Arterial stenoses may cause critical blood flow and wall conditions leading to clinical complications. In this paper computational models of stenotic carotid arteries are proposed and the vessel wall collapse phenomenon is studied. The models are based on fluid-structure interactions (FSI) between blood and the arterial walls. Coupled finite element and computational fluid dynamics methods are used to simultaneously solve for stress and displacement in the solid, and for pressure, velocity and shear stress in the fluid domain. Results show high wall shear stress at the stenosis throat and low (negative) values accompanied by disturbed flow patterns downstream of the stenosis. The wall circumferential stress varies abruptly from tensile to compressive along the stenosis with high stress concentration on the plaque shoulders showing regions of possible plaque rupture. Wall compression and collapse are observed for severe cases. Post-stenotic collapse of the arterial wall occurs for stenotic severity as low as 50%, with the assumption that a given amount of blood flow needs to pass the stenotic artery; whereas if constant pressure drop should be maintained across a constriction, then collapse happens at severity of 75% and above. The former assumption is based on the requirement of adequate blood supply to the downstream organs/tissue, while the latter stems from the fact that the pumping mechanism of the body has a limited capacity in regulating blood pressure, in case a stenosis appears in the vasculature.
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http://dx.doi.org/10.1080/03091900903057326 | DOI Listing |
Ann Indian Acad Neurol
January 2025
Departments of Clinical Neurosciences and Community Health Sciences, The Hotchkiss Brain Institute, The Mathison Centre for Mental Health Research and Education, and The O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This "hot carotid" state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.
View Article and Find Full Text PDFFront Neurol
January 2025
School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Objective: To develop a machine learning-based model for predicting the clinical efficacy of acupuncture intervention in patients with upper limb dysfunction following ischemic stroke, and to assess its potential role in guiding clinical practice.
Methods: Data from 1,375 ischemic stroke patients with upper limb dysfunction were collected from two hospitals, including medical records and Digital Subtraction Angiography (DSA) reports. All patients received standardized acupuncture treatment.
Int J Stroke
January 2025
Stroke Unit, Careggi University Hospital, Florence, Italy.
Introduction: Recent evidence suggests a possible role of non-stenotic carotid atherosclerotic plaques in the aetiology of embolic stroke of undetermined source (ESUS).
Methods: We conducted a systematic review and meta-analysis of prevalence and characteristics of non-stenotic carotid plaques (NSP) with high-risk features (complicated NSP) in internal carotid artery in unilateral ESUS in the anterior circulation. We searched Medline and Ovid-Embase databases.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Background: Carotid webs are rare nonatherosclerotic disorders in the carotid artery and are increasingly recognized as factors of ischemic stroke in the young population. Asymptomatic webs can be treated with antithrombotic therapy, whereas symptomatic cases frequently require surgical interventions, including carotid endarterectomy (CEA). However, guidelines for the optimal timing of these treatments remain unestablished, especially compared to atherosclerotic stenotic lesions, due to the rarity of carotid webs.
View Article and Find Full Text PDFAnn Ital Chir
January 2025
Institute of Central Nervous System Vascular Injury and Repair, Jining Medical Science Research Institute, The First People's Hospital of Jining, 272000 Jining, Shandong, China.
Aim: This study aims to report a rare case of an embolization protection device (EPD) entrapment during Carotid Artery Stent (CAS) and to discuss the management strategy, including open surgery and concurrent carotid endarterectomy (CEA).
Case Presentation: A 71-year-old female presented with left limb weakness and unclear speech following CAS. Imaging revealed a new cerebral infarction and right internal carotid artery stenosis.
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