Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, China.
Shanghai Jiao Tong University and Chiba University International Cooperative Research Center, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai, China.
Sci Rep. 2018 Apr 3;8(1):5493. doi: 10.1038/s41598-018-23842-0.
Prospective observation of hemodynamic changes before and after the formation of atherosclerotic stenosis in the carotid artery is difficult. Thus, a vessel surface repairing method was used for retrospective hemodynamic study before and after atherosclerotic stenosis formation in carotid artery. The three-dimensional geometry of sixteen sinus atherosclerotic stenosis carotid arteries were repaired and restored as normal arteries. Computational fluid dynamics analysis was performed to estimate wall shear stress (WSS), velocity and vortex in atherosclerosis-free areas and sinus in stenosis-repaired carotid artery. The analysis was also performed in the stenotic segment and upstream and downstream of stenosis in stenotic carotid artery. Compared to the atherosclerosis-free areas in stenosis-repaired carotid artery, sinus presented significantly lower WSS (P < 0.05), lower velocity (P < 0.05) and apparent vortex. Compared to the sinus, the WSS in the upstream of stenosis was lower (P < 0.05), while in the downstream area was similar (P = 0.87), both upstream and downstream of stenosis demonstrated similar velocity to sinus (P = 0.76 and P = 0.36, respectively) and apparent vortex. Atherosclerosis-prone areas including normal carotid sinus and upstream and downstream of stenosis in stenotic carotid artery were subjected to lower WSS and velocity as well as apparent vortex, thereby might be associated with the formation and progress of atherosclerosis.
在颈动脉粥样硬化狭窄形成前后进行血流动力学变化的前瞻性观察是困难的。因此,采用血管表面修复方法对颈动脉粥样硬化狭窄形成前后的血流动力学进行回顾性研究。将 16 例窦部粥样硬化性狭窄颈动脉的三维几何形状修复并恢复为正常动脉。通过计算流体动力学分析来估计无粥样硬化斑块区域和狭窄修复颈动脉窦中的壁面剪切应力(WSS)、速度和涡流。还在狭窄颈动脉的狭窄段及其上下游进行了分析。与狭窄修复颈动脉中的无粥样硬化斑块区域相比,窦部的 WSS 明显降低(P<0.05),速度也明显降低(P<0.05),涡流也更明显。与窦部相比,狭窄上游的 WSS 较低(P<0.05),而下游区域相似(P=0.87),狭窄上下游的速度与窦部相似(P=0.76 和 P=0.36),涡流也相似。易发生动脉粥样硬化的区域包括正常颈动脉窦以及狭窄颈动脉的上游和下游,这些区域的 WSS、速度和涡流均较低,因此可能与动脉粥样硬化的形成和进展有关。