The relationship between the wall thickness of the internal carotid artery, shear stress, and blood flow turbulence

Ultrasound imaging is one of the modern methods for detecting atherosclerotic vascular lesions.

Goal. To evaluate the relationship between wall thickness, shear stress, and blood flow turbulence in atherosclerosis of the internal carotid artery.

Research materials and methods. 32 healthy men and women aged 29 to 44 years (average age 32±2.1 years) and with internal carotid artery stenosis of less than 50% in 48 patients aged 43 to 64 years (average age 51±3.1 years) were examined. All studies were performed at rest on a Mindray Resona 7 ultrasound machine (China) equipped with a linear sensor (3–11 MHz) with Vflow software. The wall thickness, systolic blood flow velocity (Vs) before and after stenosis, wall shear stress (WSS) by vector analysis, and blood flow turbulence before and after stenosis were calculated. The change in the direction of the voltage vector during the cardiac cycle was described using the oscillation index (OSI). The intragroup correlation coefficient was calculated for measuring arterial tension, wall thickness, and blood flow turbulence.

Results. The results of examination of patients with less than 50% internal carotid artery stenosis were analyzed. The thickness of the internal carotid artery wall and the percentage of plaque stenosis were assessed. The average arterial wall thickness ranged from 0.8 to 2.1 mm, the average value was 1.4±0.4 mm. Blood flow turbulence in stenosis after narrowing was almost 6 times higher than normal (P<0.01). The shear stress of the wall correlated with vascular wall thickness (r= 0.55) and blood flow turbulence (r=0.42).

Conclusion. With internal carotid artery stenosis < 50%, the wall shear stress was higher than normal. The narrowing is accompanied by turbulence of blood flow in both the distal and proximal sections. An increase in the wall thickness of the internal carotid artery leads to a decrease in tension in the area of stenosis by more than 1.6 times compared with the norm. At the same time, the oscillation index in stenosis is increased by 8 times compared to the norm. The registration of wall shear stress using vector flow mapping is a new and promising direction for assessing pathology and assessing the initial form of vascular narrowing.

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