WALL SHEAR STRESS AND OSCILLATORY SHEAR INDEX DISTRIBUTION IN CAROTID ARTERY WITH VARYING DEGREE OF STENOSIS: A HEMODYNAMIC STUDY

Abstract

A significant proportion of cerebral stroke is a consequence of the arterial stenotic plaque rupture causing local thrombosis or distal embolization. The formation and subsequent rupture of the plaque depends on wall shear stress (WSS) and oscillatory shear index (OSI). The purpose of the present study was to understand the effect of hemodynamics on the spatial and temporal variations of WSS and OSI using realistic models with varying degree of carotid artery stenosis (DOS). Multiple CT volumes were obtained from subjects in the carotid bifurcation zone and the 3D models were generated. A finite volume-based computational fluid dynamics (CFD) method was utilized to understand the hemodynamics in pulsatile flow conditions. It was observed that high stenosis models occupied a large value of normalized WSS in the internal carotid artery (ICA) whereas they had smaller values of normalized WSS in the common carotid artery (CCA). For clinical use, the authors recommend using the spatial average value of oscillatory shear rather than the maximum value for an accurate knowledge about the severity of stenosis. The resultant vorticity changes the direction of spin after the bifurcation zone. Additionally, we propose the use of limiting streamlines as a novel and convenient method to identify the disturbed flow regions that are prone to atherogenesis.