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Published on: February 7, 2015
Blood Flow Characteristics in Patients with Asymptomatic Carotid Artery Stenosis Using Ultrasound-based Velocity
Janna Ruisch1, Suzanne Holewijn2, Sarah E Vermeer3
1Medical Ultrasound Imaging Centre, Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Vascular Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
Ultrasound-based velocity vector imaging (US-VVI) reveals that disturbed blood flow patterns in carotid artery stenosis are linked to plaque progression. Bending jet flow conditions, not straight jets, are associated with more atheroprone and rupture-prone characteristics.
Area of Science:
- Cardiovascular Imaging
- Biomedical Engineering
- Fluid Dynamics
Background:
- Disturbed blood flow and altered shear stress contribute to atherosclerotic plaque progression and vulnerability.
- Longitudinal studies correlating blood flow patterns with carotid plaque progression using ultrasound-based velocity vector imaging (US-VVI) are limited.
Purpose of the Study:
- To identify atheroprone or rupture-prone flow characteristics in asymptomatic carotid artery stenosis using US-VVI.
- To establish a link between specific blood flow patterns and carotid plaque development.
Main Methods:
- Eighty-five asymptomatic carotid stenoses (30%-70%) underwent conventional and ultrafast ultrasound at baseline and one-year follow-up.
- US-VVI was reconstructed, and blood flow patterns were visually assessed for atheroprone and rupture-prone features.
- Flow parameters including vector complexity, vortex presence, time-averaged wall shear stress (TA-WSS), and oscillatory shear index were quantified.
Main Results:
- Sixty-eight US-VVI acquisitions from 66 patients were analyzed after exclusions.
- Three flow conditions were identified: straight jet (61.8%), bending jet toward plaque (11.8%), and bending jet away from plaque (26.5%).
- Bending jet conditions exhibited more atheroprone characteristics (higher vector complexity, more/longer vortices, lower TA-WSS, elevated oscillatory shear index) and higher TA-WSS at peak stenosis (a rupture-prone characteristic).
Conclusions:
- US-VVI can identify local flow patterns associated with plaque progression and vulnerability in asymptomatic carotid stenosis.
- Bending jet flow patterns, influenced by jet direction, were more commonly linked to atheroprone regions.
- These findings highlight the role of specific hemodynamics in carotid atherosclerosis.
