title: Extended Eversion Carotid Endarterectomy: Computation of Hemodynamics.
abstract: BACKGROUND
  Stroke prevention includes surgery for significant stenosis of internal carotid artery (ICA). Consensus on a standard approach lacks and one alternative approach is eversion carotid endarterectomy (eCEA). To overcome disadvantages of eCEA, we developed extended-eversion carotid endarterectomy (exeCEA). Aiming to investigate hemodynamics after different surgical approaches, we created computational fluid dynamics (CFD) models of exeCEA and eCEA with included progressing lumen narrowing, representation of artery restenosis at the incision line.
  
  
  METHODS
  Blood flow velocities, volume flow rates, and wall shear stress (WSS) were established in carotid arteries from models of eCEA and exeCEA with included increasing groove (1, 1.5, 2, and 2.5 mm) at the "incision line", under input pressure of 120 and 150 mm Hg.
  
  
  RESULTS
  For the corresponding restenosis grade, models of exeCEA had a larger orifice toward ICA, lower blood flow velocities and higher volume flow rates in ICA, with lower volume flow rates in external carotid artery. WSS values in ICA of exeCEA models were lower than in eCEA models, later reaching the thrombotic range.
  
  
  CONCLUSIONS
  CFD showed better hemodynamic properties in exeCEA models, indicating presented approach might be better at preserving brain perfusion.
authors: Department of Vascular Surgery of Clinic for Surgery, University Hospital Osijek, Osijek, Croatia.
authors: Tomislav
authors: T
authors: Ištvanić
authors: Department of Radiology, University Hospital Osijek, Osijek, Croatia; Department of Anatomy and Neuroscience, Faculty of Medicine, University of Osijek, Osijek, Croatia.
authors: Zvonimir
authors: Z
authors: Vrselja
authors: Department of Biophysics, Medical Statistics and Medical Informatics, Faculty of Medicine, University of Osijek, Osijek, Croatia.
authors: Hrvoje
authors: H
authors: Brkić
authors: Department of Anatomy and Neuroscience, Faculty of Medicine, University of Osijek, Osijek, Croatia.
authors: Radivoje
authors: R
authors: Radić
authors: Department of Anatomy and Neuroscience, Faculty of Medicine, University of Osijek, Osijek, Croatia.
authors: Igor
authors: I
authors: Lekšan
authors: Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Osijek, Osijek, Croatia. Electronic address: gcuric@mefos.hr.
authors: Goran
authors: G
authors: Curic
mesh_terms: D062186:Arterial Pressure / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D016893:Carotid Stenosis / Q000503:physiopathology* / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D066230:Patient-Specific Modeling; D012039:Regional Blood Flow / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology