On the shape of the common carotid artery with implications for blood velocity profiles

Clinical and engineering studies typically assume that the common carotid artery (CCA) is straight enough to assume fully developed flow, yet recent studies have demonstrated the presence of skewed velocity profiles. Toward elucidating the influence of mild vascular curvatures on blood flow patterns and atherosclerosis, this study aimed to characterize the three-dimensional shape of the human CCA. The left and right carotid arteries of 28 participants (63 +/- 12 years) in the VALIDATE (Vascular Aging-The Link that Bridges Age to Atherosclerosis) study were digitally segmented from 3D contrast-enhanced magnetic resonance angiograms, from the aortic arch to the carotid bifurcation. Each CCA was divided into nominal cervical and thoracic segments, for which curvatures were estimated by least-squares fitting of the respective centerlines to planar arcs. The cervical CCA had a mean radius of curvature of 127 mm, corresponding to a mean lumen: curvature radius ratio of 1:50. The thoracic CCA was significantly more curved at 1: 16, with the plane of curvature tilted by a mean angle of 25 degrees and rotated close to 90 degrees with respect to that of the cervical CCA. The left CCA was significantly longer and slightly more curved than the right CCA, and there was a weak but significant increase in CCA curvature with age. Computational fluid dynamic simulations carried out for idealized CCA geometries derived from these and other measured geometric parameters demonstrated that mild cervical curvature is sufficient to prevent flow from fully-developing to axisymmetry, independent of the degree of thoracic curvature. These findings reinforce the idea that fully developed flow may be the exception rather than the rule for the CCA, and perhaps other nominally long and straight vessels.