Hemodynamic simulation analysis of tandem carotid artery stenosis based on a patient-specific case

IF 2.4 3区医学 Q3 BIOPHYSICS

Journal of biomechanics Pub Date : 2025-08-12 DOI:10.1016/j.jbiomech.2025.112907

Junjie Cao , Ziyi Tan , Yao Tang , Zhanao Liu , Jian Huang , Guijun Huo , Zhichao Yao , Yang Zhou , Dayong Zhou

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引用次数: 0

Abstract

Tandem carotid artery stenosis (TCAS) presents significant hemodynamic challenges, necessitating a multidisciplinary approach to treatment. This study integrates imaging, pathology, and computational fluid dynamics (CFD) to analyze a patient-specific TCAS case. A three-dimensional (3D) model of the carotid bifurcation was reconstructed from computed tomography angiography (CTA) scans, and CFD simulations assessed hemodynamic parameters under different stenosis conditions. Preoperative imaging was cross-referenced with postoperative histology to identify regions of elevated time-averaged wall shear stress (TaWSS), indicative of plaque vulnerability, and areas of abrupt TaWSS reduction, which may signal potential rupture sites. Additionally, surgical intervention models revealed that internal carotid artery (ICA) stenosis had a more pronounced effect on blood flow and hemodynamics compared to common carotid artery (CCA) stenosis, emphasizing the complexity of tandem lesions. These findings suggest that integrating advanced imaging, pathology, and CFD could enhance personalized treatment strategies for TCAS, improving understanding of the associated hemodynamic risks.

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串联式颈动脉狭窄的血流动力学模拟分析，基于患者个案

串联颈动脉狭窄（TCAS）提出了显著的血流动力学挑战，需要多学科的治疗方法。本研究结合影像学、病理学和计算流体动力学（CFD）来分析一个患者特异性TCAS病例。通过计算机断层血管造影（CTA）扫描重建颈动脉分叉的三维模型，并通过CFD模拟评估不同狭窄条件下的血流动力学参数。术前影像与术后组织学交叉对照，以确定时间平均壁剪切应力（TaWSS）升高的区域，表明斑块易损性，以及TaWSS突然减少的区域，这可能是潜在破裂部位的信号。此外，手术干预模型显示，与颈总动脉（CCA）狭窄相比，颈内动脉（ICA）狭窄对血流和血流动力学的影响更为明显，强调了继发性病变的复杂性。这些发现表明，将先进的影像学、病理学和CFD相结合，可以增强TCAS的个性化治疗策略，提高对相关血流动力学风险的认识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of biomechanics 生物-工程：生物医学

CiteScore

5.10

自引率

4.20%

发文量

345

审稿时长

1 months

期刊介绍： The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership. Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to: -Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells. -Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions. -Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response. -Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing. -Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine. -Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction. -Molecular Biomechanics - Mechanical analyses of biomolecules. -Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints. -Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics. -Sports Biomechanics - Mechanical analyses of sports performance.