Numerical study on the cerebral blood flow regulation in the circle of Willis with the vascular absence and internal carotid artery stenosis.

IF 4.3 3区工程技术 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Frontiers in Bioengineering and Biotechnology Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI:10.3389/fbioe.2024.1467257

Hong Lv, Kailei Fu, Wei Liu, Zhiyi He, Zhiqing Li

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Abstract

Objectives: This study explores how vascular stenosis and absence affect the regulation of cerebral blood flow in the Circle of Willis (CoW) and the hemodynamic changes downstream of the stenosis.

Materials and methods: Forty idealized CoW models were simulated to analyze the impact of vascular absence and internal carotid artery (ICA) stenosis on hemodynamics. Inlet conditions were set using a physiological pressure waveform, and outflow boundaries were modeled using three-element Windkessel models.

Results: The absence of vessels such as RP1, LP1, RA1, or LA1 had a comparable effect on total blood flow to a 40% stenosis of the left internal carotid artery (LICA) across the entire CoW. Specifically, when LP1 and RA1 were absent with a 50% LICA stenosis, the total blood flow closely resembled that of a complete CoW with 75% LICA stenosis. In cases of proximal ICA stenosis, downstream regions showed elevated oscillatory shear index (OSI >0.2) and reduced time-averaged wall shear stress (TAWSS <1 Pa). With increasing stenosis severity, areas of high OSI shifted, and regions of low TAWSS expanded notably. At 75% stenosis, the area with TAWSS <1 Pa downstream significantly increased. Until complete occlusion, the area of low TAWSS and high OSI were maximized.

Conclusion: This study underscores how anatomical variations in the CoW, combined with ICA stenosis, impact both total cerebral blood flow and its distribution among different outlets. Moreover, it highlights the potential for increased atherosclerosis development in affected areas. Particularly notable is the finding the absence of LP1 and RA1 vessels alongside 50% LICA stenosis results in blood flow patterns similar to those seen with 75% LICA stenosis in a complete CoW, emphasizing clinical implications for the patient. Hemodynamic changes, including TAWSS and OSI, are most pronounced downstream of the stenosis especially when the stenosis rate exceeds 75%.

查看原文本刊更多论文

血管缺失和颈内动脉狭窄对 Willis 圈脑血流调节的数值研究。

研究目的本研究探讨了血管狭窄和缺失如何影响威利斯环（CoW）的脑血流调节以及狭窄下游的血流动力学变化：模拟了 40 个理想化的 CoW 模型，以分析血管缺失和颈内动脉（ICA）狭窄对血液动力学的影响。入口条件使用生理压力波形设定，流出边界使用三元素 Windkessel 模型建模：结果：RP1、LP1、RA1 或 LA1 等血管的缺失对整个 CoW 的总血流量的影响与左侧颈内动脉（LICA）狭窄 40% 的影响相当。具体而言，当 LP1 和 RA1 缺失且 LICA 狭窄 50%时，总血流量与 LICA 狭窄 75% 的完整 CoW 非常相似。在近端 ICA 狭窄的病例中，下游区域显示出振荡剪切指数升高（OSI >0.2）和时间平均壁剪应力降低（TAWSS 结论）：本研究强调了CoW的解剖学变化与ICA狭窄如何影响脑总血流量及其在不同出口的分布。此外，它还强调了受影响区域动脉粥样硬化发展加剧的可能性。尤其值得注意的是，在 50% LICA 狭窄的同时，LP1 和 RA1 血管的缺失导致的血流模式与完全 CoW 中 75% LICA 狭窄时的血流模式相似，这强调了对患者的临床影响。血流动力学变化（包括 TAWSS 和 OSI）在狭窄下游最为明显，尤其是当狭窄率超过 75% 时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Bioengineering and Biotechnology Chemical Engineering-Bioengineering

CiteScore

8.30

自引率

5.30%

发文量

2270

审稿时长

12 weeks

期刊介绍： The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs. In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.

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