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. 2024 May 18;10(11):e31383.
doi: 10.1016/j.heliyon.2024.e31383. eCollection 2024 Jun 15.

Evaluafion of the efficacy of wall shear stress in carotid artery stenting

Tao Xiaoyong  1 , Chen Yuping  1 , Huang Wei  1 , Chen Juan  1 , Qiu Feng  1 , Li Zhuo  2
Affiliations

Evaluafion of the efficacy of wall shear stress in carotid artery stenting

Tao Xiaoyong et al. Heliyon. .

Abstract

Objective: To characterize the value of carotid wall shear stress (WSS) following carotid artery stenting (CAS) in patients with carotid stenosis.

Methods: Twenty-eight patients with carotid stenosis treated with CAS between March 2021 to May 2022 in the eighth medical center of the PLA General Hospital were selected for our study. Carotid ultrasound was performed before the operation, one week post-operation, and six months post-operation. Carotid artery WSS was detected by blood flow vector imaging, and the changes in WSS before and after the operation were collected. Genetic testing of drugs was detected for patients with restenosis.

Results: Pre-operative WSS of the proximal, narrowest region, and distal carotid arteries in patients with ischemic carotid artery stenosis was 7.88 ± 3.18Pa, 14.36 ± 6.66Pa, and 1.55 ± 1.15Pa, respectively. Comparatively, pre-operative WSS of the proximal, narrowest region and distal carotid arteries in patients without ischemic symptoms was 5.02 ± 1.99Pa, 9.68 ± 4.23Pa, and 1.10 ± 0.68Pa, respectively, with a significant difference between the two groups (p < 0.001). Overall WSS of the proximal, narrowest region, and distal carotid arteries in patients before CAS was 6.68 ± 3.0Pa, 12.47 ± 5.98Pa, and 1.39 ± 0. 96Pa. WSS of the proximal, narrowest region, and distal carotid was 4.15 ± 1.42Pa, 6.71 ± 2.64Pa, and1.86 ± 1.13Pa one week after CAS, compared to 4.44 ± 1.91Pa, 7.90 ± 4.38Pa, and 2. 36 ± 1.09Pa six months after CAS. WSS of the proximal and narrowest region of the carotid artery was reduced after carotid stenting, and the difference was statistically significant (p < 0.001). There was no statistically significant difference in WSS between one week and six months after stenting (P > 0.05).

Conclusion: We employed early carotid WSS as a means of evaluating the efficacy of carotid artery stenting. Changes in carotid WSS are closely associated with carotid artery stenosis, providing valuable hemodynamic information for CAS treatment. This technique holds great application value in pre-operative evaluation and long-term follow-up.

Keywords: Carotid artery stenosis; Flow vector imaging; Ischemic stroke; Stenting; Wall shear stress.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Pre-operative v-flow imaging showed high-velocity flow (red vectors) at the narrowest region. WSS measurements exhibited a maximum WSS (WSSmax) value of 17.11Pa at the narrowest region and abnormally low WSSmax values were detected at the proximal (0.35Pa) and distal (1.93Pa) regions.
Fig. 2
Fig. 2
One week after CAS, the v-flow imaging showed that the flow velocity returned to normal at the narrowest region. While WSS measurements revealed that the WSSmax could decrease significantly at the narrowest region and the WSSmax values at the proximal and distal regions were returned to normal.
Fig. 3
Fig. 3
Six months after CAS, there was no significant change in blood flow velocity at the narrowest region compared to that of one-week post-CAS. The WSSmax values at the narrowest proximal and distal regions were not significantly different, compared to those at one-week post-CAS.
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