[Measurements of blood velocities using duplex sonography in carotid artery stents: analysis of reliability in an in-vitro model and computational fluid dynamics (CFD)].
OBJECTIVE
Stents are commonly used for the treatment of occlusive artery diseases in carotid arteries. Today, there is a controversial discussion as to whether duplex sonography (DS) displays blood velocities (BV) that are too high in stented areas. The goal of this study was to evaluate the effect of stenting on DS with respect to BV in artificial carotid arteries. The results of computational fluid dynamics (CFD) were also used for the comparison.


METHODS
To analyze BV using DS, a phantom with a constant flow (70 cm/s) was created. Three different types of stents for carotid arteries were selected. The phantom fluid consisted of 67 % water and 33 % glycerol. All BV measurements were carried out on the last third of the stents. Furthermore, all test runs were simulated using CFD. All measurements were statistically analyzed.


RESULTS
DS-derived BV values increased significantly after the placement of the Palmaz Genesis stent (77.6 ± 4.92 cm/sec, p = 0.03). A higher increase in BV values was registered when using the Precise RX stent (80.1 ± 2.01 cm/sec, p < 0.0001). The Strecker Tantalum stent (85.9 ± 1.95 cm/sec, p < 0.0001) generated the highest BV values. CFD simulations showed similar results.


CONCLUSIONS
Stents have a significant impact on BV, but no effect on DS. The main factor of the blood flow acceleration is the material thickness of the stents. Therefore, different stents need different velocity criteria. Furthermore, the results of computational fluid dynamics prove that CFD can be used to simulate BV in stented silicone tubes.
Schönwald
U G
UG
Physikalische Technik, Fachhochschule Gelsenkirchen, Dorsten. gerrit@schoenwald-mail.com
Jorczyk
U
U
Kipfmüller
B
B
D001783:Blood Flow Velocity / Q000502:physiology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D019295:Computational Biology; D003198:Computer Simulation; D006801:Humans; D057446:Hydrodynamics; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data*; D066298:In Vitro Techniques; D019047:Phantoms, Imaging; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods* / Q000706:statistics & numerical data*