Effects of progressive carotid stenosis on cerebral haemodynamics: aortic-cerebral 3D patient-specific simulation
| Autor: | Jeong-Min Kim, Jaiyoung Ryu, Debanjan Mukherjee, Taehak Kang, Kwang Yeol Park |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
cerebral haemodynamics General Computer Science business.industry three-dimensional simulation circle of willis (cow) ica-to-cow domain Patient specific medicine.disease Engineering (General). Civil engineering (General) carotid stenosis (cs) aortic-cerebral vasculature (acv) Three dimensional simulation Stenosis Modeling and Simulation Internal medicine Cardiology medicine TA1-2040 Cerebral haemodynamics business |
| Zdroj: | Engineering Applications of Computational Fluid Mechanics, Vol 15, Iss 1, Pp 830-847 (2021) |
| DOI: | 10.6084/m9.figshare.14597166.v1 |
| Popis: | We investigated the effects of atherosclerosis in the carotid region on cerebral haemodynamics. A total of 15 stenosis cases following NASCET criteria were modelled using patient-specific medical image data and an open-source package, SimVascular. The formulation adopted the stabilised Petrov–Galerkin scheme with Newtonian and incompressible assumptions. The boundary conditions employed pulsatile inflow and three-element lumped Windkessel outlet conditions with a rigid wall assumption. We present transitions in the represented CoW during stenosis progression using three-dimensional aortic-cerebral vasculature for the first time. This was driven by the conserved total cerebral blood flow to 50% carotid stenosis (CS) (P-value, P > 0.05), which deteriorated during subsequent stages of CS (P < 0.01), and the effective collateral capability of the communicating arteries (CoAs) activated from a degree of 75% and above (P < 0.0001). The prevalence of ‘complete’ CoW peaked at 50% CS and then declined. Despite the collateral flow, the ipsilateral hemispheric perfusion was moderately reduced (P < 0.01), and the contralateral perfusion was conserved (P > 0.05), revealing the ineffectiveness of collateral capability of CoW at the extreme stages of CS. We identified bulk cerebral auto-regulation effects of the conventional Windkessel model, demonstrating accurate flow reduction in the stenosed artery. |
| Databáze: | OpenAIRE |
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