Finite Element Simulation of Carotid Endarterectomy

Carotid endarterectomy is the standard surgical procedure to remove the plaque from inside the artery. The current work is concerned with the mechanical behavior of human carotid arteries subjected to endarterectomy. A 3D tuning-fork-shaped model of the average carotid bifurcation geometry is analysed in the context of the finite element method. A patch is added in the model to cover the incised region of internal carotid artery. In this study, the non-linear and near incompressible mechanical behavior of the artery is described by an isotropic function of strain energy potential. The materials used for patches in arteries may be either biological (veins, bovine pericardium) or synthetic (PTFE, Dacron). A linear elastic material model is used to describe the behavior of the patch. The residual stresses, present in the unloaded state of the artery, are accounted for in the analysis. A crack is gradually opened in the region of the internal carotid artery in order to simulate the incision made at the beginning of the surgery. The patch is then added in the model and rigidly connected with the artery only at the boundary nodes where the sutures are placed during the surgery. Finally, the patched artery is loaded under physiological conditions. The stress and deformation fields that develop on the carotid artery wall during the endarterectomy process and subsequently during operation of the patched artery under physiological conditions are investigated.