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. 2025 Mar 21:16:1509875.
doi: 10.3389/fphys.2025.1509875. eCollection 2025.

The effects of carotid plaque classification and bifurcation angle on plaque: a computational fluid dynamics simulation

Ai Chen  1 , Zhuo Chen  2 , Jun Su  1 , Jie Pen  1 , Tao Luo  1 , Hua Zhong  1
Affiliations

The effects of carotid plaque classification and bifurcation angle on plaque: a computational fluid dynamics simulation

Ai Chen et al. Front Physiol. .

Abstract

Objectives: To investigate the influence of plaque distribution and vascular bifurcation angle on hemodynamics within the carotid artery bifurcation and to explore the role these factors play in the development of vulnerable carotid plaques. The study aims to provide a more comprehensive understanding of how complex hemodynamic patterns affect plaque formation, vulnerability, and progression.

Methods: Patient-specific carotid bifurcation models were reconstructed using 3D rotational angiography and CT angiography, validated by digital subtraction angiography. Computational fluid dynamics (ANSYS Fluent) with non-Newtonian modeling simulated hemodynamics under patient-specific boundary conditions. Plaque morphology and hemodynamic parameters (TAWSS, OSI, ECAP) were quantified. Statistical analyses included Spearman's correlations and non-parametric tests for bifurcation angles/plaque locations.

Results: Numerical simulations demonstrated that plaque subtypes and bifurcation angles critically modulate carotid hemodynamics. Elevated wall shear stress (WSS) upstream of plaques (sites M/N) increased rupture susceptibility, whereas low WSS at the outer bifurcation (site P) exacerbated atherogenesis. Larger bifurcation angles reduced peak velocities, expanded low-velocity zones, and diminished WSS, amplifying atherosclerosis risk. Vortex-driven low-shear regions prolonged platelet residence, enhancing thrombotic propensity. Fluid-structure interactions revealed arterial wall deformation near bifurcations, correlating with endothelial injury and plaque progression. These hemodynamic alterations underscore the biomechanical interplay driving plaque vulnerability and thrombosis in carotid atherosclerosis.

Conclusion: Carotid plaque vulnerability arises from bifurcation angle-dependent hemodynamic disturbances, where elevated upstream wall shear stress predisposes to rupture, while low-shear zones at the outer bifurcation accelerate atherogenesis. Vortex-driven platelet retention and fluid-structure interactions exacerbate endothelial dysfunction, underscoring hemodynamic targeting for clinical risk mitigation.

Keywords: carotid artery bifurcation; hemodynamics; plaque formation; shear stress; vascular bifurcation angle.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Model of plaques at different locations of the strong artery.
FIGURE 2
FIGURE 2
Model of different bifurcation angles of carotid artery vessels.
FIGURE 3
FIGURE 3
Plaque velocity, pressure, and shear force results in three locations. (a) Velocity distribution cloud. (b) Pressure distribution cloud. (c) Wall shear stress distribution cloud.
FIGURE 4
FIGURE 4
Distribution of shear forces on the wall ((“O” is located at the bifurcation ridge, “M” is the outer side of the common carotid artery (CCA), “N” is the outer side of the internal carotid artery (ICA), and “P” is the outer side of the external carotid artery (ECA)).
FIGURE 5
FIGURE 5
Middle section velocity distribution.
FIGURE 6
FIGURE 6
Wall pressure distribution.
FIGURE 7
FIGURE 7
Pressure distribution at bifurcated ridges.
FIGURE 8
FIGURE 8
Flow velocity distribution at bifurcated ridges.
FIGURE 9
FIGURE 9
Cross-sectional velocity distribution curves of different bifurcation angle models.
FIGURE 10
FIGURE 10
Shear stress and pressure extremes at different bifurcation angles.
FIGURE 11
FIGURE 11
Extreme distribution of shear stress and pressure.
FIGURE 12
FIGURE 12
Movement trajectory of cells.
See this image and copyright information in PMC

References

    1. AbuRahma A. F. (2021). “Overview of cerebrovascular disease,” in Noninvasive vascular diagnosis. Editors AbuRahma A. F., Perler B. A. (Cham: Springer; ).
    1. Ahmadpour M., Nooraeen A., Tafazzoli-Shadpour M., Taghizadeh H. (2021). Contribution of atherosclerotic plaque location and severity to the near-wall hemodynamics of the carotid bifurcation: an experimental study and FSI modeling. Biomechanics Model. Mechanobiol. 20 (3), 1069–1085. 10.1007/s10237-021-01431-x - DOI - PubMed
    1. Alkarithi G., Duval C., Shi Y., Macrae F. L., Ariëns R. A. S. (2021). Thrombus structural composition in cardiovascular disease. Arteriosclerosis, thrombosis, Vasc. Biol. 41 (9), 2370–2383. 10.1161/ATVBAHA.120.315754 - DOI - PMC - PubMed
    1. Bantwal A., Singh A., Menon A. R., Kumar N. (2021). Pathogenesis of atherosclerosis and its influence on local hemodynamics: a comparative FSI study in healthy and mildly stenosed carotid arteries. Int. Eng. Sci. 167, 103525. 10.1016/j.ijengsci.2021.103525 - DOI
    1. Bennati L., Vergara C., Domanin M., Malloggi C., Bissacco D., Trimarchi S., et al. (2021). A computational fluid–structure interaction study for carotids with different atherosclerotic plaques. Biomechanical Eng. 143 (9), 091002. 10.1115/1.4050910 - DOI - PubMed

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