Abstract
Hemodynamics plays a critical role in the development of atherosclerosis, specifically in regions of curved vasculature such as bifurcations exhibiting irregular blood flow profiles. Carotid atherosclerotic disease can be intervened by stent implantation, but this may result in greater alterations to local blood flow and consequently further complications. This study demonstrates the use of a variant of Doppler optical coherence tomography (DOCT) known as split spectrum DOCT (ssDOCT) to evaluate hemodynamic patterns both before and after stent implantation in the bifurcation junction in the internal carotid artery (ICA). Computational fluid dynamics (CFD) models were constructed to simulate blood velocity profiles and compared to the findings achieved through ssDOCT images. Both methods demonstrated noticeable alterations in hemodynamic patterns following stent implantation, with features such as slow velocity regions at the neck of the bifurcation and recirculation zones at the stent struts. Strong correlation between CFD models and ssDOCT images demonstrate the potential of ssDOCT imaging in the optimization of stent implantation in the clinical setting.
Highlights
Stroke is a significant global medical issue and is recognized as the third most frequent cause of death in Canada, as well as a leading cause of long-term disability [1]
This study demonstrates the use of a variant of Doppler optical coherence tomography (DOCT) known as split spectrum DOCT to evaluate hemodynamic patterns both before and after stent implantation in the bifurcation junction in the internal carotid artery (ICA)
We have previously shown in vivo DOCT imaging of a misplaced stent in the carotid artery [10]
Summary
Stroke is a significant global medical issue and is recognized as the third most frequent cause of death in Canada, as well as a leading cause of long-term disability [1]. Carotid atherosclerotic disease is characterized by a decrease in arterial lumen size and is well known to contribute to ischemic stroke. Implantation of stents interferes with flow patterns as stent struts protrude into the arterial lumen, causing vortices and stagnation zones, which influence wall shear stress patterns and exposure time of platelets [6]. These local variations in shear stress can affect endothelial cells and result in inflammation and greater plaque formation or remodeling [7]. Thrombus formation may occur which can increase the risk of a stroke [8]
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