A Preliminary Study of Wall Shear Stress in Carotid Artery Stenting

Abstract Objective: To characterize carotid wall shear stress (WSS)following carotid artery stenting (CAS) in patients with carotid stenosis. Methods: Twenty-eight patients with carotid stenosis treated with CAS between March 2021 to May 2022 in the eighth medical center of the PLA General Hospital were selected for our study. Carotid ultrasound was performed before the operation, one week post-operation, and six months post-operation. Carotid artery WSS was detected by blood flow vector imaging, and the changes in WSS before and after the operation were collected. Genetic testing of drugs was detected for patients with restenosis. Results: Pre-operative WSS of the proximal, narrowest region, and distal carotid arteries in patients with ischemic carotid artery stenosis was 7.88±3.18Pa, 14.36±6.66Pa, and 1.55±1.15Pa, respectively. Comparatively, pre-operative WSS of the proximal, narrowest region and distal carotid arteries in patients without ischemic symptoms was 5.02±1.99Pa, 9.68±4.23Pa, and 1.10±0.68Pa, respectively, with a significant difference between the two groups (p<0.001). Overall WSSof the proximal, narrowest region, and distal carotid arteries in patients before CAS was 6.68±3.0Pa, 12.47±5.98Pa, and 1.39±0. 96Pa. WSS of the proximal, narrowest region, and distal carotid was 4.15±1.42Pa, 6.71±2.64Pa, and1.86±1.13Pa one week after CAS, compared to 4.44±1.91Pa, 7.90±4.38Pa, and 2. 36±1.09Pa six months after CAS. WSS of the proximal and narrowest region of the carotid artery was reduced after carotid stenting, and the difference was statistically significant (p<0.001). There was no statistically significant difference in WSS between one week and six months after stenting (P > 0.05). Conclusion: Changes in carotid WSS are closely related to carotid stenosis, which can provide important hemodynamic information for the treatment of CAS. The technique has important application value in pre-operative evaluation, curative effect evaluation, and long-term follow-up.