Ceserani Valentina, Conti Michele, Curcio Nicoletta, Secchi Francesco, Baroni Irene, Bari Vlasta, Righini Paolo, Nano Giovanni, Mazzaccaro Daniela
Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy.
3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Sci Rep. 2025 Jul 1;15(1):20442. doi: 10.1038/s41598-025-05466-3.
Biomechanical analysis of crosstalk between the carotids remains poorly underexplored. This study aims to clarify the impact of severe carotid stenosis on the local hemodynamics of the opposite carotid artery, before and after treatment. Data from patients diagnosed with severe internal carotid artery stenosis (≥ 70%), treated with carotid artery stenting (CAS) or carotid endarterectomy (CEA) were analyzed. Both sides' anatomical and hemodynamic remodeling parameters were evaluated before and after treatment. Forty-two patients underwent computed tomography angiography (CTA) and phase-contrast magnetic resonance imaging (PC-MRI) to measure carotid diameters and flow rates in the common, internal, and external carotids (CCA, ICA, and ECA, respectively) before and after CAS or CEA. Additionally, patient-specific computational fluid dynamics (CFD) simulations were performed to calculate time-averaged wall shear stress (taWSS) before and after the treatment. Post-treatment analysis revealed anatomical and hemodynamic changes in the contralateral side. Specifically, there was a decrease in blood flow and an increase in vessel diameters, particularly in the CCA, of patients who had undergone CEA (pre vs. post: flow p = .029, diameter p = .007). Additionally, there was an increase in low taWSS areas in the SOI after the operation: CEA from 15.50 (10.80) % to 18.00 (20.25) %, CAS from 17.00 (15.55) % to 19.50 (20.50) %. The study revealed new anatomical and hemodynamic parameters changes in both carotids, offering insights into the interaction between stenotic and contralateral carotid arteries in post-operative conditions.
颈动脉之间串扰的生物力学分析仍未得到充分探索。本研究旨在阐明重度颈动脉狭窄对治疗前后对侧颈动脉局部血流动力学的影响。分析了诊断为重度颈内动脉狭窄（≥70%）并接受颈动脉支架置入术（CAS）或颈动脉内膜切除术（CEA）治疗的患者的数据。评估了治疗前后两侧的解剖和血流动力学重塑参数。42例患者在CAS或CEA治疗前后接受了计算机断层血管造影（CTA）和相位对比磁共振成像（PC-MRI），以测量颈总动脉、颈内动脉和颈外动脉（分别为CCA、ICA和ECA）的直径和流速。此外，还进行了患者特异性计算流体动力学（CFD）模拟，以计算治疗前后的时间平均壁面剪应力（taWSS）。治疗后分析揭示了对侧的解剖和血流动力学变化。具体而言，接受CEA治疗的患者血流量减少，血管直径增加，尤其是在CCA中（术前与术后：血流量p = 0.029，直径p = 0.007）。此外，术后SOI中低taWSS区域增加：CEA从15.50（10.80）%增加到18.00（20.25）%，CAS从17.00（15.55）%增加到19.50（20.50）%。该研究揭示了双侧颈动脉新的解剖和血流动力学参数变化，为术后狭窄颈动脉与对侧颈动脉之间的相互作用提供了见解。
