Carotid Hemodynamic Analysis After Carotid Endarterectomy

Purpose:Carotid hemodynamic parameters after standard carotid endarterectomy and patch carotid endarterectomy were analyzed by Computational Fluid Dynamics: laminar flow or turbulent flow state,and wall shear stress in local areas.Which kind of surgical methods postoperative blood flow state,local wall shear stress more consistent with physiological indicators.Methods:Twenty-one patients underwent s CEA surgery,41 patients underwent p CEA surgery,and 30 patients under normal physiologic control.Divided into S group,P group and CK group.Carotid blood flow lines and local wall shear stress values obtained by CFD.Results:1.S group: Disturbance of blood flow: 6 cases;laminar flow state: 15 cases.P group: Disturbance of blood flow: 23 cases,blood flow laminar flow: 18 cases.Control group: 0 cases of disordered blood flow,and laminar flow: 30 cases.Set four wall shear stress measurement points: point A: change in the common carotid vascular caliber(ie suture starting and ending points);point B: carotid bifurcation;C: lateral wall of the internal carotid artery initiating;D Points: The end of internal carotid artery vessels(outside wall of plateau phase);The shear stress at four points of the vessel wall was measured,and the results were obtained by CFD and analyzed by t-test.CK data of s CEA group and control group: s CEA group A: WSS was 13.62±8.52 Pa,CK group A: WSS was 10.07±4.27 Pa,t=-1.763,p=0.089>0.05;s CEA group B: WSS At 4.90±2.99 Pa,the CK group B: WSS was 4.42±3.00 Pa,t=-0.560,p=0.578>0.05;s CEA group C: WSS was 8.14±5.75Pa;CK group C: WSS was 2.05± 1.33 Pa,t=-4.762,p=0.000<0.05;s CEA group D: WSS was 19.35±7.74Pa;CK group D: WSS was 14.06±3.88 Pa,t=-2.889,p=0.008<0.05.p CEA group and control CK group data: p CEA group A: WSS was 8.00±5.64 Pa,CK group A: WSS was 10.07±4.27 Pa,t=-1.775,p=0.084>0.05;p CEA group B point: WSS It was 3.92±2.87 Pa.In CK group,point B: WSS was 4.42±3.00 Pa,t=-0.705,p=0.483>0.05.In p CEA group,point C: WSS was 3.11±1.91 Pa,CK group C: WSS was 2.05± 1.33,t=-2.751,p=0.008<0.05;p CEA group D: WSS is 13.64±6.47Pa;CK group D: WSS is 14.06±3.88 Pa,t=-0.334,p=0.740> 0.05.Conclusion:1.Compared with standard carotid endarterectomy,the carotid artery blood flow after patch carotid endarterectomy has a higher incidence of turbulence.2 In the carotid systole,the shear stress of the external wall of the internal carotid artery and the distal wall of the internal carotid artery after patch carotid endarterectomy is more in line with the normal carotid wall shear stress.