Electrical Circuit Model of Fractional Flow Reserve in Cerebrovascular Disorders

H Pranevicius,V Pilkauskas,O Pranevicius,D Naujokaitis,M Pranevicius

doi:10.5755/j01.eee.20.10.8877

Abstract

We developed electrical circuit based model for the different components of the cerebral circulation, what allowed us to simulate cerebral blood flow in a variety of cerebrovascular disorders. This approach allowed us to derive a set of equations by which relative maximum, or fractional flow reserve, can be defined and calculated in three relevant sites: the stenotic artery, in the veins related to the stenotic artery, and in the collateral circulation of the affected region of the brain. Our results create theoretical basis for the entirely new approach to cerebrovascular disorders that currently emphasise anatomical identification of the disease to guide the treatment, such as the degree of arterial luminal stenosis obtained from various imaging modalities. In doing so, we directly address an urgent need for stroke experts to advance the care of their patients, since current approach of stroke treatment has not been meaningfully successful. DOI: http://dx.doi.org/10.5755/j01.eee.20.10.8877

Highlights

Cerebrovascular occlusive disease (COD) remains one of the most widespread diseases amongst humans, and its extreme expression - stroke, still remains one of the primary causes of the morbidity and mortality
Current, outmoded approach to cerebrovascular disorders heavily relies on the anatomical identification and quantification of the disease to guide the treatment
Despite millions of cases around the world, the results of the current approach have been dismal. This state of affairs can only change with a full understanding of how stenosis of the cerebrovascular vasculature can be defined in the terms of it’s geometric dimensions, pressure gradient-flow relations, resistances of inflow, outflow, and collateral vessels, and regional fractional flow reserve, or maximum flow capacity

Summary

Introduction

Cerebrovascular occlusive disease (COD) remains one of the most widespread diseases amongst humans, and its extreme expression - stroke, still remains one of the primary causes of the morbidity and mortality. Current, outmoded approach to cerebrovascular disorders heavily relies on the anatomical identification and quantification of the disease to guide the treatment. Despite millions of cases around the world, the results of the current approach have been dismal. This state of affairs can only change with a full understanding of how stenosis of the cerebrovascular vasculature can be defined in the terms of it’s geometric dimensions, pressure gradient-flow relations, resistances of inflow, outflow, and collateral vessels, and regional fractional flow reserve (rFFR), or maximum flow capacity.

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Conclusion