title: Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics--a pilot study.
abstract: OBJECTIVE
  To compare postoperative morphological and rheological conditions after eversion carotid endarterectomy versus conventional carotid endarterectomy using computational fluid dynamics.
  
  
  METHODS
  Hemodynamic metrics (velocity, wall shear stress, time-averaged wall shear stress and temporal gradient wall shear stress) in the carotid arteries were simulated in one patient after conventional carotid endarterectomy and one patient after eversion carotid endarterectomy by computational fluid dynamics analysis based on patient specific data.
  
  
  RESULTS
  Systolic peak of the eversion carotid endarterectomy model showed a gradually decreased pressure along the stream path, the conventional carotid endarterectomy model revealed high pressure (about 180 Pa) at the carotid bulb. Regions of low wall shear stress in the conventional carotid endarterectomy model were much larger than that in the eversion carotid endarterectomy model and with lower time-averaged wall shear stress values (conventional carotid endarterectomy: 0.03-5.46 Pa vs. eversion carotid endarterectomy: 0.12-5.22 Pa).
  
  
  CONCLUSIONS
  Computational fluid dynamics after conventional carotid endarterectomy and eversion carotid endarterectomy disclosed differences in hemodynamic patterns. Larger studies are necessary to assess whether these differences are consistent and might explain different rates of restenosis in both techniques.
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Demirel
authors.affiliation: Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China.
authors.forename: D
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Mei
authors.affiliation: Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, USA.
authors.forename: S
authors.initials: S
authors.lastname: Partovi
authors.affiliation: Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Inselspital, Bern, Switzerland Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: von Tengg-Kobligk
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Dadrich
authors.affiliation: Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Böckler
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: H U
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany Matthias.Mueller-E@med.uni-heidelberg.de.
authors.forename: M
authors.initials: M
authors.lastname: Müller-Eschner
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D058070:Asymptomatic Diseases; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003198:Computer Simulation; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008955:Models, Cardiovascular; D010865:Pilot Projects; D012008:Recurrence; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012212:Rheology; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Computational fluid dynamics; carotid artery stenosis; carotid endarterectomy; conventional carotid endarterectomy; eversion carotid endarterectomy; rheology