Impact of carotid web orientation on long-term thrombus growth risk: A numerical study using fluid-solid interaction

Area of Science:

• Cardiovascular research
• Biomedical engineering
• Medical imaging analysis

Background:

• Carotid web (CaW) is a rare fibromuscular dysplasia lesion.
• CaW is linked to thromboembolic events in young patients.
• CaW-induced hemodynamic disturbances contribute to thrombosis, but morphology's impact on long-term risk is unclear.

Purpose of the Study:

• To investigate the impact of carotid web (CaW) morphology on hemodynamic disturbances and thrombus formation.
• To assess the influence of CaW angles and vessel wall elasticity on thrombotic risk.

Main Methods:

• Developed patient-specific 3D numerical models of carotid arteries with varying CaW angles (30°, 60°, 90°).
• Incorporated vessel wall elasticity and thrombus growth mechanisms using fluid-structure interaction simulations.
• Analyzed wall deformation, stress, flow fields, and wall shear stress.

Main Results:

• Larger CaW angles increased wall deformation and stress, indicating higher mechanical load.
• Reduced internal carotid artery velocity and generated recirculation zones with larger angles.
• Thrombus growth models showed pronounced formation at 60° and 90°, with rigid wall models underestimating thrombus areas significantly.

Conclusions:

• Larger CaW angles are associated with increased flow disturbances and elevated thrombus risk.
• CaW angle variations influence thrombus distribution; vessel wall elasticity is crucial for accurate risk assessment.
• Clinical evaluation of carotid geometry and wall elasticity can optimize thrombus risk assessment and guide interventions.