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2 Acta of Bioengineering and Biomechanics

2 2023

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Hemodynamic impact of snoring on carotid artery after stent implantation: the role of oscillation

Zhang Xianghao, Fan Zhenmin, Liu Xiao, Liu Mingyuan, Ye Xia, Deng Xiaoyan

Acta of Bioengineering and Biomechanics

2023

Vol. 25, no. 1

35--45

Snoring is common in overweight and elderly patients treated by endovascular stenting. Studies have proved a correlation between snoring and carotid stenosis, thus, snoring after carotid artery stenting (CAS) might promote or worsen clinical performance. This study tested this hypothesis by constructing a patient-specific carotid bifurcation model and numerically analyzing hemodynamic changes of the carotid artery under different snoring conditions. These conditions included small and large amplitude, low and high frequency, and different age groups. The results found that high amplitude snoring suppressed the disturbed flow at the stented segment while the downstream region of ICA became more chaotic, accounting for in-stent intimal restenosis and thrombosis. Furthermore, local blood flow patterns of elder groups with snoring symptoms were more likely to be changed due to low-speed flow, increasing the possibility of vascular remodeling and thrombosis. Besides, increased snoring frequency hardly influenced the local disturbed flow. Therefore, older adults should receive medical treatment actively after stenting for high-amplitude snoring as soon as possible to avoid potential adverse events.

Effect of exercise rehabilitation on hemodynamic performance after carotid artery stenting: a numerical study

Liu Jiashuai, Fan Zhenmin, Liu Xiao, Xu Xiao, Liu Mingyuan, Ye Xia, Deng Xiaoyan

Acta of Bioengineering and Biomechanics

2023

Vol. 25, no. 2

3--13

A high in-stent restenosis rate and thrombosis have compromised clinical benefits after vascular stent placement. Exercise rehabilitation after stenting emerges as a promising and practical therapeutic strategy to improve the clinical performance of this therapy, although it remains controversial. The present study aimed to explore the impact of exercise training on hemodynamic performance after vascular stent implantation. Different 3-dimensional computational models based on the patient-specific carotids were constructed to calculate hemodynamic parameters, including flow velocity, time-averaged wall shear (TAWSS), oscillatory shear index (OSI) and relative residence time (RRT). The results demonstrated that exercise training increased TAWSS but decreased OSI and RRT in some cases after the intervention, and high-intensity exercise further suppressed the adverse blood flow. However, exercise training remarkably reduced TAWSS and elevated OSI and RRT in patients with mild stenosis at upstream of stented segment. Additionally, we discovered that the hemodynamic environment change induced by exercise training was not significant compared to the stent position in some cases. Exercise had a less beneficial impact on the disturbed blood flow after the distal common carotid artery (CCA) stenting. These findings highlighted that exercise-induced hemodynamic changes differ under different conditions. The exercise training for the intervention patients should only be performed after a comprehensive vascular function assessment.