Abstract
BackgroundThe Circle of Willis (CoW) is an important collateral pathway of the cerebral blood flow. An experimental study of the cerebral blood flow (CBF) distribution in different anatomical variations may help to a better understanding of the collateral mechanism of the CoW.MethodsAn in-vitro test rig was developed to simulate the physiological cerebral blood flow in the CoW. Ten anatomical variations were considered in this study, include a set of different degrees of stenosis in L-ICA and L-ICA occlusion coexist with common anatomical variations. Volume flow rates of efferent arteries and pressure signals at the end of communicating arteries of each case were recorded. Physiological pressure waveforms were applied as inlet boundary condition.ResultsIn the development of L-ICA stenosis, the total CBF decreases with the increase of stenosis degree. The blood supply of ipsilateral middle cerebral artery (MCA) was affected most by the stenosis of L-ICA. Anterior communicating artery (ACoA) and ipsilateral posterior communicating artery (PCoA) function as important collateral pathways of cerebral collateral circulation when unilateral stenosis occurred. The blood supply of anterior cerebral circulation was compensated by the posterior cerebral circulation through ipsilateral PCoA when L-ICA stenosis degree is greater than 40% and the affected side was compensated immediately by the unaffected side through ACoA. Blood flow of the anterior circulation and the total CBF reached the minimum among all cases studied when L-ICA occlusion coexist with the absence of PCoA.ConclusionThe results demonstrated the flow distribution patterns of the CoW under anatomical variations and clarified the collateral mechanism of the CoW. The flow ACoA is the most sensitive indexes to the morphology change of ipsilateral ICA. The relative independence of the circulation in anterior and posterior sections of the CoW is not broken and the function of ipsilateral PCoA is not activated until a severe stenosis of unilateral ICA occurs. PCoA is the most important collateral pathway of the collateral circulation and the missing of PCoA has the highest risk of stroke when the ipsilateral ICA has severe stenosis. These findings may provide the basis for future therapeutic and diagnosis applications.
Highlights
The Circle of Willis (CoW) is an important collateral pathway of the cerebral blood flow
The pressure difference at the L-posterior communicating artery (PCoA) is found decreased sharply when the L-ICA stenosis degree is greater than 40%
Experiment showed that PCoA is the most important collateral pathway in cerebral collateral circulation
Summary
The Circle of Willis (CoW) is an important collateral pathway of the cerebral blood flow. The Circle of Willis (CoW) is a ring like artery structure located at the bottom of brain. This structure provides important collateral circulation paths to maintain the sufficient blood supply, especially when stenosis or surgical clamping of the cerebral arteries happens. These collaterals consist of cross-flow through the anterior communicating artery toward the ipsilateral sphere of the ICA lesion, posterior to anterior flow through the ipsilateral posterior communicating artery, or both these systems [1,2,3,4]. It is important to be able to assess the blood distribution and collateral flow patterns of the CoW under various anatomical and pathological situations to help understanding the mechanism of stroke, planning the clinical surgery and diagnosis of early stage stroke
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
