Background: There is recent interest in the role of carotid bifurcation anatomy, geometry and hemodynamic\r\nfactors in the pathogenesis of carotid artery atherosclerosis. Certain anatomical and geometric configurations at the\r\ncarotid bifurcation have been linked to disturbed flow. It has been proposed that vascular dimensions are selected\r\nto minimize energy required to maintain blood flow, and that this occurs when an exponent of 3 relates the radii\r\nof parent and daughter arteries. We evaluate whether the dimensions of bifurcation of the extracranial carotid\r\nartery follow this principle of minimum work.\r\nMethods: This study involved subjects who had computed tomographic angiography (CTA) at our institution\r\nbetween 2006 and 2007. Radii of the common, internal and external carotid arteries were determined. The\r\nexponent was determined for individual bifurcations using numerical methods and for the sample using nonlinear\r\nregression.\r\nResults: Mean age for 45 participants was 56.9 �± 16.5 years with 26 males. Prevalence of vascular risk factors was:\r\nhypertension-48%, smoking-23%, diabetes-16.7%, hyperlipidemia-51%, ischemic heart disease-18.7%.\r\nThe value of the exponent ranged from 1.3 to 1.6, depending on estimation methodology.\r\nConclusions: The principle of minimum work (defined by an exponent of 3) may not apply at the carotid\r\nbifurcation. Additional factors may play a role in the relationship between the radii of the parent and daughter\r\nvessels.
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