Blood Flow and Arterial Disease
Atherosclerosis is a localized disease. It develops near bifurcations and areas where shear stress, the frictional force that the blood flow exerts on the intimal surface, is low (shear stress less than 4 dynes/cm2). A classic example is the carotid sinus, where flow separation takes place in some periods of the cardiac cycle leading to low and oscillatory shear stress. Low shear results in lesions and vulnerable plaque, while in areas with vortices and variable shear more stable plaques develop, composition of these plaques also differs. Wall shear stress not only plays a role in atherosclerosis, but is also a major determinant of graft failure and intima hyperplasia following angioplasty and stenting.
KeywordsAtherosclerosis Plaque Shear stress Carotid sinus Endothelium
- 8.De Santis G, Conti M, Trachet B, De Schryver T, De Beule M, Degroote J, et al. Impact of stent-vessel (mal) apposition following carotid artery stenting: mind the gaps! Ann Biomed Eng. 2013;16:648–59.Google Scholar