Fig. 3.

a, b Abnormal flow dynamics at the level of the bulb of the carotid bifurcation. The simultaneous presence of high shear stress (HSS) and low shear stress (LSS) determine a favourable condition for the proliferation of endothelial and smooth muscle cells, as well as for the incorporation of low density lipoproteins in the arterial wall. In areas subjected to high shear stress, there is increased production of growth factors and inflammatory cytokines which act on the neighbour regions subjected to low shear stress (modified from Thondapu et al [69]