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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Mathematical modeling in assessing the risk of restenosis after carotid endarterectomy
V G Borisov1,2, Yu N Zakharov2, R A Vinogradov3,4
1Kemerovo State University, 650000, Kemerovo, Russia.
Insights
Carotid endarterectomy impacts cerebral circulation, with hemodynamic indices indicating atherosclerosis risk. This study compares carotid bifurcation models, revealing that post-surgery models show worse overall indices but improved near-bifurcation results.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Computational Fluid Dynamics
Background:
- Carotid endarterectomy is a primary treatment for carotid artery atherosclerosis affecting cerebral blood flow.
- Hemodynamic indices, particularly near-wall shear stress, are key markers for atherogenesis risk.
- Understanding carotid bifurcation hemodynamics is crucial for managing cerebrovascular disease.
Purpose of the Study:
- To comparatively analyze hemodynamic indices in diverse carotid bifurcation models.
- To investigate the impact of virtual geometric modifications on optimizing hemodynamic indices.
- To evaluate the effectiveness of virtual surgery in improving vascular hemodynamics.
Main Methods:
- Construction of carotid bifurcation models from computed angiography data.
- Utilizing computational fluid dynamics (CFD) to identify critical hemodynamic zones.
- Comparative analysis of hemodynamic indices across different model types, including 'normal,' post-operative, and virtually altered models.
Main Results:
- Post-operative models exhibited over five times worse averaged indices in critical zones compared to normal models.
- Near-bifurcation regions in post-operative models showed a 25% improvement in indices.
- Virtual removal of minor plaques led to up to 40% index deterioration at former plaque sites.
Conclusions:
- The study presents a method for identifying and comparing critical hemodynamic zones in various vascular models.
- A novel virtual surgery technique allows for shape modification to optimize hemodynamics.
- Comparative analysis of real and virtual models, with sub-zone analysis of post-operative critical zones, offers new insights into vascular interventions.
Abstract:
Carotid endarterectomy is the main way to combat atherosclerosis of the carotid arteries, which disrupts cerebral circulation. The generally accepted marker of atherogenesis risk are hemodynamic indices associated with near-wall shear stress. The purpose of the work is to conduct a comparative analysis of hemodynamic indices in various carotid bifurcation models. The influence of a virtual change in the geometric shape of the model in order to optimize hemodynamic indices is also being studied. On the basis of computed angiography data, carotid bifurcation models are constructed, in which critical zones of hemodynamic indices are built using computational fluid dynamics. A comparative analysis of the critical zones for different classes of models is carried out. Comparison of averaged indices for critical zones between 'normal' and post-operative groups gave more than 5-x worse results for the latter. The same results for the near-bifurcation parts of the zones give a 25% better result for postoperative models. Virtual 'removal' of insignificant plaques leads to a deterioration of the indices of up to 40% in the places of the plaque's former location. The described method makes it possible to build the indices critical zones and compare them for various types of models. A technique for virtual changing the shape of a vessel (virtual surgery) is proposed. The novelty of the approach lies in the use for comparative analysis both real vessel models and hypothetical 'improved' virtual ones, as well in the proposed division of post-operative model's critical zones into subzones of different genesis.
