Effects of progressive carotid stenosis on cerebral haemodynamics: aortic-cerebral 3D patient-specific simulation
- Authors
- Kang, Taehak; Mukherjee, Debanjan; Kim, Jeong-Min; Park, Kwang-Yeol; Ryu, Jaiyoung
- Issue Date
- 1-Jan-2021
- Publisher
- TAYLOR & FRANCIS LTD
- Keywords
- Carotid stenosis (CS); circle of Willis (CoW); cerebral haemodynamics; three-dimensional simulation; aortic-cerebral vasculature (ACV); ICA-to-CoW domain
- Citation
- ENGINEERING APPLICATIONS OF COMPUTATIONAL FLUID MECHANICS, v.15, no.1, pp 830 - 847
- Pages
- 18
- Journal Title
- ENGINEERING APPLICATIONS OF COMPUTATIONAL FLUID MECHANICS
- Volume
- 15
- Number
- 1
- Start Page
- 830
- End Page
- 847
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/51362
- DOI
- 10.1080/19942060.2021.1916601
- ISSN
- 1994-2060
1997-003X
- Abstract
- 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.
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Collections - College of Engineering > School of Mechanical Engineering > 1. Journal Articles
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