Kolachalama Vijaya B, Bressloff Neil W, Nair Prasanth B, Shearman Clifford P
Biomedical Engineering Center, Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA.
IEEE Trans Biomed Eng. 2007 May;54(5):802-12. doi: 10.1109/TBME.2006.889188.
A diagnostic technique is proposed to identify patients with carotid stenosis who could most benefit from angioplasty followed by stent implantation. This methodology involves performing a parametric study to investigate the haemodynamic behavior due to alterations in the stenosis shapes in the internal carotid artery (ICA). A pulsatile 1-D Navier-Stokes solver incorporating fluid-wall interactions for a Newtonian fluid which predicts pressure and flow in the human carotid artery bifurcation is used for the numerical simulations. In order to assess the performance of each individual geometry, we introduce pressure variation factor as a metric to directly compare the global effect of variations in the geometry. It is shown that the probability of an overall catastrophic effect is higher when the stenosis is present in the upstream segment of the ICA. Furthermore, maximum pressure is used to quantify the local effects of geometry changes. The location of the peak and extent of stenosis are found not to influence maximum pressure. We also show how these metrics respond after stent deployment into the stenosed part of the ICA. In particular, it is found that localized pressure peaks do not depend on the length of a stent. Finally, we demonstrate how these metrics may be applied to cost-effectively predict the benefit of stenting.
本文提出了一种诊断技术，用于识别那些最能从血管成形术及后续支架植入术中获益的颈动脉狭窄患者。该方法包括进行一项参数研究，以探究颈内动脉（ICA）狭窄形状改变所导致的血流动力学行为。采用一种用于牛顿流体的包含流体 - 壁面相互作用的一维脉动纳维 - 斯托克斯求解器来预测人体颈动脉分叉处的压力和流量，进行数值模拟。为了评估每个单独几何形状的性能，我们引入压力变化因子作为一种度量标准，以直接比较几何形状变化的整体影响。结果表明，当狭窄出现在ICA的上游段时，出现整体灾难性影响的概率更高。此外，使用最大压力来量化几何形状变化的局部影响。发现峰值位置和狭窄程度并不影响最大压力。我们还展示了在将支架植入ICA狭窄部位后，这些度量标准的响应情况。特别是，发现局部压力峰值并不取决于支架的长度。最后，我们展示了如何应用这些度量标准来经济高效地预测支架植入的益处。
