Variation of Shear Stresses and Flow Dynamics in Stented Patient Specific Carotid Bifurcation Model using Numerical Investigation

The carotid artery is a clinically important site in the human circulatory system as the consequences of its disease results in adverse outcomes like ischemic strokes, or death for too prolonged ischemia. Understanding the hemodynamics of this artery and its bifurcation are important. A method of treating the stenosis of this artery is Carotid Angioplasty and Stenting (CAS). This procedure results in a heavily modified hemodynamics or state of flow. To understand and predict this flow field modification Computational Fluid Dynamics (CFD) is an important computational tool. Further, the presence of a stent would affect hemodynamics. The aim of this work is to study these effects in patient-specific cases. The reconstructed patient-specific models will form the basis of the construction of the post-stenting carotid bifurcation models. A transient analysis was carried out to estimate the time-varying parameters in the fluid domains over a cardiac cycle as well as to gauge time average values over a cardiac cycle. Results are obtained for hemodynamic parameters, like wall shear stress, velocity, pressure, vorticity, and helicity, in both the prepared stenosed and stented geometries. It is seen that the stenting procedure leads to the renewal of the CCA to ICA flow path. But simultaneously the region in which the stent is present becomes a region of low TAWSS and contains areas of high OSI. These areas of low TAWSS and high OSI within the stented portions of the carotid bifurcations are indications for regions of possible restenosis. Therefore, the investigation demonstrates the likely region for future plaque growth. Further, the effects of widening of the lumen are also noted in comparison to the pre-stent cases.