Computational fluid dynamic comparison between patch-based and primary closure techniques after carotid endarterectomy

We analyzed the effects of the closure technique after carotid endarterectomy on hemodynamic quantities by comparing real cases and virtual scenarios in which the patch graft (PG) has been removed or inserted. PG virtual removal did not seem to create negative hemodynamic effects on the carotid bifurcation but rather seemed to allow a reduction of disturbed flows. The insertion of PG in an already wider carotid bifurcation could further enhance disordered flow development. This indiscriminate artificial enlargement due to the PG insertion in the carotid section could create pernicious flows that could enhance restenosis instead of preventing it.