Mechanically-motivated selection of patching material for the patient-specific carotid artery

Patch angioplasty is the most common technique used for performing a carotid endarterectomy. A large number of materials are available for use as patches, but little is known to aid the surgeon in selecting a patch while caring for a patient with carotid disease. The objective of the study, described in this paper, was to suggest a hemodynamically motivated choice of a patch material from those currently used by vascular surgeons. A patient-specific mathematical model of the carotid artery repaired with patch angioplasty was built and used to study atherogenesis-related mechanical factors such as wall shear stress, cyclic strain and effective stress. Model incorporated fluid-structure interaction and non-linear mechanical properties of the arterial wall. The analysis performed indicated that patches made of bovine pericardium may promote better hemodynamics than patches made of synthetic polytetrafluoroethylene and Dacron in terms of reducing stresses and strains in the repaired arterial wall. Our data can aid vascular surgeons in their selection of repair technique for the care of patients undergoing patch angioplasty.