Our Summary

This research paper explains a new method for creating 3D models of a specific part of the artery (the carotid bifurcation) and using computer simulations to practice a common surgical procedure (endarterectomy). This is done with the aim to identify areas where there is the highest chance of artery narrowing (restenosis) happening again after the surgery. The method also allows to compare the risk factors when using different types and sizes of patches used in the procedure.

The procedure is demonstrated on a 3D model of a healthy vessel. The model is constructed based on CT scans before the surgery of a patient’s affected vessel. The flow of blood in the vessel is simulated using data from the patient’s ultrasound test.

Risk factors are evaluated based on the force applied by blood on the vessel wall (Wall Shear Stress). The distribution of risk zones in the healthy vessel, which could potentially lead to plaque formation, is analysed. They also compare the outcomes of using 10 different types of patches and determine which is the best option.

The method proposed in this research could be used to predict the outcomes of surgery when using patches of different sizes and shapes.

FAQs

  1. What is the purpose of constructing geometric models of the carotid bifurcation and simulating endarterectomy surgery?
  2. How is the flow in the vessel simulated in these models?
  3. How are risk factors assessed in these simulations and how do they contribute to the understanding of restenosis risk with different patches?

Doctor’s Tip

A helpful tip a doctor might give a patient about carotid endarterectomy is to follow all post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and making lifestyle changes such as quitting smoking and maintaining a healthy diet and exercise routine. It is important to monitor for any signs of infection or complications and to report them to your healthcare provider immediately. Regular monitoring and follow-up care are crucial for successful recovery and long-term health outcomes.

Suitable For

Carotid endarterectomy is typically recommended for patients with significant carotid artery stenosis, especially those who have had a previous transient ischemic attack (TIA) or stroke. Other patients who may be recommended for carotid endarterectomy include those with symptoms of carotid artery disease such as amaurosis fugax (temporary loss of vision in one eye), or patients with severe carotid artery narrowing detected on imaging studies. The decision to undergo carotid endarterectomy is usually made after a thorough evaluation of the patient’s overall health and individual risk factors.

Timeline

Before carotid endarterectomy:

  • Patient undergoes diagnostic tests such as ultrasound Doppler velocimetry and computed tomography to assess the severity of carotid artery stenosis.
  • Patient may experience symptoms such as transient ischemic attacks or stroke due to reduced blood flow to the brain.
  • Surgeon evaluates the patient’s overall health and risk factors for surgery.

After carotid endarterectomy:

  • Patient undergoes the surgical procedure to remove the plaque from the carotid artery and restore blood flow to the brain.
  • Patient is monitored closely in the postoperative period for any complications such as bleeding or stroke.
  • Patient may experience improved blood flow to the brain, reducing the risk of future stroke or transient ischemic attacks.
  • Patient undergoes follow-up appointments to monitor the success of the surgery and to address any potential issues that may arise.

What to Ask Your Doctor

  1. What is carotid endarterectomy and why is it recommended for me?
  2. What are the potential risks and complications associated with carotid endarterectomy surgery?
  3. How should I prepare for the surgery and what can I expect during the recovery process?
  4. How long will it take for me to recover fully from the surgery?
  5. Are there any alternative treatment options available for my condition?
  6. How will carotid endarterectomy surgery affect my overall cardiovascular health in the long term?
  7. Can you explain the hemodynamic factors that will be considered during the surgery, such as Wall Shear Stress?
  8. Will the use of patches during the surgery affect my risk of restenosis in the future?
  9. How will you determine the optimal size and shape of the patches to be used during the surgery?
  10. What can I do to reduce my risk of complications and improve the success of the surgery?

Reference

Authors: Kazantsev AN, Korotkikh AV, Lider RY, Mukhtorov OS, Palagin PD, Sirotkin AA, Lebedev OV, Kazantsva EG. Journal: Curr Probl Cardiol. 2023 Feb;48(2):101505. doi: 10.1016/j.cpcardiol.2022.101505. Epub 2022 Nov 17. PMID: 36402216