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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The arteries of the neck have their origins from the aortic arch. At roughly the level of the right sternoclavicular joint the brachiocephalic trunk bifurcates into the right common carotid and the right subclavian arteries. The left common carotid branches directly from the aortic arch. Both right and left common carotid arteries ascend up the neck lateral to the trachea and the oesophagus. The common carotid arteries divide into the external and internal carotid arteries (ECA and ICA respectively) at the level of the superior margin of the thyroid cartilage. The ECA supplies the areas of the head and neck external to the cranium and divides into six branches before terminating, including the facial, maxillary and superficial temporal arteries. The ICA passes through the skull base and eventually divides into the anterior and middle cerebral arteries, which provide the major blood supply to the brain. There is a swelling at the bifurcation of the common carotid artery known as the carotid bulb; turbulent flow in the bulb increases the risk of atheroma formation and it is therefore a common site of carotid artery stenosis.
Carotid hemodynamic response to external pressure and comparison with induced-stenosis progression: a fluid-structure interaction study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Kshitij Shakya, Dalchand Ahirwar, P. M. Nabeel, Shubhajit Roy Chowdhury
Atherosclerosis is an inflammatory disease of the medium and large arteries such as carotid, aorta, coronary and peripheral arteries (Mantella et al. 2021). It is a prominent cause of death worldwide due to its role in the development of cardiovascular disease and its chronic nature (Khamehgir-Silz et al. 2021; Libby 2021). The injury to the arterial wall induces an inflammatory response which can lead to intimal thickening and the initiation of atherosclerosis (Shabbir et al. 2021). Additionally, high cholesterol, hypertension, and high shear stress in blood vessels increase the formation of lesions (Mohmmad-Rezaei et al. 2021; Zhang 2021). The endothelial cells forming the uppermost layer of the lumen act as a selective barrier between blood and the vessel wall and make it easy for the low-density lipoprotein to diffuse through the endothelium, which, however, is suggested to be the primary source of plaque lipids (do Brito Valente et al. 2021; Kato et al. 2021). The atherosclerotic plaque is classified as early plaques where lipid droplets are found in the intima, and fatty streaks are visible with layers of foam cells. In the intermediate plaques, lipid core is formed with new fibrous tissue overlying it and sometimes causes calcification and miscellaneous features accompanied by surface disruption, intraplaque haemorrhage, and thrombosis (Sakakura et al. 2013; Babaniamansour et al. 2020). Carotid artery stenosis, a consequence of atherosclerosis, is an important cause of stroke. Atherosclerotic plaque in the carotid artery can occur from the aortic arch to cerebral arteries along the carotid artery axis (Heck and Jost 2021). However majority of the stroke events happen due to plaque at the carotid artery bifurcation region. In a study, it was found that, among the total patients who suffered ischemic strokes, 20–30% of them were closely related to carotid atherosclerosis (Dalai and Datla 2021). Carotid artery stenosis can be either symptomatic like a transient ischemic attack (TIA) or asymptomatic.