Pressure-induced mechanical stress in the carotid artery bifurcation: a possible correlation to atherosclerosis

A possible correlation between regions of high intramural wall stress and the development of atherosclerotic lesions in the carotid artery bifurcation is investigated. The bifurcation geometry is determined through in vivo studies, as well as the analysis of cadaver specimens. Having compiled accurate geometric data, two representative finite element models were created in order to determine the areas of localized stress concentrations that occur in the bifurcation. The artery is assumed isotropic and is mechanically loaded with an incremental pressure of 40 mmHg. A highly localized stress concentration of approximately 9 to 14 times the proximal circumferential wall stress occurs at the point of bifurcation. A lower stress concentration of approximately 3 to 4 times the proximal circumferential stress occurs over a large area of the sinus bulb. Acknowledging that these two regions of the carotid bifurcation are highly susceptible to atherosclerotic lesions, it appears possible that a correlation between wall stress and atherosclerosis may exist.