Hemodynamic study by numerical simulation to complete the diagnosis in carotid stenosis tributary of endarterectomy

Introduction In patients with moderate symptomatic or severe asymptomatic carotid stenosis, prior to an endarterectomy it is recommended to do a detailed study, in which the complet set of morphological and hemodynamic parameters are included. In this work the effect that the location and shape of the stenosis has on the distribution of wall shear stresses and their impact on clinical diagnosis in these cases is analyzed. Materials and methods First the model of the area to study is generated and the numerical simulation is done. Then the wall shear stress, the oscilation index and the wall shear stress exposure time are established, and the impact of the results for embolization risk or the growth of arterial plaque because of intimal hiperpasia are analysed. The methodology is applied to three idealized carotids with different localization and geometrical slope of the stenosis. Results For the idealized carotids it is obtained that stenosis close to bifurcation present a higher embolization risk that the most distant one and has more risk as more stenosis slope it has. For the clinical case, the results show a high risk of embolization by break located near the atheromatous plaque. As well, it is obtained that the risk the arterial plaque to continue growing is low. Conclusions The results show that the location of a moderate stenosis related to carotid bifurcation and their geometry they are factors that aid to complete the diagnosis of lesion