Background: The functional assessment of hemodynamic significant stenosis base on blood pressure variation has been applied for evaluation of the myocardial ischemic event. This functional assessment shows great potential for improving the accuracy of the classification of the severity of carotid stenosis. Methods: In order to explore the value of grading the stenosis using pressure gradient, we had reconstructed patient-specific carotid geometries base on MRI images, computational fluid dynamics was performed to analyze pressure gradient in their stenotic arteries. Doppler ultrasound image data and the corresponding MRI image data of 19 patients with carotid stenosis were collected. Based on these, 31 stenotic carotid arterial geometries were reconstructed. A combinatorial boundary condition method was implemented for steady-state CFD simulations. Anatomic parameters include tortuosity, angle of the bifurcation, and the cross-section area of the remaining lumen were collected to investigate the effect on the pressure distribution. Result: The pressure gradient is highly correlated with the severe stenosis (r=0.902) while the tortuosity and the angle of the bifurcation generally negatively correlate to the pressure drop of the ICA stenosis. The calculation required less than 10 minutes per case, which made the it prepared for the fast diagnosis of the severe stenosis. According to the results, we had proposed a potential threshold value for distinguishing severe stenosis to mild-moderate stenosis (PG = 0.88). Conclusions: In conclusion, the pressure gradient could serve as the additional factor for improving the accuracy of grading the severity of the stenosis.
- Carotid artery bifurcation
- pressure gradient
- computational simulation
- Copyright © 2015, American Journal of Physiology - Heart and Circulatory Physiology