Head Rotation Influences the Geometric Features of the Stenotic Carotid Bifurcation

2012 ◽  
Author(s):  
Nicolas Aristokleous ◽  
Ioannis Seimenis ◽  
Yannis Papaharilaou ◽  
Eleni Eracleous ◽  
Georgios C. Georgiou ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Carotid Arteries ◽  
Head Rotation ◽  
Carotid Bifurcation ◽  
Geometric Features ◽  
Hemodynamic Variables ◽  
Prone Sleeping ◽  
Left And Right ◽  
The Right ◽  
Geometric Changes

Previous investigators have reported that posture changes may influence the geometry and hemodynamics of the carotid bifurcation [1,2]. As a result, head rotation may cause geometric changes that alter the hemodynamic variables previously cited to correlate with the development of atherosclerosis. Glor et al. [1] had reported changes in the right carotid bifurcation geometry with leftward rotation of the head. Aristokleous et al. [2] have reported that geometric differences in the right and left carotid bifurcation occur with a rightward rotation of the head in 10 healthy volunteers [2]. Also, a similar study on bilateral head rotation on the left and right carotid bifurcation of two volunteers has shown similar results [3]. In this study a group of four patients with atherosclerotic disease in the carotid arteries was investigated at two head postures, a) the supine neutral and b) the prone sleeping with head rotation leftwards up to 80° to investigate the level of stenosis and the changes in geometric parameters with head rotation.

Rightward and Leftward Head Rotation Influence the Geometric Features of the Healthy Carotid Bifurcation

2011 ◽  
Author(s):  
Nicolas Aristokleous ◽  
Ioannis Seimenis ◽  
Yannis Papaharilaou ◽  
Georgios Georgiou ◽  
Brigitta C. Brott ◽  
...  
Keyword(s):  
Internal Carotid ◽  
Head Rotation ◽  
Carotid Bifurcation ◽  
Neutral Position ◽  
Sleeping Position ◽  
Hemodynamic Variables ◽  
Prone Sleeping Position ◽  
Prone Sleeping ◽  
The Right ◽  
Geometric Changes

Posture changes may influence the geometry and hemodynamics of the carotid bifurcation [1]. As a result, head rotation may cause geometric changes that alter the hemodynamic variables previously cited to correlate with the development of atherosclerosis. Such variables include oscillating wall shear stress (WSS) and particle residence times. Glor et al. [1] had reported changes in the right carotid bifurcation geometry with leftward rotation of the head. We have previously reported that geometric differences in the right and left carotid bifurcation occur with a rightward rotation of the head [2]. To investigate the geometric changes in the carotid geometry that occur in the prone sleeping position with rightward and leftward head rotation, we have performed studies in two healthy young volunteers. We defined specific geometric parameters of the carotid bifurcation, such as bifurcation angle, internal carotid artery (ICA) angle, ICA planarity angle, in-plane asymmetry angle, tortuosity, curvature, area and diameter ratios, and compared their corresponding values in three head postures: 1) the supine neutral position, 2) the prone sleeping position with head rotation to the right (∼80 degrees), and 3) the prone sleeping position with head rotation to the left (∼80 degrees).

Effect of Head Rotation at the Prone Position on the Geometric Features of the Healthy Carotid Bifurcation

2010 ◽  
Author(s):  
Nicolas Aristokleous ◽  
Ioannis Seimenis ◽  
Yannis Papaharilaou ◽  
Georgios Georgiou ◽  
Brigitta C. Brott ◽  
...  
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Prone Position ◽  
Head Rotation ◽  
Carotid Bifurcation ◽  
Geometric Features ◽  
Residence Times ◽  
Hemodynamic Variables ◽  
Posture Change ◽  
The Right

The influence of posture change on the geometry and hemodynamics of the carotid bifurcation has not been thoroughly studied [1,2,3]. Such changes may alter the hemodynamic variables that are generally associated with the development of atherosclerosis, such as low oscillating wall shear stress (WSS) and particle residence times. Glor et al. (2004) had reported changes in the right carotid bifurcation geometry with leftward rotation of the head. We have previously reported that geometric differences in the right and left carotid bifurcation occur with a rightward rotation of the head [3].

scholarly journals Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alessandro Robaldo ◽  
Guido Carignano ◽  
Alberto Balderi ◽  
Claudio Novali
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
High Risk Patient ◽  
Carotid Bifurcation ◽  
Left Common Carotid Artery ◽  
The Right ◽  
Bovine Aortic Arch ◽  
Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

Influence of head position on carotid hemodynamics in young adults

2004 ◽  
Vol 287 (4) ◽  
pp. H1670-H1681 ◽  
Author(s):  
F. P. Glor ◽  
B. Ariff ◽  
A. D. Hughes ◽  
P. R. Verdonck ◽  
D. C. Barratt ◽  
...  
Keyword(s):  
Carotid Arteries ◽  
Head Rotation ◽  
Carotid Bifurcation ◽  
3D Ultrasound ◽  
Head Position ◽  
Cross Sectional ◽  
Flow Rates ◽  
Head Positions ◽  
Change In Mean ◽  
Carotid Flow

Studies in adults have shown marked changes in geometry and relative positions of the carotid arteries when rotating the head. The aim of this study was to quantify the change in geometry and analyze its effect on carotid hemodynamics as a result of head rotation. The right carotid arteries of nine young adult subjects were investigated in supine position with straight and left turned head positions, respectively. The three-dimensional (3D) carotid geometry was reconstructed by using 3D ultrasound (3D US), and the carotid hemodynamics were calculated by combining 3D US with computational fluid dynamics. It was observed that cross-sectional areas and shapes did not change markedly with head rotation, but carotid vessel center lines altered with planarification of the common carotid artery as a main feature ( P < 0.05). Measured common carotid flow rates changed significantly at the individual level when the head was turned, but on the average, the change in mean common carotid flow rate was relatively small (0.37 ± 1.11 ml/s). The effect of the altered center lines and flow rates on the atherogenic nature of the carotid bifurcation was evaluated by using calculated hemodynamic wall parameters, such as wall shear stress (WSS) and oscillatory shear index (OSI). It was found that WSS and OSI patterns changed significantly with head rotation, but the variations were very subject dependent and could not have been predicted without assessing the altered geometry and flow of the carotid bifurcation for individual cases. This study suggests that there is a need for standardization of the choice of head position in the 3D US scan protocol, and that carotid stents and emboli diverters should be studied in different head positions.

Effect of Head Posture Changes in the Geometry and Hemodynamics of a Healthy Human Carotid Bifurcation

2007 ◽  
Author(s):  
Yannis Papaharilaou ◽  
Yiannis Seimenis ◽  
Nikos Pattakos ◽  
John Ekaterinaris ◽  
Georgios Georgiou ◽  
...  
Keyword(s):  
Computational Models ◽  
Carotid Bifurcation ◽  
The Body ◽  
Neutral Position ◽  
Healthy Human ◽  
Hemodynamic Variables ◽  
Hemodynamic Characteristics ◽  
Atherosclerosis Development ◽  
The Right ◽  
Geometric Morphology

Recent reports have stressed the importance of studying the morphology and hemodynamic changes of peripheral arteries in parts of the body that experience motion and posture change and their relationship to the hemodynamic hypothesis of atherosclerosis development [1, 2]. The carotid arteries may fall into this category since their geometric morphology and hemodyamic conditions may change due to head and neck posture changes. Such changes may alter the hemodynamic variables that are generally associated with the development of atherosclerosis, such as low and oscillating wall shear stress (WSS) and particle residence times. In this study, the carotid bifurcation of a healthy volunteer was imaged in the neutral position and in 3 different posture positions: a) flexion sideways to the right 80°, b) flexion upwards 45°, and c) flexion downwards 45° (Fig. 1). Anatomic and quantitative flow MR data were used to develop computational models to investigate the effect of different postures on arterial geometry and hemodynamic characteristics.

Internal jugular dimensions and common carotid overlapping assessed in a cross-sectional study by ultrasonography at three neck levels in healthy volunteers

2016 ◽  
Vol 18 (1) ◽  
pp. 69-72
Author(s):  
Helena Norin ◽  
Andreas Pikwer ◽  
Fredrik Fellert ◽  
Jonas Åkeson
Keyword(s):  
Carotid Artery ◽  
Healthy Volunteers ◽  
Internal Jugular Vein ◽  
Common Carotid Artery ◽  
Jugular Vein ◽  
Clinical Success ◽  
Head Rotation ◽  
Ultrasound Technique ◽  
The Right ◽  
Cervical Level

Background Cannulation of the internal jugular vein may be associated with inadvertent puncture of the common carotid artery. Systematic use of ultrasound guidance has improved clinical success rates and reduced complications, but better knowledge of topographic relationships of the internal jugular vein and common carotid artery is desirable. This preclinical study was designed to determine by ultrasound technique relative topographic characteristics in humans of the internal jugular veins and common carotid arteries at different levels on both sides of the neck. Methods One hundred and twenty healthy volunteers were examined bilaterally by ultrasound at three neck levels with and without contralateral rotation of the head. Twelve digital pictures were recorded and used to determine venous diameters and extents of arteriovenous overlapping in each subject. Results Venous dimensions and arteriovenous overlapping were larger on the right side (p = 0.008) regardless of head rotation at all levels. There was more arteriovenous overlapping with than without rotation at right high- and mid-cervical levels (p<0.001). The only difference between right mid- and low-cervical levels was less arteriovenous overlapping at mid-cervical level without rotation (p = 0.017). The smallest venous dimensions and extent of arteriovenous overlapping were recorded at high-cervical level. Conclusions Despite similar venous dimensions, less arteriovenous overlapping regardless of head rotation at mid-cervical level, together with the pleural proximity at low-cervical level, propose the internal jugular vein to be anatomically (other factors disregarded) favorable for vascular access on the right side, at mid-cervical level, close to the angle between the sternocleidomastoid muscle bellies, and with minimal rotation of the head.

Head Rotation Effects on the Flow and Hemodynamics of the Human Carotid Bifurcation

2013 ◽  
Author(s):  
Nicolas Aristokleous ◽  
Yannis Papaharilaou ◽  
Ioannis Seimenis ◽  
Georgios C. Georgiou ◽  
Brigitta C. Brott ◽  
...  
Keyword(s):  
Numerical Simulations ◽  
Prone Position ◽  
Blood Flow Rate ◽  
Head Rotation ◽  
Carotid Bifurcation ◽  
Velocity Waveform ◽  
Magnetic Resonance Imaging Mri ◽  
Geometric Changes ◽  
Measured Input ◽  
Human Carotid

The use of realistic anatomic human carotid artery bifurcation (CB) models with a realistic blood waveform leads to physiologically relevant numerical simulations. To study the effects of head posture on the geometry and hemodynamics of the CB, Magnetic resonance imaging (MRI) was used on six healthy volunteers in two different head postures: 1) the supine neutral (N) and 2) the prone with rightward head rotation (P) up to 80°. Geometric differences with posture change in both the left (LCA) and right (RCA) carotid arteries were reported before [1]. The blood velocity waveform for each individual was obtained using phase-contrast MRI (PCMRI) at five diameters upstream of CB. Results have shown that peak systolic blood flow rate is reduced, in the prone position for both RCA and LCA in all six volunteers. To investigate the effects of the reduced peak systolic flow on the hemodynamics of the CB, numerical simulations were performed for a volunteer that exhibited the most geometric changes for the prone position in comparison to the other five based on specific geometric parameters [1, 2]. For the two investigated head postures the observed measured input waveforms were used.

scholarly journals Anatomical Considerations of the Ostium of the Subclavian Artery

2018 ◽  
Vol 24 (2) ◽  
pp. 108-113
Author(s):  
Sachoulidou Anna ◽  
Bărdaş Ana Maria ◽  
Bordei Petru
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Computer Tomography ◽  
Computed Tomography Angiography ◽  
Carotid Arteries ◽  
General Rule ◽  
Left And Right ◽  
The Right ◽  
Common Carotid Arteries

Abstract The subclavian artery’s are two voluminous artery’s, left and right, which have their origin in a different way, the right one originating from the brahiocefalic trunk, and the left one directly from the aortic arch, at a distance that varies according to the origin of the left common carotid arteries. Our study was made on computed tomography angiography, on which we have had the opportunity to examine the scans from Medimar Imagistic Center, in the County Clinical Hospital “Sf. Andrei” in Constanta, being carried out on a computer tomography GE LightSpeed 16 slice CT. Also, we had available angiography’s executed in the center for diagnosis Pozimed, being carried out on a computer tomography GE LightSpeed VCT64 Slice CT. The variability of the findings in the anatomical parts of the subclavicular artery’s ostium, both as regards the size of the horizontal and vertical diameters, also their shape and as regards morfological relations with other branches of the aortic arch. The dimensions of the diameters vary according to sex, but it is a general rule that the dimensions are higher in male, the minimum and maximum values may be different in the two sexes.

scholarly journals Morphological characteristics of the external carotid artery

2013 ◽  
Vol 19 (2) ◽  
pp. 74-78
Author(s):  
P. Gavrilidou ◽  
D.M. Iliescu ◽  
R. Baz ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Morphological Characteristics ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
The Common ◽  
The One ◽  
The Right

Abstract The morphological characteristics at the level of the bifurcation of the common carotid artery were studied on 46 cases, finding that the most frequent, in 52.17% of cases, the common carotid bifurcation appear as the letter “V”, with two possible variations: a wide “V”, in 43.48% of cases and narrow “V” in 8.7% of cases. In 30.43% of cases, the two carotids showed an ascending traject, united for 1-2 cm up to their crossing; in 13,04% of the cases the two arteries were superimposed, the external located anteriorly. In only in two cases on the right side (4.35% of cases and 8.33% of right samples) we found a peculiar aspect of a “U” shaped bifurcation. Regarding the caliber of the external carotid artery, we found that in 43.33% of the cases the external carotid artery had a similar diameter to the internal carotid, also in 43.33% of the external carotid artery have a higher caliber than internal one and the remaining 13.33% of the cases, the external carotid artery had a smaller diameter than the internal one, with all cases on the left (16.67% of left carotid arteries). The caliber of the right external carotid artery was between 4 to 5.6 mm and the one of the left was between 3.6 to 5 mm. When the external carotid was more voluminous than the internal, the differences were 0.5 to 1.2 mm and when the internal carotid was more voluminous than the external, the differences were smaller, 0.2 to 0.8 mm. In relation to the common carotid, the external carotid had a smaller caliber from 0.6 to 1.1 mm. Regarding the external carotid traject, most commonly, from the bifurcation of the common carotid, the external carotid artery showed a vertical trajectory, in 50% of cases; in 40% of cases, the traject was oblique superomedially and in 6.67% of cases the external carotid artery described a curve with the convexity facing laterally, with all cases on the right (11.76% of right carotid arteries); in 3.33% of cases, both on the left (7.69% of the left carotid arteries), the external carotid artery traject described an inverted italic “S”

Preliminary study of hemodynamics in human carotid bifurcation by computational fluid dynamics combined with magnetic resonance angiography

2007 ◽  
Vol 48 (7) ◽  
pp. 788-797 ◽  
Author(s):  
Yunjing Xue ◽  
Peyi Gao ◽  
Yan Lin ◽  
Chengbo Dai
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Magnetic Resonance ◽  
Carotid Arteries ◽  
Carotid Bifurcation ◽  
Outer Wall ◽  
Vascular Imaging ◽  
Hemodynamic Variables ◽  
Systolic Phase

Background: A longstanding hypothesis that correlates fluid dynamic forces and atherosclerotic disease has led to numerous analytical, numerical, and experimental studies over the years because it is very difficult to measure the hemodynamic variables of blood in vivo. Purpose: To investigate the technique of visualization and quantitation of hemodynamic variables at carotid artery bifurcation in vivo by combining computational fluid dynamics (CFD) and vascular imaging. Material and Methods: Twenty-six healthy volunteers underwent magnetic resonance (MR) angiography of the bilateral carotid artery by a 3.0T whole-body scanner. Hemodynamic variables at these carotid bifurcations were calculated and visualized by combining vascular imaging post-processing and CFD. Results: The average velocity of the carotid bifurcation in the systolic phase and the diastolic phase was 0.46±0.24 m/s and 0.23±0.05 m/s, respectively. Eddy current and back flows were observed at bifurcation and the lateral part of the proximal internal carotid arteries (ICA) and external carotid arteries (ECA), and the shapes of them changed with phases of the cardiac cycle, which were significant at the middle of the systolic phase and faded out quickly downstream of the ICA and ECA. The average range of wall shear stress (WSS) at the bifurcation was 4.36±1.32 Pa, and the maximum WSS was 18.02±4.11 Pa. The WSS map revealed a large region of low WSS at the carotid bulb and extended to the outer wall in the proximal end of the ICA (the lowest value was below 0.5 Pa), and there was also a small region of low WSS at the outer wall in the proximal end of the ECA. Conclusion: CFD combined with vascular imaging can calculate and visualize hemodynamic variables at carotid bifurcation in vivo individually.

Sign in / Sign up

Export Citation Format

Share Document