Hemodynamic effects of stenosis with varying severity in different segments of the carotid artery using computational fluid dynamics

Carotid atherosclerosis is a leading cause of ischemic stroke. As a result of atherosclerotic plaque formation, the carotid artery lumen narrows, leading to significant hemodynamic alterations. These changes can further contribute to the development of subsequent lesions. In this study, we built 54 idealized carotid artery stenosis (CAS) models by using a single healthy carotid artery to simulate six different degrees of stenosis at nine various locations. Computational fluid dynamics (CFD) was applied to analyze blood flow changes, focusing on three key hemodynamic indicators: wall shear stress (WSS), oscillatory shear index (OSI), and relative residence time (RRT). Numerical simulations and model validations were conducted to ensure the correctness and validity of the results. The results show that increasing stenosis severity leads to higher WSS values at the site of stenosis, which may facilitate plaque rupture, while OSI and RRT decrease at the stenosis site. In the external carotid artery (ECA) and internal carotid artery (ICA), increasing stenosis severity results in a reduction in WSS at bifurcation sites, promoting plaque formation. These findings offer new insights into the hemodynamic changes associated with carotid artery stenosis and provide a solid foundation for future research and clinical applications.