Wall shear stress is lower in the carotid artery responsible for a unilateral ischemic stroke

• Published in: Atherosclerosis Vol. 185; no. 1; pp. 108 - 113
• Main Authors: Carallo, Claudio, Lucca, Lucia Francesca, Ciamei, Monica, Tucci, Saverio, de Franceschi, Maria Serena
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2006; Elsevier
• Subjects: Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity - physiology; Blood vessels and receptors; Brain Ischemia - etiology; Cardiology. Vascular system; Carotid artery; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - physiopathology; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - physiopathology; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Humans; Male; Medical sciences; Middle Aged; Neurology; Retrospective Studies; Risk Factors; Severity of Illness Index; Shear stress; Stress, Mechanical; Stroke; Ultrasonography, Doppler; Vascular diseases and vascular malformations of the nervous system; Vertebrates: cardiovascular system; Shear stress; Stroke; Carotid artery; Human; Elastic modulus; Cerebral infarction; Nervous system diseases; Cardiovascular disease; Cerebral disorder; Blood flow; Vascular disease; Common carotid; Blood group; Ischemia; Atherosclerotic plaque; Central nervous system disease; Atherosclerosis; Hemodynamics; Cerebrovascular disease; Comparative study
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2005.05.019

According to the focal nature of atherosclerosis, ischemic stroke is frequently unilateral. Atherosclerotic plaques are favoured by local hemodynamic factors as low wall shear stress and/or elevated circumferential wall tension. Aim of the present study was to investigate the possible association between hemodynamic forces and cerebrovascular disease. Common carotid mean wall shear stress and circumferential wall tension, Peterson's elastic modulus, and blood flow were measured in 25 patients with a recent unilateral large-artery stroke presenting non-stenotic plaques of the carotid arteries (large-artery group), and in 10 patients affected by a recent unilateral cardioembolic stroke without carotid plaques (cardioembolic group). In the large-artery group, atherosclerosis was slightly more evident in the side of cerebral ischemia. All hemodynamic factors were more unfavourable at the affected side in this group (shear stress: 6.2 ± 3.0 versus 8.6 ± 4.0 dynes/cm 2, p < 0.0001; wall tension: (7.3 ± 1.3) × 10 4 versus (6.6 ± 1.3) × 10 4 dynes/cm, p < 0.00001; Peterson's modulus: (16.8 ± 11.9) × 10 5 versus (12.4 ± 5.7) × 10 5 dynes/cm 2, p = 0.06). No difference was detectable in blood flow and in cardioembolic group. The present data demonstrate an unfavourable hemodynamic profile in the common carotid artery supplying the area of a single large-artery stroke and might help to explain the frequent one-sidedness of this disease.