Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study
Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study
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DOI：
10.1177/1708538114552836
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发表时间：
2015-10
期刊：
影响因子：
1.1
通讯作者：
S. Demirel;Duanduan Chen;Y. Mei;S. Partovi;H. Tengg-Kobligk;M. Dadrich;M. Dadrich;D. Böckler;H. Kauczor;Matthias Müller-Eschner;Matthias Müller-Eschner
中科院分区：
文献类型：
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作者：
S. Demirel;Duanduan Chen;Y. Mei;S. Partovi;H. Tengg-Kobligk;M. Dadrich;M. Dadrich;D. Böckler;H. Kauczor;Matthias Müller-Eschner;Matthias Müller-Eschner
目的：使用计算流体动力学比较外翻颈动脉内膜切除术与传统颈动脉内膜切除术术后的形态学和流变学状况。基本方法：通过基于患者具体数据的计算流体动力学分析，对一名传统颈动脉内膜切除术后患者和一名外翻颈动脉内膜切除术后患者的颈动脉血流动力学指标（速度、壁剪切应力、时间平均壁剪切应力和时间梯度壁剪切应力）进行模拟。主要发现：外翻颈动脉内膜切除术模型的收缩峰值显示沿血流路径逐渐降低的压力，传统颈动脉内膜切除术模型显示颈动脉球部压力较高（约180 Pa）。传统颈动脉内膜切除术模型中的低壁剪切应力区域比外翻颈动脉内膜切除术模型中的低壁剪切应力区域大得多，并且具有较低的时间平均壁剪切应力值（传统颈动脉内膜切除术：0.03-5.46 Pa vs 外翻颈动脉内膜切除术：0.12-5.22 Pa）。结论：传统颈动脉内膜切除术和外翻颈动脉内膜切除术后的计算流体动力学揭示了血流动力学模式的差异。有必要进行更大规模的研究来评估这些差异是否一致，并可能解释两种技术中不同的再狭窄率。
Purpose: To compare postoperative morphological and rheological conditions after eversion carotid endarterectomy versus conventional carotid endarterectomy using computational fluid dynamics. Basic methods: Hemodynamic metrics (velocity, wall shear stress, time-averaged wall shear stress and temporal gradient wall shear stress) in the carotid arteries were simulated in one patient after conventional carotid endarterectomy and one patient after eversion carotid endarterectomy by computational fluid dynamics analysis based on patient specific data. Principal findings: Systolic peak of the eversion carotid endarterectomy model showed a gradually decreased pressure along the stream path, the conventional carotid endarterectomy model revealed high pressure (about 180 Pa) at the carotid bulb. Regions of low wall shear stress in the conventional carotid endarterectomy model were much larger than that in the eversion carotid endarterectomy model and with lower time-averaged wall shear stress values (conventional carotid endarterectomy: 0.03–5.46 Pa vs. eversion carotid endarterectomy: 0.12–5.22 Pa). Conclusions: Computational fluid dynamics after conventional carotid endarterectomy and eversion carotid endarterectomy disclosed differences in hemodynamic patterns. Larger studies are necessary to assess whether these differences are consistent and might explain different rates of restenosis in both techniques.