Numerical simulation for predicting effect of carotid artery stenting for treating severe carotid stenosis

Abstract

Objective: To observe the value of numerical simulation for predicting effect of carotid artery stenting (CAS) in treatment of severe carotid stenosis. Methods: DICOM CT angiography (CTA) data of a female severe right internal carotid artery stenosis patient who would undergo internal carotid artery stent implantation were reconstructed with Mimics and Geomagic software to obtain a three-dimensional model of carotid stenosis. Solidworks software was then used to simulate CAS and obtain a three-dimensional model of carotid artery after CAS. Finally, the hemodynamics of the model after simulated CAS were calculated with ANSYS FLUENT software, and relevant hemodynamic parameters were obtained to evaluate the therapeutic effect of the simulated CAS. Results: Before simulated CAS, the blood flow velocity and wall shear stress of arterial stenosis were both high, while wall pressure was low, and secondary flow, vortex, reflux and flow separation were observed. The distribution of wall shear stress and wall pressure of carotid artery was uneven. The blood perfusion ratio of internal and external carotid artery was 0.34, of internal and common carotid artery was 0.25. After simulated CAS, the blood flow velocity and wall shear stress decreased, while wall pressure increased, and most of the secondary flow, reflux, vortex and flow separation disappeared. The distribution of wall shear stress and wall pressure of carotid artery became uniform. The blood perfusion ratio of internal and external carotid artery was 0.63, of internal and common carotid artery was 0.62. Conclusion: Numerical simulation could effectively predict the efficacy of CAS for treatment of severe carotid stenosis before operation.