title: Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations.
abstract: Although atherosclerosis has been widely investigated at carotid artery bifurcation, there is a lack of morphometric and hemodynamic data at different stages of the disease. The purpose of this study was to determine the lesion difference in patients with carotid artery disease compared with healthy control subjects. The three-dimensional (3D) geometry of carotid artery bifurcation was reconstructed from computed tomography angiography (CTA) images of Chinese control subjects (n = 30) and patients with carotid artery disease (n = 30). We defined two novel vector angles (i.e., angles 1 and 2) that were tangential to the reconstructed contour of the 3D vessel. The best-fit diameter was computed along the internal carotid artery (ICA) center line. Hemodynamic analysis was performed at various bifurcations. Patients with stenotic vessels have larger angles 1 and 2 (151 ± 11° and 42 ± 20°) and smaller diameters of the external carotid artery (ECA) (4.6 ± 0.85 mm) compared with control subjects (144 ± 13° and 36 ± 16°, 5.2 ± 0.57 mm) although there is no significant difference in the common carotid artery (CCA) (7.1 ± 1.2 vs. 7.5 ± 1.0 mm, P = 0.18). In particular, all patients with carotid artery disease have a stenosis at the proximal ICA (including both sinus and carina regions), while 20% of patients have stenosis at the middle ICA and 20% have stenosis expansion to the entire cervical ICA. Morphometric and hemodynamic analyses suggest that atherosclerotic plaques initiate at both sinus and carina regions of ICA and progress downstream.
authors.affiliation: Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China; State Key Laboratory for Turbulence and Complex Systems, College of Engineering, Peking University, Beijing, China;
authors.forename: Xu
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Radiology, Affiliated Hospital of Hebei University, Hebei University, Baoding, China;
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Yin
authors.affiliation: Department of Radiology, Affiliated Hospital of Hebei University, Hebei University, Baoding, China;
authors.forename: Yingjin
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Internal Medicine, Affiliated Hospital of Hebei University, Hebei University, Baoding, China;
authors.forename: Xinwei
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Ultrasonic Function, Affiliated Hospital of Hebei University, Hebei University, Baoding, China;
authors.forename: Jianhui
authors.initials: J
authors.lastname: Li
authors.affiliation: College of Medicine, Hebei University, Baoding, China;
authors.forename: Pei
authors.initials: P
authors.lastname: Niu
authors.affiliation: College of Medicine, Hebei University, Baoding, China;
authors.forename: Wenzeng
authors.initials: W
authors.lastname: Shen
authors.affiliation: California Medical Innovations Institute, San Diego, California; and.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.affiliation: Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China; State Key Laboratory for Turbulence and Complex Systems, College of Engineering, Peking University, Beijing, China; Shenzhen Graduate School, Peking University, Shenzhen, China.
authors.forename: Wenchang
authors.initials: W
authors.lastname: Tan
authors.affiliation: Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China; State Key Laboratory for Turbulence and Complex Systems, College of Engineering, Peking University, Beijing, China; College of Medicine, Hebei University, Baoding, China; yhuo@pku.edu.cn.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Huo
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002681:China; D003198:Computer Simulation; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler
keywords: atherosclerosis; carotid artery bifurcation; computed tomography angiography; stenosis