciech Orciuch1, Krzysztof Wojtas1
1Faculty of Chemical and Process Engineering, Warsaw University of Technology, Waryńskiego 1, 00-645 Warsaw, Poland.
Insights
This study identifies key carotid artery stenosis shapes that increase shear stress and hemolysis risk. A new correlation allows rapid risk assessment using non-invasive test data for clinical practice.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Medical Imaging
Background:
- Atherosclerosis causes significant morbidity and mortality via ischemic events.
- Post-stenotic blood flow disruption and shear stress contribute to artery wall damage and hemolysis.
- Maximum shear stress in atherosclerotic plaques is a key determinant of hemolysis risk.
Purpose of the Study:
- To identify critical parameters of carotid artery stenosis that increase shear stress.
- To develop a rapid assessment tool for hemolysis risk in patients with atherosclerotic stenosis.
- To provide practical guidelines for identifying high-risk stenosis shapes.
Main Methods:
- 3D modeling of internal carotid artery stenosis from patient CT scans.
- Computational simulations to analyze shear stress in different stenosis geometries.
- Development of a correlation based on stenosis shape parameters and non-invasive test data.
Main Results:
- Specific stenosis shape parameters were identified as critical for increasing shear stress.
- The study demonstrated the impact of carotid artery size, length, and narrowing degree on maximum shear stress.
- A novel correlation for rapid hemolysis risk assessment was established.
Conclusions:
- The developed correlation enables quick initial diagnosis of atherosclerotic stenosis related to hemolysis risk.
- Practical guidelines can help clinicians identify stenosis shapes posing a hemolysis risk.
- This approach can be adapted for medical practice to improve patient care.
Abstract:
Atherosclerosis affects human health in many ways, leading to disability or premature death due to ischemic heart disease, stroke, or limb ischemia. Poststenotic blood flow disruption may also play an essential role in artery wall impairment linked with hemolysis related to shear stress. The maximum shear stress in the atherosclerotic plaque area is the main parameter determining hemolysis risk. In our work, a 3D internal carotid artery model was built from CT scans performed on patients qualified for percutaneous angioplasty due to its symptomatic stenosis. The obtained stenosis geometries were used to conduct a series of computer simulations to identify critical parameters corresponding to the increase in shear stress in the arteries. Stenosis shape parameters responsible for the increase in shear stress were determined. The effect of changes in the carotid artery size, length, and degree of narrowing on the change in maximum shear stress was demonstrated. Then, a correlation for the quick initial diagnosis of atherosclerotic stenoses regarding the risk of hemolysis was developed. The developed relationship for rapid hemolysis risk assessment uses information from typical non-invasive tests for treated patients. Practical guidelines have been developed regarding which stenosis shape parameters pose a risk of hemolysis, which may be adapted in medical practice.
